Garnett Genuis

[An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), June 16th, 2016]

Mr. Speaker, I will resist the temptation to offer some comments on the Alberta government in the context of that question. I have a great working relationship with my local MLAs, even if we do not agree.

I do want to specifically address the question in terms of surveys. One of the concerns I have with many of the surveys that are done on this issue is that people often misidentify, and questions can poorly identify, the distinction between the withdrawal of treatment and active euthanasia or assisted suicide.

It is regular and supported by everyone here that in a medical environment there would be certain cases—many cases, frankly—where extraordinary measures would need to be withdrawn and the natural process allowed to take its course. That is something that is fundamentally different from the act of killing associated with euthanasia or assisted suicide.

One of the problems we routinely see with these surveys is that they often fail to identify the distinction. I would be interested in looking at the back data and the questions in the survey to which the member refers. However, having been in the polling business myself, I have an understanding of those issues.

With respect to palliative care, there are members on our side who can speak to it in greater detail than I can. I simply disagree with the premise of the member's question. Significant actions were taken on palliative care. Yes, there is more work that needs to be done. I and others have called for more work to be done.

However, we supported an initiative to have a national palliative care strategy. I think that was supported by many parties in the last House. The work was begun and needs to continue.

[An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), June 16th, 2016]

Mr. Speaker, I thank the parliamentary secretary for his work on this, although he knows I think there is some sleight of hand involved in that question.

I certainly did not say that politicians could not be involved in the discussion in the lead-up to the election. What I said is that it is difficult for politicians to undertake a formal government consultation in the midst of an election period. I think that is fairly obvious. The approach we took was a responsible approach, where there was an expert panel that was conducting consultations and reporting after the election.

This member and the government have to explain why they cut that process off. It is simply not true to say that members were denied an opportunity for debate in this place, as the member knows, and he in fact alluded to it. There was a supply day discussion of the issue. Supply days are a process and a part of the debate.

The reason there was no government-orders debate at the time was that there was no government legislation. It would have been irresponsible for the government to try to bring forward and pass legislation in the spring of last year, that shortly after—

[An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), June 16th, 2016]

Mr. Speaker, it is a pleasure to rise for what will probably be my last time speaking to this particular bill, though I am sure not to this issue in general.

I am going to give a fairly disparate speech addressing a number of different issues that have been raised and loose ends in this conversation.

First, it is important to underline that we do not exist in a legislative vacuum at the present time. The government has, in my judgment, created this sort of artificial sense of fear, this artificial timeline that says we have to pass its bad legislation, in my judgment, just because if we do not do it, there will be no legislation.

June 6 has come and gone. There are provincial guidelines in place. I do not dispute the fact that a better version of a federal framework would have many desirable things about it. I have not certainly opposed the principle of the federal government legislating in this area. We are, after all, talking about the contours of an exception to the Criminal Code. However, in the absence of the federal government having done the detailed work, in terms of actually coming up with a system of checks and balances, a system of safeguards, it may well be—and in my view, it is the case with the present legislation—that we are better off to defeat it, perhaps to bring back a better bill in the future. I will talk specifically about why that is and what a better bill would look like.

However, I think it is fundamental that we recognize the reality that there is not a legislative vacuum. It is not as if people are being killed without some kinds of systems, checks and balances, and safeguards in place. Provinces were ready in a way that the federal government simply was not.

I think we have a failure of process here. I will just briefly outline what that process was.

We had a Supreme Court decision at a time when the Conservatives were in government. We created this expert panel to review and report back, and it would have reported back after the election. It would have been difficult for politicians to be involved in a government consultation process in the immediate lead-up to and during an election. However, we had this external expert panel that was consulting Canadians and that was ready to report back the results of its consultation, as well as make policy recommendations.

When the new government came in, it removed the power of that expert panel to make recommendations with respect to policy. It only reported on its consultation. When we hear the government talk about this timeline, somewhat misleadingly, it will say that the previous government did nothing to advance this, when it was its decision to remove that essential power of the expert panel to make policy recommendations.

Then we had a motion in this House, in December, to create a joint committee of the House and Senate to review this issue. That panel could have sat during the Christmas break, but it did not. It faced a time crunch when it came back. Then we waited months before seeing any kind of federal legislation. The failure of process was that in every case, in as much as a year and four months is not that much time, we faced a time crunch toward the activities of the committee and toward the activities of the House and certainly the Senate, because we did not more effectively use the panel that was put in place by the previous government. That panel consulted far beyond what the special committee did, far beyond what the justice committee did—in the case of the justice committee, not for any ill intention, I am sure. I was concerned about the process of witness selection with the joint special committee. There were many people who were even intervenors in the Carter case who were not able to participate in those hearings. In any event, the point is that we had this artificial time crunch that was created, and we see it happening again today.

