Mr. Speaker, I freely admit that until very recently I was convinced that forced sterilization was already illegal, as it seems to me to be a matter of basic common sense. No one should be subjected to such an inhumane and degrading practice.
Despite a legal framework that is already strict in Quebec and Canada and despite multiple safeguards that protect patient consent, this requirement can still be compromised in certain clinical contexts, particularly when indigenous or minority women are in vulnerable situations. By explicitly banning forced or coerced sterilization in the Criminal Code, victims would have a clear recourse for launching investigations or taking legal action. Depending on the circumstances, these actions may constitute aggravated assault. That is why we support Bill S‑228. The Bloc Québécois will vote in favour of it. This ban would also act as a deterrent for health care professionals. It would also encourage hospitals, medical associations and professional bodies to adopt policies to ensure that medical practices are fully in line with the law.
The bill specifies that “a sterilization procedure is an act that wounds or maims” a person for the purposes of subsection 268(1) of the Criminal Code, that is, aggravated assault. It also defines what constitutes sterilization, which is helpful. The bill states:
sterilization procedure means the severing, clipping, tying or cauterizing, in whole or in part, of the Fallopian tubes, ovaries or uterus of a person or any other procedure performed on a person that results in the permanent prevention of reproduction, regardless of whether the procedure is reversible through a subsequent surgical procedure.
Historical data shows that the forced or coerced sterilization of indigenous women in Canada was part of a eugenic and colonial attitude that persisted until the 1970s. It is estimated that between 1966 and 1976, more than 1,200 sterilizations were performed, including approximately 1,150 on indigenous women and 50 on men or people whose gender was not documented, with more than 70 additional procedures performed on women in Nunavut. In Alberta, under the Sexual Sterilization Act, 74% of indigenous people referred to the Alberta Eugenics Board were actually sterilized, compared to 60% of all people referred, illustrating a clear overrepresentation of indigenous people in these programs.
In her work on these practices, researcher Karen Stote documented 580 sterilizations performed in federal Indian hospitals between 1970 and 1975 alone, which suggests that the already high numbers available are just a minimum, given the destroyed archives, incomplete records and the lack of systematic data by community or identity. Little data seems to be publicly available on sterilizations that may have taken place before the 1960s. However, make no mistake: These numbers are alarming. In my community, as a member of the Huron-Wendat Nation, I have not heard of any such instances. I am not aware of any. Some may have occurred, but I have not heard anything about it. However, all first nations stand in solidarity with each other.
In the more recent past, the magnitude of the issue is reflected more in class actions and investigations than in official administrative statistics. A class action filed in Saskatchewan in 2017 includes more than 100 indigenous women from various regions alleging coerced sterilization or sterilization without free and informed consent, including tubal ligations performed between 2008 and 2012. At least 55 women had already contacted lawyers by the late 2010s.
Across the country, organizations such as the Native Women's Association of Canada and various reports mention at least five ongoing or announced class actions involving institutions and doctors in several provinces. In Quebec, a university study cited in the media and by indigenous groups identified at least 22 instances of forced or coerced sterilization of indigenous women between 1980 and 2019.
Approximately 30 Atikamekw women are currently participating in a class action against the Centre intégré de santé et de services sociaux de Lanaudière and three doctors for sterilizations performed without consent from 1980 to the present.
Forced or coerced sterilization has no place in a free and democratic society. It must come to an end once and for all. The bill is an important step toward explicitly prohibiting forced or coerced sterilization. Its passage will provide vulnerable women with greater legal protection and affirm the primacy of free and informed consent in the face of forced sterilization.
During the last parliamentary session, the Standing Senate Committee on Legal and Constitutional Affairs expressed concern that tensions might arise between obtaining consent for sterilization and intervention during medical emergencies or other situations requiring sterilization. A number of amendments were made to Bill S-250, which became Bill S-228, the one before us today. It now offers clearer and more precise language that could have a significant impact on the importance of free, informed and prior consent, as well as on the importance of informing patients of the medical risks associated with procedures, including the possibility of sterilization when a doctor must act to protect the patient's health or life from a medical standpoint.
Furthermore, some inclusion groups have criticized the bill for the limited scope of the definition of “sterilization procedure”. They would like to include transgender, non-binary and intersex individuals, as well as men. However, it should be noted that the current definition remains inclusive, as it encompasses “any other procedure performed on a person that results in the permanent prevention of reproduction”.
In any case, adopting legislative provisions is not enough. For them to have a real impact, they need to be accompanied by specific regulations, rigorous enforcement mechanisms and strategies that respect the cultural realities and autonomy of indigenous nations. Without this, the Canadian government risks repeating its usual ineffective centralizing practices. The full and complete participation of indigenous organizations is an essential condition for the legitimacy and effectiveness of any reform. Only through this collaboration can we guarantee the real protection of the rights of indigenous women and all those who may be exposed to these unacceptable practices.
In addition, any legislative or regulatory action in this area must fully respect the jurisdictions of Quebec and the provinces in health care. Ottawa cannot impose one-size-fits-all measures that circumvent Quebec's autonomy. Otherwise, it would repeat the historical mistakes of centralization. Protecting women's rights and overseeing medical practices both fall primarily under provincial jurisdiction. Any reform must fully involve Quebec, its institutions and indigenous organizations in its design and implementation.
One specific example of this is the Collège des médecins du Québec. Following the report of the First Nations of Quebec and Labrador Health and Social Services Commission, the college put in place an action plan and added a preamble to its code of ethics recognizing the realities of first peoples, respect for all identities and the fight against systemic inequalities. What is more, the ALDO‑Québec training program was updated with a new social responsibility unit on equity, diversity, inclusion and global health.
That is what we need to keep an eye on and put in place. However, for now, we fully support this bill.