Garnett Genuis

[Criminal Code, May 2nd, 2016]

Mr. Speaker, this bill makes it possible for a person to ask a doctor for help committing suicide. If the doctor refuses because the person does not meet the criteria, that person can go to plenty of other doctors to get help.

Does the member agree that we need some rules around that practice of going from doctor to doctor?

[Criminal Code, May 2nd, 2016]

Mr. Speaker, I want to follow up on the question from the member for Mount Royal about jurisdiction and conscience, because it is a very important question. In fact, the Carter decision recognizes health care as a joint area of jurisdiction, so it is very clear that there is involvement of the federal jurisdiction. Also, it is important to acknowledge the parallels to the same-sex marriage debate and what the then Liberal government did in the Civil Marriage Act with respect to protecting the conscience of religious officials who did not want to perform same-sex marriages. It was important at the time, as part of that debate, to ensure that nobody would be forced to perform that union, a religious official who did not want to. It was put in that legislation, even though the solemnization of marriage is done at the provincial level.

We see a clear parallel, and if it was doable then by a Liberal government, there is no reason not to include conscience protection in this legislation as well. Very similar language could in fact be used in the development of the amendment. That is important. It is something worth considering when we have a major social change like this. Some people will want to be part of that change, but others will not want to be part of that change, and we should respect those who do not want to be part of that change.

I wonder if the member sees a parallel between these two debates and would support including a similar provision in this law, as the previous Liberal government did in the Civil Marriage Act.

[Criminal Code, May 2nd, 2016]

Mr. Speaker, I thank the member for his work on this. I want to address a few of the points the member made.

It is a strange definition of lack of action to say that the repeated express will of the House on the issue of euthanasia somehow constitutes a lack of action. Of course we had proposals that came forward before the court decision, and those were rejected by an overwhelming majority of this House, which included the majority of Liberal and, I believe, New Democrat members at the time, as well.

With respect to the issue of a legal vacuum, I would like to see better legislation come forward which clarifies the situation. I would support this bill if it were amended in a number of key ways. However, the existing legislation does not in any way address the task that the court asked us to do, which is to actually describe and define what the situation would look like in terms of euthanasia and assisted suicide in Canada.

The government has replaced some ambiguity in the court decision with greater ambiguity in the legislation. Legislation is only worth proposing if it improves on the absence of legislation.

In terms of investment in palliative care, I agree with the hon. member that there is more work to do. I would not accept his characterization of the previous government as doing nothing on that issue, but I would certainly agree that more investment is needed.

The problem with this legislation is it moves in the opposite direction. Allowing euthanasia and assisted suicide without conscience protection has the effect of pulling doctors who would otherwise want to be involved in palliative care out of palliative care if they do not want to participate in euthanasia. At the very least, conscience protection should be added. That would preserve the existing system of palliative care that we have, and then we could build on that by working to do more.

[Criminal Code, May 2nd, 2016]

Mr. Speaker, I was actually very clear about that point in my speech.

Regardless of the private opinions of members with respect to this issue more generally, we know that the government is not addressing at all the task that the court put in front of it. The task that the court gave the government was to develop a system that would make this happen while also protecting the vulnerable. The government replaced some criteria in the court decision with equally, if not more, ambiguous criteria in its response. We are not seeing any development in this regard from the government at all.

I do have to underline, and again we see it in the question that the member asked, the euphemistic language here. Doctors provide medical assistance in dying every day that does not involve killing their patients. If members defend it, good for them, but they should have the honesty to describe the issue properly, because calling something “medical assistance in dying” is clearly misleading. It distracts from the central question we are supposed to be debating.

[Criminal Code, May 2nd, 2016]

Mr. Speaker, this legislation contains no meaningful safeguards. Even its exceptions are full of holes: the written consent provision excludes those who cannot sign; the waiting period can be routinely waived; mental illness is not excluded; the requirement that death be reasonably foreseeable would exclude no one; and the requirement that two doctors sign off merely encourages doctor shopping. Even if the already ambiguous criteria are not followed, someone who kills an unwilling patient can be let off the hook if he or she claims a reasonable but mistaken belief that the criteria applied.