Again today, the government is trying to create this artificial urgency instead of delving into this substantive conversation. Quebec did this in six years. I am not saying we should, or could, take six years, but having the prudence to have introduced legislation earlier and to have drawn on the wisdom of the expert panel would have been much better because we are in this seeming time crunch. However, I think we need to reject the time crunch the government is creating and, instead, do the diligent work that we need to do to fix some of the big problems in the bill.

We see sloppiness in this legislation, especially around this discussion of reasonable foreseeability. The justice minister just spoke, and I actually share many of the concerns she raised about leaving this wide open, but I think what she neglects is that reasonable foreseeability is not clear enough to be, in any sense, a meaningful safeguard.

I have listened to the minister speak repeatedly about reasonable foreseeability, and I understand that in response to my short question, she did not have enough time to define it fully, even if she had wanted to. However, having listened to her speak many times on this subject, I am not at all clear—and maybe subsequent speeches will provide some clarity—what that term actually means.

Obviously, death is reasonably foreseeable for all of us. This is part of the human condition. We are born and we die. There was certainly nobody on either side of this debate who suggested that natural death is abnormal, bad, or something to be feared. It is a part of life and reasonably foreseeable for all of us. That does not mean that we should not be concerned, though, about policies that would artificially cut short the process of natural life and death.

However, if “reasonably foreseeable” is so important, then we should actually have a definition. There should be some clarity about what that means. Liberals have said they are not talking about imminent natural death, but at some point in the future. I have quipped before that, when I was learning to drive, my mother thought death was reasonably foreseeable every time we got in the car, but the central point is that death is reasonably foreseeable for all of us. It is part of the human condition.

Therefore, this is very sloppy. It is not a safeguard. We need real, meaningful safeguards. I suggest that the federal government should contemplate safeguards along the lines that the government of Manitoba has brought in, whereby some competent legal authority reviews cases to ensure that legal criteria were met, not a model of judicial review but government lawyers designated for this purpose.

Other provinces have put in place systems that necessarily involve the attending physician, or if the attending physician is a conscientious objector, a different attending physician can assess the situation. However, it does not allow someone to just find any doctor anywhere who agrees that someone meets the criteria, but involves the physician or somebody actually involved in providing the person with care to make the assessment. If we look at what the provinces have already done in terms of safeguards, we see these are things that the federal government could adopt.

It is disappointing for me, frankly, as a member of Parliament, to see the government not doing the diligence that provinces have shown is possible when it comes to finding meaningful safeguards within a relatively compressed timeline. The government's approach has been to emphasize sort of an artificial timeline of urgency, but then not actually do the diligent work in advance. It created this time crunch by leaving it until the last minute and then said that it has to be passed or there is a legislative vacuum. There is no legislative vacuum, and again, the important work has not been done in terms of clarifying the safeguards.

I will make a general comment. I find myself repeatedly asking the government for definitions of things. On this issue and a range of other issues, it repeatedly uses words without actually clarifying what the words mean. It is true of the provisions of this bill, but more broadly, it is true of the underlying philosophy of this bill. So much of the motivating arguments for this legislation come from the concept of human dignity, human rights founded on an idea of human dignity. I think we would all agree that human rights have their foundation in human dignity. We give rights to people on the basis of what they are, intrinsically. Yet the government, in the context of talking about dying with dignity, has not told us what it means by dignity.

I believe in the idea of intrinsic human dignity. Dignity is present in all of us. I know that one member of the other place who was criticizing me in the media suggested that young people cannot understand this issue because they do not spend enough time in nursing homes. I have volunteered regularly in nursing homes for a very long time and, recently, my grandfather passed away in a care facility. It is important for me to believe, but more than that, to know, that he had dignity in spite of his suffering.

Many of us here have seen or been with people as they suffered and died. It is important that we know and believe that people, regardless of their circumstances, regardless of their suffering, have dignity.

Dignity is not conditional on circumstance. Dignity is intrinsic. If the government disagrees with that, if it has a different concept of human dignity, then it should at least define the term.

This work is sloppy, the philosophy is sloppy, the legislation is sloppy, and I encourage members to defeat this bill in every way possible.

[An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), June 16th, 2016]

Mr. Speaker, I rise on a point of order. I believe Standing Order 62 provides for the member who rises first to be recognized.

[An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), June 16th, 2016]

Mr. Speaker, the minister puts a great deal of stock in the reasonably foreseeable provision. “Reasonably foreseeable” in this context is not a recognized legal term or medical term. The minister herself has said in previous debates that it does not mean terminal. Therefore, given the alleged significance of this criteria, this safeguard, so to speak, could the minister tell us what “reasonably foreseeable” means?

