Madam Speaker, we certainly are dealing with a very sensitive subject matter with today. This Parliament and the last Parliament both have had quite a long journey in dealing with the substance and subject matter of medical assistance in dying.
I know that I along with many of my colleagues in all parties have been recipients of a huge amount of correspondence on this subject matter, both from organized groups across the country and our very own constituents. It can be hard as a member of Parliament to find one's own way through all of that, because the feedback we receive and the strong passions are evident on both sides of the argument. I was a witness to that with Bill C-14 and, of course, it has been replayed for Bill C-7.
There have been difficult conversations with constituents. I have constituents who feel the government legislation does not go far enough. They felt that way for Bill C-14 and some feel the same way for Bill C-7. Others feel it goes too far and establishes dangerous precedents. It can be tough, but in those conversations I have had with my constituents, I have always tried to guide myself with the difference between sympathy and empathy. With sympathy, we can feel sorry for one's situation in life, but we are still looking at another person's situation with our own biases and world view, whereas true empathy, which is very much required when we are dealing with medical assistance in dying, is to try to put ourselves into that other people's shoes, to try to see the world from their point of view, to see exactly why these issues and matters are so important to them.
I also try to use section 7 of the charter to guide myself, the fact that it is explicitly written that everyone has the right to life, liberty and security of the person and the right not to be deprived thereof, except in accordance with the principles of fundamental justice. Essentially it means that people have a right to control their own bodily integrity. It is engaged whenever the state tries to interfere with personal autonomy.
This is really the crux of the matter. It is personal autonomy, a person's decision on how he or she is going to meet the end of his or her life. For those of us who are blessed to lead healthy lives, who are not intolerably suffering from a grievous and irremediable medical condition, we really cannot know what other people's lives are like. We do not know what it is like for those people to not have autonomy over their own bodily functions or their bodily integrity, so to speak.
In today's debate, one thing should be very clear. The House of Commons has already spoken to Bill C-7. We have already decided on what we want to do as the people's elected representatives. Of course, the Senate has reviewed the final third reading version of the bill that we sent to it and the Senate sent it back to us with some of its recommendations. This is not the time or the place to go over old arguments that were already dealt with by the House. This is really a time for us to focus exclusively on what the Senate has brought to us.
It is important to note that nothing in Bill C-7 is going to change the very high standards set out in the original Bill C-14. To receive medical assistance in dying, patients need to have a condition that is incurable. They must be in a state of irreversible decline and they must be facing intolerable suffering. The door is not being opened wide, as some have suggested. Those basic parameters are still in place.
When we are dealing with this subject matter, it is important to note that most Canadians know someone who has been affected by intolerable suffering at the end of his or her life. Generally, my caucus has been supportive of this bill because it does respond to the need to reduce that unnecessary suffering at the end of life. As I alluded to, section 7 of the charter helps to preserve the autonomy of decision-making for individuals.
I made reference to the fact that most Canadians know someone who has been affected by a disease and intolerable suffering. I have had that personal experience as well with a close family member, and that happened at a time before we had medical assistance in dying. It was a long-drawn-out battle with cancer. It can be hard on the family members too, because they have to watch a beloved family member suffer, in some cases for several months, before the end mercifully does come.
It is a very weighty subject matter, and I want to approach today's debate with that firmly in mind.
I was first elected in 2015, so I was a member of the 42nd Parliament. I was there for all the Bill C-14 debate, which was forced upon Parliament at the time by the Supreme Court of Canada's decision in Carter. We, as New Democrats, ultimately did not support Bill C-14, because we felt the bill at the time was too restrictive. I remember referring to the fact that the courts would force this bill back before Parliament, and that happened with the Quebec Superior Court.
I do not want to dwell too long on this history, but one thing that is very important to mention, in the context of today's debate, is that Bill C-14 had a provision in clause 10, which mandated that a legislative review had to happen at the beginning of the fifth year. I will read it out for my hon. colleagues. Clause 10 reads as follows:
At the start of the fifth year after the day on which this Act receives royal assent, the provisions enacted by this Act are to be referred to the committee of the Senate, of the House of Commons or of both Houses of Parliament that may be designated or established for the purpose of reviewing the provisions.
That is very clear language, and the beginning of the fifth year was in June 2020. We are almost at the end of February 2021.
The reason I raise this is that this important legislation review would have dealt with a lot of the questions the House is now considering and debating. It almost feels like we are building parts of the plane as we are flying. Many of these debatable items that are going on with Bill C-7 need a very careful study. They need to have the timeline afforded to them so we can hear from Canadians across the country, from expert witnesses and actually craft a law that responds to those very important bits of feedback.
I also want to take this opportunity to recognize my friend and colleague, the member for Esquimalt—Saanich—Sooke, a neighbouring riding of mine. He has long recognized this legislative requirement of Bill C-14. He has raised it with the Minister of Justice on several occasions.
Due to his frustration at the government's inaction on this front, he introduced Motion No. 51, which would establish a special committee of the House to include a review that would not be limited to but would expand on several issues. It would have looked at requests for medical assistance in dying by mature minors, advanced requests and, most important, requests where mental illness was the sole underlying medical condition. The committee would also be charged with looking at the state of palliative care, the adequacy of safeguards against pressure on the vulnerable and so on. If we had such a committee in place, already looking at these issues, then we may have had some answers to these important questions by this point.