Clearly, we have a perfect storm of ambiguous criteria and a reasonable but mistaken belief clause which means that it would be nearly impossible to prosecute anyone who kills a patient, even without consent.

Today I want to make three additional points: the decline of moral language, the need for advance review, and the way in which an absence of conscience protection is further undermining an already inadequate system of palliative care.

This debate has been characterized by a decline of language. Terms like “suicide”, “euthanasia”, and “killing” are rejected and replaced by fundamentally inaccurate phrases like “medical assistance in dying”. Every day physicians assist their patients in the context of dying without killing them.

The decline of language is also evident in the euphemistic use of terms like “dignity” and “compassion”. The phrase “dying with dignity” implies that suffering or disabled people do not have dignity, and this reflects a very dangerous world view. For a long time we have understood that dignity is immutable; it is an intrinsic characteristic of all human beings. Our immutable dignity is the reason we put down suffering dogs, but we do not put down suffering humans.

This human exceptionalism, this idea of universal and immutable human dignity is the basis of our conception of human rights. Human rights, the ostensible basis on which this legislation is advanced, stand on a moral foundation of universal immutable human dignity, and those who wish to redefine dignity so dramatically should at least provide us with their alternative definition.

I have encouraged the government to amend this legislation to include a system of advance review by competent legal authority. This could take many forms. It could involve review by a provincial consent and capacity board. It could involve a requirement for review by a judge. It could involve the simple requirement in this legislation that each province set up its own system of advance legal review or that an independent lawyer certified and retained for this purpose replace the role of one of the witnesses.

There are multiple options here, some better than others. The criteria are not worth the paper they are written on if someone with competent legal authority is not making a determination in advance to ensure the legal criteria are met.

The government, though, wants to force doctors into this role. However, doctors do not constitute competent legal authority. Doctors do not make these types of decisions in other parts of their work, given how aberrant the taking of life is from the normal medical process of protecting life, and the proposed legislation's allowance for doctor shopping does not actually mean that the doctor providing the prior care would provide advance review, since the patient, or worse, someone else, could simply go on the Internet to find a doctor with a more liberal interpretation of the criteria.

A simple system of advance legal review by competent authority would eliminate doctor shopping and achieve the central objective: it would ensure that people who have not consented or do not meet the criteria are not killed, without any effective means to investigate that after the fact. Data from Benelux countries show alarmingly high rates of euthanasia for patients who have not consented; however, prosecution of those who take life without consent in a medical environment is almost non-existent.

Finally, a lack of conscience protection pushes people out of the provision of palliative care when already far too few Canadians have access to it. Dr. Nancy Naylor, a family and palliative care physician with 40 years of experience, is now leaving the profession. She said, "I have no wish to stop, but I will not be told that I must go against my moral conscience." She is speaking out because her patients who will be left without access to palliative care cannot. What good does it do anyone to leave conscience protection out of this legislation, and chase good principled palliative care physicians out of the profession at a time when we need them most?

Many doctors say that this is not medical care at all, and we should let them focus on what they do best.

The Supreme Court decision punched a hole in the previous law, and this legislature cannot change that, but the government appears to be taking advantage of these events to widen the hole still further. No law would be a bad situation, but this law could make a bad situation worse. It would leave vulnerable seniors and sick and disabled persons at risk with no meaningful restrictions.

Stop the madness. Fix the bill.

[Protection of Pregnant Women and Their Preborn Children Act (Cassie and Molly's Law), May 2nd, 2016]

Mr. Speaker, I appreciate the opportunity to address this very important issue and to distill out what is some confusion on the other side of the House. We hear constant efforts by the other side to conflate this very important issue of criminal justice, as the member for St. Albert—Edmonton and the sponsoring member said very ably, with something else, which is the issue of abortion which we know is very contentious and very difficult in this country.

We should be able to have a rational conversation about issues that are different, that are unrelated to abortion, that still touch on justice and still touch on preventing violence against women. It is important that we be able to make these distinctions because when it comes down to these issues, there are two separate questions we can talk about. There is the question about the basic rights of individuals, in this case of preborn children, and then there is the separate question of whether or not the rights of the mother exceed or supersede the rights of that preborn child. What is maybe missed by other hon. members is that these are very clearly two separate questions.

