Mr. Speaker, rarely in this parliamentary life are we called upon to debate such an important subject, an issue that requires such seriousness, rigour, sensitivity, and compassion.
With that in mind, I want to begin by commending the professionalism of all my colleagues in the House, who, from the beginning of our study of Bill C-14, have set partisanship aside and have made this debate more of a discussion, rather than a debate per se.
The subject that we are being asked to deal with today is one that invariably raises sincere emotions and touches a nerve with all of us, not only here in Ottawa, but all across the country. Developing a framework for medical assistance in dying means striking a balance between implementing a right with such irrevocable consequences on the one hand, and protecting vulnerable people with regard to that right on the other hand.
What right are we talking about? It is the right of a competent adult, who freely consents and suffers from a grievous and irremediable illness causing intolerable suffering, to die at the time of their choosing and with the necessary assistance and medical support. This is a right guaranteed by section 7 of the Canadian Charter of Rights and Freedoms, which states that everyone has the right to life, liberty, and security of the person. This right was unanimously recognized by the Supreme Court of Canada on February 6, 2015, in the Carter case. This right protects life, because the absolute prohibition in section 14 and paragraph 241(b) of the Criminal Code on aiding or counselling another person to commit suicide made individuals suffering from grievous and irremediable illness feel that they were forced to take their own lives prematurely out of fear that the progression of their illness would make it impossible for them to do so and that their suffering would become intolerable.
The absolute nature of the blanket prohibition on medical assistance in dying deprived people of a portion of their life that they could otherwise have enjoyed. This right also protects the liberty and security of the person.
As the Supreme Court explained in paragraph 66 of its decision in Carter, by denying people the right to request a physician’s assistance in dying, the Criminal Code is interfering with “their ability to make decisions concerning their bodily integrity and medical care”. The Criminal Code thus trenches on liberty. Since that option was not available to Canadians, they had to endure intolerable suffering, which also impinged on their right to security of the person.
Although the Supreme Court recognized that medical assistance in dying is one of the rights guaranteed under section 7 of the charter, those rights are not absolute. Limitations and restrictions can be placed on those rights, according to the principle set out in Oakes, which is based on section 1 of the charter. The principles in question are those of minimal impairment and an important government objective.
Bill C-14 must be examined through that lens. Although people with grievous and irremediable medical conditions should be given the right and means to die with dignity, that is not an absolute right. We also need to protect vulnerable people, people who are unable to provide informed consent, and people who could be subject to undue pressure.
My position could evolve, as I continue to listen to my colleagues and constituents and as I continue to reflect on this topic.
However, I think that it is a good idea to exclude minors and people with mental illness from this bill. Like many members in the House, and like the Quebec National Assembly when their work was complete, I think that including minors would have created some virtually insurmountable problems with respect to consent, as my Conservative colleague from Louis-Saint-Laurent pointed out.
With respect to people with mental illness, I think that in the absence of full and informed consent, the sanctity of life must prevail. Since such consent is nearly impossible to obtain under the circumstances, it is prudent to exclude people with mental illness from the bill.
Conversely, I think that some aspects of the bill raise some questions. One aspect is the notion of a death that is reasonably foreseeable, which the government wants to introduce, even though this notion was not in the Carter decision.
The court recognized that not having access to medical assistance in dying could cause intolerable suffering and, therefore, impinges on the individual's right to security of the person.
I also think that individuals who are suffering from a grievous and irremediable medical condition but who are not at the end of their life, which unfortunately is the case for many people in Canada, are therefore being deprived of the right to security and integrity of the person.
I am afraid that with this addition, one of the appellants in Carter would not have had access to medical assistance in dying. I am not certain either that such a restriction minimally impairs a charter right, as seen in Oakes.
Second, although I am aware that there is a need for robust protections and that the bill includes many, which is a good thing most certainly, I have doubts about the protection provided by the provision in paragraph 241.2(3)(h), which stipulates that immediately before medical assistance in dying is provided, a patient must reiterate his or her free, informed, and full consent.
Doctors would have to stop administering medication, such as morphine, which eases the patient's pain, in order to obtain this full consent. I fear that this provision will create excessive suffering for individuals at a moment when they want to gently leave behind their overwhelming suffering.
Third, I was not convinced that advance consent was a good idea, but I was enlightened by my colleagues. Although I am still not convinced, I welcome the government's willingness to study the issue further.
Lastly, like many of my constituents, I think medical assistance in dying must be brought into the broader context of end-of-life care. To that end, I also welcome the promise to invest $3 billion over four years in home care.
I believe that, like the bill, this is a step in the right direction, but it is not the final destination. I will vote in favour of this bill at second reading, and I encourage my colleagues to do the same.