[Criminal Code, June 16th, 2016]

Mr. Speaker, I appreciate the member's arguments with respect to the urgency of this issue. However, he may be aware, and I think should be, that provincial guidelines have already been proposed with respect to this, and provinces are bringing in a framework to deal with this at the provincial level.

That does not negate the possible arguments for or against having a federal framework, but I think it is important to acknowledge, in the context of a claim to the alleged urgency of this issue, what the reality is at the provincial level, because if we look at the various guidelines, it actually seems fairly clear to me that a number of provinces have done a much better job of protecting the vulnerable than the framework the federal government has put in place.

I have raised concerns repeatedly in this House about the lack of protection for the vulnerable in this legislation. It is important that we separate out two different issues. There is the issue of the eligibility criteria, which has been fairly contentious in terms of whether it should be terminal, whether it should simply repeat the language of the Supreme Court, or whether it should use other types of language, as the government does in the somewhat ambiguous term of death being “reasonably foreseeable”, but then there is the separate question with respect to safeguards.

I think, especially in this legislation, whatever Canadians and members of this House think of the provisions in terms of eligibility criteria, that there is an absence of safeguards. If we look at what the provinces have put in place, they have, in many cases, done a much better job of providing important safeguards.

One of the models I would like to draw to the attention of members of the House is the law in place in Manitoba. The law put in place there has actually been praised. It was welcomed as a welcome development, even by someone involved in assisting people accessing assistance in dying, with an understanding of the real benefits of this law.

The system that was set up in Manitoba was that it allowed individuals seeking assistance in dying, euthanasia, or physician-assisted suicide, whatever we want to call it, to have their cases reviewed by government lawyers. It did not require judicial review, which has many advantages but is something that some members have claimed is unduly onerous. It instead created a procedure by which government lawyers would review the eligibility criteria and would be able to, in the context of their legal expertise and knowledge, rule on whether the person in fact met the criteria.

The government's legislation contains absolutely no mechanism for advance legal review by a competent authority, and we proposed an amendment to that effect in hopes of seeing the government bring it in. Unfortunately, it would not agree to that.

I think the Manitoba law strikes a good compromise. It does not require judicial review, but it does have some kind of apparatus whereby we have review by competent legal authority. Certainly in the case of Manitoba, the vulnerable in Manitoba are better off under the provisions of the existing standards in Manitoba than they would be under federal legislation.

Let us talk about some of the other provinces. In general, the provinces I was able to look at use language around attending physicians. They have protections in terms of conscience, but they are rooted in this idea of an attending physician being in some way involved in the process.

The federal legislation, Bill C-14, makes no reference to attending physicians. It does not require the involvement of the attending physician at all. It simply says that any two physicians can sign off. We could have two physicians in the country who see a particular case one way, with every other physician in the country seeing the case a completely different way, and that person would still be able to access euthanasia or assisted suicide.

In their wisdom, most of the provinces, at least most of the ones I have had a chance to look at, have guidelines that deal specifically with some kind of carved-out role for an attending physician. I would argue that involving, in the guidelines, specifically the attending physician provides significantly greater safeguards than we would have otherwise.

This speaks very much to the motion the government House leader put forward, because he is claiming that there is some urgency to passing this legislation on the basis of the protection of the vulnerable. However, if we look at the rules that are in place in the various provinces, it is very clear that they may, so far, in terms of the interim guidelines they have put in place since June 6, have a somewhat more liberal interpretation of the eligibility criteria, but on the issue of safeguards, on the issue of the protection of the vulnerable, they are actually doing a much better job.

I have stated before concerns about the College of Physicians and Surgeons of Ontario's policy with respect to conscience. It is evident in its interim policies that it has introduced, as well, a requirement for effective referral, requiring someone to be complicit or to refer for euthanasia, which is gravely concerning to physicians as well as to many other people within the province of Ontario. However, that would not change with the federal legislation, because the legislation would not provide the necessary protections for conscience.

In other provinces, though, we see a better job in terms of understanding processes that can be put in place which protect the vulnerable and also protect conscience. Therefore, generally speaking, they make reference to this issue of having the attending physician involved, but they do not specifically require the participation or an effective referral. In my home province of Alberta, there has been a system constructed whereby there is a sort of central hub where people would go directly, or where someone might be pointed, in order to have their situation addressed or adjudicated in some way.

These systems prevent what I think is one of the very pernicious aspects of Bill C-14, which is the possibility of doctor shopping. It is where a person, or even a member of their family, could shop the case around, and 10 or 20 different doctors could say absolutely not because the person does not meet the ambiguous criteria. It is somewhat ambiguous under Carter, but no less ambiguous under the provisions of the new government legislation.