One could come to the conclusion that preborn children should have no rights, should have no acknowledged status as persons, but one could also come to the conclusion that there is clearly some genuine humanity to that preborn child, even if one further concluded that the rights of the mother ought to supersede the rights of the unborn child in that case.

The importance of understanding that these are two separate questions really has been missed by the other side. Members instead infer from the fact that one philosophical conclusion might be drawn in the case of preborn children, that therefore we cannot take this action because it might be inferred to mean something else later on down the road.

The members on our side who have spoken to this issue have already been very clear on that point. They have underlined that we are talking about a particular issue which is addressing violence against women and also recognizing that there is a loss of life involved and that there is a loss of women's choice involved as well.

It is a little disappointing to see members of other parties wanting to stir up these hot button debates when this really should be something on which there is a consensus. I do not think that any member would disagree with the basic philosophical proposition that an unborn human child is in some sense human and can be recognized to be as such without opening up a separate and distinct philosophical question around the rights of women.

The lack of acknowledgement of these separate questions is a problem, and let us be clear that it is a problem with some real practical consequences, with some real implications. Those implications have been laid out well, not only by my colleagues, but by members from other parties who understand the problem of violence against women, who understand the pressing need to address it, to overcome long-standing perhaps cultural ideas that have not addressed this properly in the past. There should be consensus. I look forward to working with members from all sides on this issue.

Before getting elected, I served on the board of an organization called Saffron in my riding which is working to address bullying and violence against women and sexual violence. It is great to see in my community and other communities that this obviously is an issue where there is a consensus across parties and across different political philosophies and perspectives.

From what some other members are saying, it is disappointing because if we do not pass the bill, then we will have missed a very good opportunity. We will have missed an opportunity to do something good. We will have missed an opportunity to make a difference for families who are victims and a difference for potential victims as well. We will have missed this opportunity because instead of confronting an important issue in a concrete, effective way, and members are welcome to propose amendments on some of the specific details that have been mentioned at the committee stage, but by simply rejecting it out of hand, an opportunity will have been missed to make a real positive difference when it comes to something that we should all agree is very important.

[Criminal Code, April 22nd, 2016]

Mr. Speaker, I appreciate the opportunity, and I will be splitting my time.

I want to discuss specific aspects of the legislation today. On Monday, I will have an opportunity to talk about some underlying philosophical questions.

I want to be clear that I do not believe in an all-or-nothing approach. Many of my colleagues and I who have broad philosophical concerns about what is happening here are still willing to vote in favour of legislation that does not recriminalize euthanasia, if it advances positively in the direction of saving some lives, especially minimizing the risk to vulnerable persons. However, this legislation does not contain meaningful safeguards. Without amendment, it will protect no one.

We know that this law has written exceptions. However, it has exceptions to the exceptions; and may I say it has exceptions to the exceptions that are not at all exceptional?

This legislation has a requirement for the provision of written consent. However, if people cannot provide written consent, someone else can do it on their behalf.

This legislation prescribes a waiting period. However, the waiting period does not apply in the event of possible imminent death or loss of capacity.

There is so much ambiguity here.

The government has said that mental illness is excluded. However, in section 241.2(2) the legislation clearly states that physical or psychological suffering qualifies a person to seek premature death.

The legislation says that death must be “reasonably foreseeable”. May I say that death is reasonably foreseeable for all of us? It is those who think that death is not reasonably foreseeable who probably need the medical attention. Why not put in the word “terminal”? When I was learning to drive, my mother thought that death was “reasonably foreseeable” every time we got into the car. That is no criterion.

There is a requirement that two physicians sign off. However, given the huge ambiguities, obviously doctors are likely to have a wide range of interpretations of the rules. The estimates are that there are 77,000 physicians in this country, and the likely practice of doctor-shopping will ensure that people who think they meet the wooly and ambiguous criteria can somewhere find two physicians.

