Jane Philpott

[Health, September 19th, 2016]

Mr. Speaker, I thank my colleague for his question.

Arthritis is a disease that affects too many Canadians. Those who have it face a variety of difficult symptoms. We are continuing to invest $46 million in the Canadian Institutes of Health Research to learn more about chronic inflammation and develop better prevention and treatment options.

[Indigenous Affairs, September 19th, 2016]

Mr. Speaker, as the member opposite is well aware, we do have a non-insured health benefits program that is available to first nations and Inuit families. These features of care are provided on the basis of medically necessary needs, including, of course, orthodontic care.

I am pleased that the member continues to work with us to seek ways that the program can be improved, as all good programs can be. We will find ways to make sure that the care is there for the people who need it.

[Health, September 19th, 2016]

Mr. Speaker, I am happy to talk about why our approach to health care does constitute real change. We are investing. The Canada health transfer this year is the largest ever, to the tune of $36.1 billion. It will go up accordingly next year, according to plan.

However, what Canadians want are investments in innovation. Canadians know that while our health care system is something we are proud of, it could be better. We are going to talk with our colleagues in the provinces and territories about where those investments should be made and what Canadians can expect.

[Health, September 19th, 2016]

Mr. Speaker, I have had the great pleasure of working collaboratively with my colleagues in the provinces and territories since the time I became minister of health. I have enjoyed many good conversations with my colleagues across the country. We have talked about our shared priorities and where we want to invest in health.

There will be no cuts to health. We will continue to increase the Canada health transfer, as previously discussed, and we will discuss other areas where there can be investments made that are important to Canadians.

[Health, June 16th, 2016]

Mr. Speaker, as I stated in the House earlier this week, I am working with my colleagues in the provinces and territories to negotiate a new health accord. Within that accord we will make new investments in health care in our country.

I look forward to working with all of the health ministers across the country. I have already had conversations with Minister Barrette in Quebec and my other officials. We look forward to announcing a new health accord hopefully later this year.

[Health, June 16th, 2016]

Mr. Speaker, our government works alongside Canadian Blood Services and Héma-Québec. We are fully in support of ensuring that organ and tissue donations are done well in this country. There is a Canadian transplant registry to which we have already committed $64 million in recent years to develop.

This is a matter that is under provincial jurisdiction, and it is for that reason that the bill was unsupportable. We encourage all Canadians to consider going online now and committing to being an organ donor.

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

Madam Speaker, this legislation would change the social fabric of this country. We need to think about how this legislation would affect the lives of individual Canadians as they face the end of their life. We are pleased to put forth a piece of legislation that we believe is the right approach for Canada.

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

Madam Speaker, my colleague's question gives me an opportunity to reiterate again, as my colleague the Minister of Justice and I have said on numerous occasions, that we are absolutely clear on the fact that the two cases that were reviewed in the matter of Carter v. Canada are cases of people who would absolutely have been eligible under the legislation that is before the House today.

If the Carter decision is read carefully one will understand that it was clearly speaking to people who were facing end-of-life decisions. We are fundamentally affirming today that the people in question in that case would have met the criteria of Bill C-14 for medical assistance in dying.

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

Madam Speaker, I want to thank my hon. colleague for the time that he has committed to being here to debate this important matter.

I share his concerns over the protection of people who are facing mental illness. This is one of the fundamental reasons why we hope that he and his colleagues will support the motion that we have put forward in the House today. We are concerned with the Senate's recommendation for the removal of the clause that recommends that this be considered only in the face of natural death being reasonably foreseeable because of the fact that people with mental illness, among others, would not be adequately protected.

The member also talked about other safeguards that were suggested by the Senate. This piece of legislation was drafted in totality. The safeguards that are in place to recognize that no one would be coerced need to be seen in totality so that one piece or clause in particular does not adequately put those safeguards in place. My colleagues and I who have worked on this—

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

Madam Speaker, I want to say before I begin that I will be splitting my time with the hon. member for Montcalm.

I am pleased to be here today to continue our important discussion on Bill C-14 concerning medical assistance in dying.

We have seen the serious thought and deliberation that hon. senators have put into this bill over the past few weeks. It is now up to us to carefully examine the amendments that the Senate has presented.

Medical assistance in dying is only available in a very small number of jurisdictions around the world and it is brand new to Canada. What we are talking about with this bill is a fundamental change to social policy in this country. We are pursuing transformative change at the same time as we are facing incredible time pressure to put federal legislation in place. It is, therefore, critically important that we move forward with great care.

There are a number of paths that we could choose to follow with respect to medical assistance in dying in this country. I believe that the choice we have made with Bill C-14 represents the approach that is most appropriate and responsible for Canada, and here is why. It strikes a careful balance between respecting the autonomy of patients seeking assistance in dying and protecting vulnerable people. It would protect the conscience rights of providers and support those who choose to participate. It would put measures in place to study the legislation over time as we understand and gather further data to deal with the issues.

