Kim Rudd

[The Environment, June 1st, 2016]

Mr. Speaker, I am pleased to have the opportunity to address the question by the hon. member for Saanich—Gulf Islands regarding the Canadian Environmental Assessment Act.

Our government campaigned on a promise to conduct a comprehensive review of environmental assessment processes, and to implement reforms that reflect an approach that is based on science, facts, and evidence. That is exactly what we intend to do.

We will work to ensure that this review and subsequent reforms are informed by consultation and partnerships with provinces, territories, and indigenous peoples. This has been our approach from the moment we took office and is central to restoring the legitimacy of the environmental assessment process that was lost under the previous government.

This government has already demonstrated the need to change the approach to environmental assessment implemented by the previous government. In January, we introduced five principles to guide our decision-making on all major resource projects under review. These principles ensure predictable, timely assessments based on science and data, that we account for the realities of climate change, and that we have meaningful engagement with communities and consultation with indigenous peoples. These principles, along with a review of the Canadian Environmental Assessment Act, 2012, are part of the government's broad strategy to restore confidence in Canada's environmental assessment processes.

While we undertake the broader review of environmental assessment processes, this government is ensuring that the Canadian Environmental Assessment Agency is adequately resourced to fulfill its responsibilities with respect to the Canadian Environmental Assessment Act, 2012 and the interim principles.

As the member opposite notes, budget 2016 provided funding to the Canadian Environmental Assessment Agency so that it does have the ability to deliver on its responsibilities. The funding announced in budget 2016 will provide the agency with the resources it needs to undertake consultations with the public and indigenous groups, and will support compliance and enforcement.

To the member opposite's question, I will say this. The fact that four years of funding has been guaranteed to the Canadian Environmental Assessment Agency in no way implies that our government is not planning to undertake significant reform. As previously noted, this government intends to launch a broad review of environmental assessment processes later this year.

I know that the hon. member opposite cares deeply about this issue, as do I, and that she has many thoughtful things to say regarding these matters.

With that, I would like to thank the member opposite for the question and we look forward to working with her as we work to reform Canada's environmental assessment processes.

[Natural Resources, May 20th, 2016]

Madam Speaker, we have received a 39,000-page report from the National Energy Board, and we will review that report. However, we have heard from Canadians that they did not have confidence in the flawed process that has been used over the past 10 years. Indeed, we have committed to ensuring that Canadians have a voice, that our indigenous peoples are consulted in communities along the proposed route.

When that report is received November 1, it will be considered, with a decision on or before December 19.

[Natural Resources, May 20th, 2016]

Madam Speaker, I am pleased to inform the member opposite that in addition to the panel, and to ensure that all Canadians have the opportunity to be heard, an online engagement tool will be launched when the panel begins its work in early June. Canadians have asked that their views be heard on these important decisions. We are providing them with an opportunity to do just that.

[Natural Resources, May 20th, 2016]

Madam Speaker, in January, the Premier of Alberta spoke positively about our panel and its role of consulting those who believed they were not heard, and its goal of helping to inform the process of getting our natural resources to market sustainably.

We are building bridges and relationships with our indigenous peoples, industry partners, and communities along the project. We look forward to doing that work.

[Natural Resources, May 20th, 2016]

Madam Speaker, as we said and we promised Canadians, we would put together a ministerial panel, which is one action that our government is taking to ensure major resource projects carry the confidence of Canadians.

We have asked that the panel members travel the pipeline route to hear from and talk to indigenous peoples and local communities, and report back to the minister by November 1, for a decision on or before December—

[Criminal Code, May 20th, 2016]

Madam Speaker, as I said in my remarks and have said previously, in the bill there is protection for those medical practitioners who do not want to participate in this. I believe that the idea of having a registry or a place for patients and for physicians and other medical practitioners to go to be able to exchange those ideas and support each other is a very important step.

[Criminal Code, May 20th, 2016]

Madam Speaker, I am not a constitutional lawyer, so I will not speak to the constitutionality. There are a lot of lawyers who have looked at the bill and believe it will pass the test, but that is not the point.

The point is that we have a framework for Canadians for now. This is historic in terms of putting the bill forward, of having this very difficult conversation with Canadians, and we as a government have committed very clearly to the next steps, whether it be advance directives or other elements on which we have made a commitment to have a discussion with Canadians. I look forward to working with the members opposite to have that very important discussion.

[Criminal Code, May 20th, 2016]

Madam Speaker, in budget 2016, there is indeed $3 billion for health care. Part of that discussion with the provinces and territories is clearly around home care and palliative care.

We have made that commitment. We certainly heard it from the Minister of Health a number of times.

As we know, the provinces and territories have jurisdiction over health care. Our role is to have the conversation with our partners to make sure we have all of those supports for assistance in dying, and to make sure we are reflecting Canadians' rights to assistance in their very difficult time at the end of their life and also the rights of physicians to support Canadians.

[Criminal Code, May 20th, 2016]

Madam Speaker, as I was saying the other day about Bill C-14, it is evident that governments, national associations, and members of the public recognize the moral and ethical struggle that health care providers could experience regarding medical assistance in dying.