The member for Victoria said earlier today that this is something doctors do every day. No, it is not. Doctors do not take lives every day. This is fundamentally different from the normal practice of medicine. When we have so many different doctors and opinions to choose from, these are not effective safeguards.

Given these five comically ridiculous exceptions to the exceptions, there is no doubt that detailed provincial legislation or regulation will be required in every case. Therefore, it is not at all clear to me what this law is supposed to accomplish.

Further, there are two key areas where the prevailing rules under this law would leave us demonstrably worse off than the Carter ruling alone.

First, there is a terrifying clause in this bill, which states that if someone kills someone else but can demonstrate, at least beyond a reasonable doubt, that he or she had a reasonable but mistaken belief that the criteria applied then that person cannot be penalized. We can find that at 241(6). Therefore, we can kill someone who did not consent and escape prosecution on the basis of reasonable but mistaken belief. Whatever is done, I implore the government to take this very dangerous section out. This is going even beyond the Belgian model.

Second, this legislation provides no protection for conscience rights, despite the court's clear statement that nothing in this decision required particular health care practitioners to be involved, and despite the clear assurance of the Canadian Medical Association that access does not require taking away section 2 conscience rights.

This legislation constitutes a perfect storm. Ambiguous criteria, no advance legal review, no conscience protection, and allowances for doctor-shopping are not meaningful safeguards at all. The bill leaves patients, seniors, the sick, and the disabled vulnerable to error and systemic abuse. We have seen this in Belgium before. I have quoted the studies during questions and comments. We do not want to go down this road in Canada at all.

The government must introduce simple amendments to this legislation, which define the criteria more clearly, which address the problems I have mentioned, and which introduce an effective system of advance legal review.

As I have mentioned, a person seeking hastened death should require the sign-off of competent legal authority. One such model could involve the use of consent and capacity boards or some kind of judicial review. It need not be onerous.

This process need not be complicated. It would ensure that people are not accidentally killed and that their killer is able to hide behind the ambiguous criteria of reasonable but mistaken belief.

We cannot save every life today. However, it is better to light a candle than to curse the darkness. From my perspective, too many have spent too long just cursing the darkness. Let us amend this bill and fix it so that we can get the work we need done.

[Criminal Code, April 22nd, 2016]

Mr. Speaker, I have a quick follow-up to the member's previous response. I do not think it is a good response at all to say there have been other studies without actually quoting them.

We have seen significant studies from Belgium and other Benelux countries that show that without an effective system of advance legal review, which need not be onerous, and one suggestion has been to use consent and capacity boards which already exist at the provincial level, a simple system of not onerous advance review could be added to this legislation which would ensure that we do not go down the road that many of the studies have shown us going down in the Benelux countries. What is wrong with adding that basic protection?

[Criminal Code, April 22nd, 2016]

Mr. Speaker, I was pleased to hear the minister talking about international comparisons. One of my disappointments with the Special Joint Committee on Physician-Assisted Dying was that we did not do a sufficient study, at all, of what has happened in other jurisdictions where we have seen these laws brought in.

Specifically, I want to talk about a study that was done in Belgium in 2010, which was quoted in the Canadian Medical Association Journal. It surveyed nurses and found that a full 120 of 248 of them said they had been involved in cases of euthanasia where there was no consent. Of the 248 nurses who had been involved in euthanasia, almost half of them had been involved in cases where there was no consent. Yet, the direction we are going with this legislation, and the model that I know the member advocates, because it follows the special joint committee, is very similar to the Belgian model.

I would ask the member why Canada would follow Belgium when there have been significant problems with actual consent. Why do we not look at jurisdictions that have been more effective and put in place things like advanced legal review?

[Physician-Assisted Dying, April 22nd, 2016]

Madam Speaker, people choose a medical career because they want to care for the sick, but without conscience protection, doctors in Ontario will now be forced to facilitate killing. Dr. Nancy Naylor of Strathroy, Ontario, will not be renewing her licence. Dr. Naylor has practised family and palliative medicine for 40 years. She writes, “I have no wish to stop. But I will not be told that I must go against my moral conscience...”.

Will the government implement conscience protection in euthanasia legislation and let Dr. Naylor continue her vital work?