I would first like to bring to the attention of hon. members the ways in which the bill respects the autonomy of patients. Under this legislation, eligible patients approaching the end of their lives would be able to choose a peaceful medically assisted death. This represents a significant shift in the way we approach suffering at the end of life in this country. It provides patients with greater autonomy over their decisions.

The bill also improves access for patients. By allowing nurse practitioners to administer medical assistance in dying, the bill recognizes Canada's unique geographic and demographic realities. Nurse practitioners often work alone to provide vital health care services in underserved regions.

In addition to supporting access and autonomy, Bill C-14 also takes care to protect patients who may be vulnerable. When changing social policy, we must proceed with great caution if there is a chance that those who are most vulnerable among us may be negatively affected. Without appropriate safeguards, the availability of medical assistance in dying could pose threats to marginalized people and those who may lack access to adequate familial, social, or economic supports. This bill would establish robust safeguards and procedures to protect vulnerable persons from being encouraged or coerced into seeking medical assistance in dying.

It is important to recognize that there has been significant support in this piece of legislation from the health care sector, including the Canadian Association for Community Living, which includes 40 individual advocates and 50 organizations. It includes various medical associations, both provincially and federally, the Canadian Nurses Association, the Canadian Association of Advanced Practice Nurses, the Canadian Pharmacists Association, the Canadian Psychiatric Association, the Canadian Association of Social Workers, and many more.

This legislation also complies with the vulnerable persons standard, which I believe sends a strong message to all Canadians about our support for those among us who need most protection.

The bill recognizes that medical professionals have the right to follow their conscience and choose whether or not they want to participate in medical assistance in dying. For those who do choose to participate, the bill ensures that the doctors and nurse practitioners who administer this assistance will not be prosecuted. It also exonerates those who may assist, such as pharmacists and authorized nurses.

Finally, it outlines criteria to help support providers in assessing patients. It is important to keep in mind that health care providers are required to assess the condition of their patients on a regular, if not daily, basis. Assessing the level and type of suffering is already part of medical practice and it is very common in all end-of-life care. It is, for example, a crucial element in determining the best approaches to alleviate suffering in palliative care.

Our eligibility criteria and safeguards offer providers direction and flexibility within their field of expertise and scope of practice to make an assessment about the condition and circumstances of a patient seeking medical assistance in dying on a case by case basis.

Given the complexity and often personal nature of this issue, there is significant debate in terms of the correct approach from many different perspectives. What we have with Bill C-14 is an approach that would put a cautious assisted-dying framework in place while leaving the door open to adjust as we better understand more challenging issues. In the legislation, there is a commitment to independent studies on challenging issues that need to be investigated further before determining what policy considerations the government should make.

One thing is certain, these are issues that present real risks to people in vulnerable circumstances and highlight the complicated nature of balancing autonomy against the protection of vulnerable patients. There is also, of course, a mandatory parliamentary review of this legislation after five years.

I would be remiss if I did not reaffirm here today the importance of improving access to high quality palliative care for all Canadians. Our government has committed to investing in this area. I continue to work with provinces and territories to help support access to all options for care at the end of life.

The motion today has given thoughtful consideration to the work of the upper chamber. I thoroughly appreciated the opportunity to take questions for a two-hour period at the committee of the whole, in addition to the time that I appeared before the committee's pre-study.

There are two amendments made by the upper chamber where we respectfully disagree. As captured in the motion today, we as a government reviewed and sought a path forward that encompasses the Senate's amendments where possible, resulting in our agreement with the five remaining amendments. There is alternative text proposed to reflect the upper chamber's desire to recognize the vital importance of palliative care options for patients. As I have said repeatedly, this is a positive outcome if the result of this legislation allows tangible improvement to access palliative care in Canada.

We also have a responsibility to provide language in the legislation that health care professionals can understand in order to provide access to assisted dying. As is stated in the proposed message to the Senate, removing the criterion of the reasonable foreseeability of natural death would undermine the objectives of Bill C-14 to recognize the significant and continuing public health issue of suicide, to guard against death being seen as a solution to all forms of suffering, and to counter negative perceptions about the quality of life of persons who are elderly, ill, or disabled. Bill C-14 strikes the right balance for Canadians between protection of vulnerable individuals and choice for those whose medical circumstances cause enduring and intolerable suffering.

In conclusion, I would like to underline to my fellow parliamentarians that the approach set out in Bill C-14 is the result of tremendous thought and deliberation over the course of many months. There have been extensive consultations over this past year on the issue of medical assistance in dying with Canadians, stakeholders, and relevant experts. The findings have been reviewed carefully to inform the legislation.

I hope both the House and the Senate are able to support the motion. I would like to thank, from the bottom of my heart, all the parliamentarians from both the upper and the lower chamber who have professionally and thoroughly debated this issue. It is a transformative social policy that governments debate once in a generation, and this piece of legislation is one of those remarkable debates. Make no mistake, this will be a dramatic change for Canada.

In the Carter decision, the Supreme Court acknowledged that it was up to Parliament to craft an appropriate regime. I believe we arrived at the best approach for our country.