I will move on to what the Senate has sent back to the House. I was reviewing some of the transcripts from the Senate, some from its legal and constitutional affairs committee, but also from its third reading of the bill.
The Senate legal and constitutional affairs committee decided to report back to the main body of the Senate with no amendments to the bill but some observations. The substantive amendments to the bill all came at third reading. For example, there was a proposed change to the wording of subsection 1(2) for mental illness to include a neurocognitive disorder, looking at advanced requests and so on.
Today, we are dealing with the government's response to those amendments. The government has crafted a motion for the House to consider on what amendments it agrees with, those it does not and those it wants to amend. The Senate disagreed with the expanded definition for the exclusion of mental illness. The government's motion disagrees with the advanced request part of it.
However, as a quick summary, the government motion agrees to the sunset clause for the mental health exclusion. Instead of 18 months, the government has proposed it be expanded to two years after royal assent. Essentially this legislation, once it becomes a statute of Canada, if passed in this manner, will have a ticking clock of two years for a committee to come up with the appropriate safeguards in place.
The government's motion in response to the Senate also mandates that the minister is to set up a committee of experts to work on mental health protocols. It requires a voluntary collection of data based on indigenous identity, race and disability. It sets up a joint committee to do the legislative review, starting 30 days after royal assent.
The most substantive part of the government's motion that really stands out to me is the fact the government is agreeing to the sunset clause on the mental health exclusion. The reason it stands out for me is because when Bill C-7 was originally proposed to the House, the government's own charter statement made some very strong references to why mental health, as an underlying condition, was to be excluded. For the government to backtrack on that and agree to a sunset clause stands out to me.
I acknowledge that we will have two years, but with such a substantive change to the law, it would make sense to me as a legislator to have a specific committee set up to look at all the things we need to look at to make this bill appropriate and proper so it fits will all the important safeguards we need to have in place. I am a bit wary of having that timeline put on the House and forcing us to do these things.
My Conservative colleague before me has now proposed an amendment to the government's motion. Basically, the Conservatives are proposing to get rid of the sunset clause. That is the most substantive thing. At first glance, that seems reasonable, but because I have only really had about 10 minutes to adequately review what the Conservatives have proposed, I would like more time to refer back to that in later days.
I mentioned the charter statement the government initially brought out for Bill C-7. I would like to read a highlighted section of that charter statement where it reasons why it wants to exclude the mental health provisions in the bill. It says, “evidence suggests that screening for decision-making capacity is particularly difficult, and subject to a high degree of error.” It further says, “mental illness is generally less predictable than physical illness.” It also highlights some concerns from other countries that permitted medical assistance in dying for mental illness, namely Belgium, the Netherlands and Luxembourg.
I want to make it clear that I am not necessarily of the opinion that mental health should be excluded, full stop. What I am saying and what I am arguing is that we need to have an appropriate review of all of this incredibly weighty subject matter before we dive into actually changing the legislation.
This is backed up by the work that was done in the House of Commons' very own Standing Committee on Justice and Human Rights. The justice committee heard that the protocols and safeguards for medical assistance in dying for those with mental illness do not exist and that it would take a significant amount of time to develop them from a clinical perspective. The fact is that if the committee's work on mental health is not complete within two years, that clause will be sunset. I have a real problem with us putting that part up front before we do the hard work at committee.
If I were to summarize my speech, the real issue I have is that I do not believe we should have a substantive expansion of what Bill C-7 purported to do when the bill was passed by the House. I do not think we should have any expansion to it before we have had those reviews in place.
I realize that in some cases, the Senate does like to provide feedback to the House, and there have been several instances of amendments being proposed by the Senate. The real issue I have, the elephant in the room, is that the Senate is still an unelected and unaccountable body.
As members of Parliament, we have to face our constituents. We are accountable to the people who elected us. Whenever the next election comes, the people of my riding of Cowichan—Malahat—Langford are going to judge me on how well I did my job. It is the same for every single member of Parliament who sits in the House of Commons. We have to be accountable for the things we say in the House and how we vote. Senators do not have to do that. I know there are a lot of honourable people who serve in that institution, but they are free from that accountability mechanism. The real problem I have is that I firmly believe the House must always be the final arbiter in the decisions that are made, because the people of Canada elected us to make the laws on their behalf.
In response to the many concerns I have heard raised, both in the House and in correspondence from the disability community, I would like to leave my colleagues with some thoughts. If we are rightly concerned about how persons with disabilities are currently living in Canada and what their quality of life is like, rather than focusing so much on Bill C-7 and medical assistance in dying, why do we not take this opportunity to start enacting reforms and enacting policies to make their lives better? If we look at the income supports that are out there for persons with disabilities and the amount of money they get to scrape by every month, we see a shameful record on our country, and it is something that we need to fix.
We have already acknowledged through the pandemic and through COVID-19 response measures that individuals should be receiving $2,000 a month to get by, but we do not afford that to persons with disabilities. Even when the House had an opportunity to get financial aid to that group of people in Canada, it took us over six months to do so. That is a shameful record, and it is something that the House really needs to concentrate on if we are going to adequately and meaningfully address that issue.
I appreciate having had this opportunity to speak to Bill C-7 and I welcome any questions and comments that my colleagues may have.