Most provincial and medical regulatory bodies have already provided professional guidance around safeguarding the conscience rights of physicians. Provinces like Alberta and New Brunswick say their physicians are under no obligation to participate in assistance in dying. However, they recognize that continuity of care, especially at this most critical time in a person's life, also cannot be neglected. Patients cannot be abandoned.

The Canadian Medical Association's submission to the Special Joint Committee on Physician-Assisted Dying recommended that physician freedom of conscience be recognized as a key component of the federal legislative response to the Carter decision. Participants at a public town hall meeting in Mississauga, Ontario, raised concerns about the ethical dilemmas facing physicians if they chose to be involved in medical assistance in dying.

On May 10, proposed new section 241.2 was carried. In effect, this amendment clarifies that there is nothing in the legislation that would compel a person to provide or assist in providing medical assistance in dying. This amendment would contribute to public awareness that the bill recognizes both the rights of health care providers for freedom of conscience and the needs of Canadians who wish to have access to medical assistance in dying.

It is clear that no health care provider would be required to provide medical assistance in dying. However, we must also respect the rights of people seeking this procedure to have reasonable access. We know that there are many physicians who would provide medical assistance in dying to an eligible patient under their care. We heard from them throughout the consultations leading up to Bill C-14.

In a poll of 372 physicians, the College of Family Physicians of Canada found that 65% would help a competent, consenting, dying patient end his or her life, if requested. However, as was presented to the Standing Committee on Justice and Human Rights by Dr. Jeff Blackmer of the Canadian Medical Association, having health care practitioners willing to provide medical assistance in dying is only one part of the equation. The other very important factor is the ability to connect eligible patients with these willing practitioners.

People seeking medical assistance in dying will have already encountered many challenges. Once they have made this difficult personal choice, they do not need additional barriers, such as the lack of a provider. The government has committed to develop measures that will support access to medical assistance in dying and to work with provinces and territories toward a common approach to referrals or transfer of patient care.

Provinces and territories have also indicated that they feel that a third party referral function would be a viable option. This would respond to the access needs of patients and protect the conscience rights of health care providers who do not wish to refer patients for medical assistance in dying. To this end, we will be working with provinces and territories to develop an end-of-life care coordination system.

In its simplest form, this system would provide a registry of authorized providers willing to accept patients whose providers consciously object to this practice. It could also provide a system through which patients could self-refer to an authorized provider to seek an assessment of their eligibility. The end-of-life care coordination system could also be a source of information and resources to both patients and providers on all aspects of medical assistance in dying—eligibility criteria, safeguards, and so on—as well as information about other end-of-life options, including palliative care.

Similar systems are used in several other countries. For example, both Belgium and the Netherlands offer specialized services that provide physicians with access to a registry of trained, independent, and impartial physicians who offer consultations on end-of-life options, including euthanasia requests.

Collaborative federal, provincial, and territorial work could consider such international examples in establishing a made-in-Canada model to provide providers and patients with access to a system that could transfer care to a physician willing to assess and administer requests for medical assistance in dying.

Additionally, the system could service medical and nurse practitioners in need of an independent consulting practitioner, for example, in rural ridings, such as the one where I live, in remote areas, and where access to a second provider is challenging.

We trust our health care providers to work hand in hand with us in helping to maintain and improve our health. When our needs change, and we look for ways to relieve suffering and avoid a long and painful end, Canadians want to be confident that these providers will not abandon them but will help them choose their own paths.

I look forward to working with my federal, provincial, and territorial colleagues to ensure that, when the time comes, compassionate care and support at the end of life will be available to Canadians without undue burden or delay.

Physicians are key to the end-of-life process. They are a critical thread that not only binds but frames this whole discussion. They are imperative to move this important debate forward. I have shared my very personal experiences on palliative care and on how critical it is.

I met this past weekend with a physician in my riding who spent years working with palliative patients. This is a man who is passionate about end-of-life care, and he expressed unequivocally to me how important this legislation is. He felt that there is a strong desire on behalf of the medical community to find the right path to ensure that we have the best care options. This legislation is a major step forward on that very important path.

This legislation has created a national conversation around end-of-life care, palliative care, and home care and how we want to be treated at the end of our lives. This has to be the most important conversation we can ever have.

This is a true legacy piece. I believe the decisions we make around this bill will reverberate positively for years to come. As I said before, I am confident the proposed legislation provides us with a balanced solution that reconciles diverse interests in medical assistance in dying and is appropriate for Canada.

[Criminal Code, May 17th, 2016]

Mr. Speaker, while my time for debate is short, I look forward to continuing it tomorrow.

As members know, the issue of conscience objection has been a topic of considerable discussion in relation to medical assistance in dying. Fundamentally, this debate highlights the need to achieve an appropriate balance in respecting the rights of physicians, nurse practitioners, and other health care providers to abstain from providing medical assistance in dying while supporting the rights of eligible patients to access such services.

It is evident that governments, national associations, and also members of the public recognize the moral and ethical struggle that health care providers could experience regarding medical assistance in dying. Most provincial medical regulatory bodies have already provided professional guidance around safeguarding the conscience rights of physicians. Provinces, like Alberta and New Brunswick, say that their physicians are under no obligation to participate in assistance in dying. However, they recognize that continuity of care, especially at this most critical time in a person's life, also cannot be neglected. Patients cannot be abandoned.