What is important in this debate is that people have raised the spectre of a legislative vacuum, in that there will be no legislation, no rules in place whatsoever. Well, June 6 has come and gone, and provinces were ready to respond in a way and to an extent that the federal government simply was not. The government proposed the legislation fairly late. It did not seek to get our buy-in on the substance of the legislation. Instead, the government pushed this forward at a late stage and said that we have to pass it now because it is urgent.

Well, provinces have done a much better job here. Now June 6 has come and gone, and we are not in a vacuum. Provinces have developed standards, policies, and procedures, some of which may be better than others; some of which I may agree with more or less. However, if we look at the substance of these, I think we see that there is not at all a legislative vacuum. In fact, the provinces have in some cases been more effective.

The central issue of doctor shopping, the issue of whether or not someone meets the criteria, needs to be adjudicated. It needs to be adjudicated, hopefully once, and may be subject to appeal or review by someone else. However, there needs to be one person or a group of people who have the expertise, legally and medically, who make the assessment, and then that decision is made.

This fearmongering from the government about the absence of a law or a vacuum, I think really misses the point. We have these bodies, colleges of physicians and surgeons at the provincial level, that have the competency and have come up with guidelines, that have recognized, unlike the government, the concerns about doctor shopping that we have raised repeatedly in the House. They have recognized the problems with conscience and said they could try to construct, using their expertise and authority at the provincial level, a system that works better and that provides real protections for the vulnerable.

Whenever we think about the eligibility criteria, and in some cases the interpretation of the eligibility criteria is different at the provincial level, let us provide the safeguards.

One thing I want to briefly mention is that the federal legislation provides immunity from prosecution for someone who has a “reasonable but mistaken belief” that the standards have been met. Therefore, someone could take the life of a person who did not meet the criteria and still avoid prosecution. That is not a protection for the vulnerable. However, in the absence of the legislation, we do not have that exemption. The vulnerable are better protected because there is not an exemption for those who take life without the consent of the patient and without the proper criteria being met.

In looking at the reality of what is in place at the provincial level, it is not correct at all to talk about a legislative vacuum. Therefore, the motion does not have the urgency that is claimed.

[Food and Drugs Act, June 15th, 2016]

Mr. Speaker, the parliamentary secretary talked about progressive trade, claiming the government is supportive of trade. Where are we at with the TPP? Why is it taking the government so long? Canadians have, I think, been clear on this in support of it. President Obama has called this the most progressive trade deal ever. Certainly, many of the things that he is talking about being important are clearly identified in the trans-Pacific partnership. Our party has a position. The NDP has a position. We have yet to hear the government's position.

Given what he said about the importance of trade, I wonder if he will take the opportunity to finally tell us where they stand on this important trade deal.

[Food and Drugs Act, June 15th, 2016]

Mr. Speaker, certainly the implementation of this deal builds on the important work that was done under the previous government. It is great to see some of that at least continuing under the current government with respect to this particular trading initiative.

We are aware that it is not just tariff barriers to trade that can prevent trade. It is also these kinds of non-tariff barriers. I wonder if the member could talk more specifically about the work we can do to expand trade, not just in terms of tariffs but also non-tariff barriers such as this agreement and other areas.

[Main Estimates 2016-17, June 14th, 2016]

Mr. Speaker, the member is quite right to point to the fact that there has to be due diligence on these kinds of projects, working with the provinces and making sure that the necessary time is taken to get to that point. There are, of course, important infrastructure needs in my province. There are important infrastructure needs in my riding and I would be remiss if I did not plug the need for a bridge in Fort Saskatchewan.

In particular, there is a need to do the due diligence and the Conservative government made substantial investments while working with the provinces to set up framework agreements that would allow that to happen, and I am very proud of that record.

[Main Estimates 2016-17, June 14th, 2016]

Mr. Speaker, let us be very clear. The government eliminated the universal child care benefit. It is now no longer universal. I take no lessons from Liberals when it comes to investing in the next generation. The next generation, by the way, is going to need a very good education to figure out how to unload the debt that it will be left with because of the disastrous fiscal policies of the government.

My point was quite specific. It was about what actually constitutes infrastructure. Child care is important. Child care is not the same as building roads and bridges. It is a category error. When the Minister of Infrastructure says that infrastructure really means everything that Canadians use, there is obviously a lack of coherence there. There is obviously a bit of a problem when we try to understand if Liberals actually know what they are doing when it comes to infrastructure or the stimulative benefits that are supposed to be associated with infrastructure.