Madam Speaker, key among the considerations lying at the centre of the debate on Bill C-14, physician-assisted dying, is the ruling made in February 2015 by the Supreme Court of Canada in the Carter case, striking down sections of the Criminal Code that prohibited the provision of assistance in dying on the grounds that they were unconstitutional as they violated parts of article 7 of the Charter of Rights and Freedoms that “everyone has the right of life, liberty and security of the person”.
The court ruled that the Criminal Code provisions were of no force or effect to the extent that they prohibited physician-assisted death for a competent adult person who clearly consented to the termination of life and had a grievous and irremediable medical condition, including an illness, disease or disability, that caused enduring suffering that was intolerable to the individual in the circumstances of his or her condition.
The court then suspended the declaration of invalidity for a year and in turn granting to the current federal government an additional four months to June 6 of this year, after which the Criminal Code offences would become null and void.
Clearly, action is necessary to uphold our constitutional and charter rights.
Also, it is important to give consideration to the recommendations by the all-party Special Joint Committee on Physician-Assisted Dying struck by the government and mandated to review the report on the external panel and options for a legislative response established by the former Conservative government, and to make recommendations on the framework of a federal response that would respect the constitution, the charter and Canadian priorities.
The committee recommendations are based on the testimony of a wide diversity of witnesses and review of parallel legislation enacted in other jurisdictions, including Quebec.
The committee considered a great many critical issues, including: Should there be a condition based on age? How will the law protect the vulnerable? Should the law recognize advance medical directives? Should the law impose waiting periods? Should the law enable conscience objections by health providers? What is the correct terminology to apply? What are the respective jurisdictions of federal and provincial authorities? How do we ensure equal access to these medical services, and the need to expand access to palliative care, including on the NDP call for a national strategy?
The challenge before us is to determine whether Bill C-14 clearly and properly addresses these matters.
This is a highly personal and emotional topic for all members in this place and frankly all Canadians facing life and death decisions. Members of my own immediate family struggled in their last days. My younger sister suffered a painful extended period prior to her death, even where some palliative care was available. My older sister suffered a lesser quality of existence for far too many years because the only accommodation for younger, chronically ill patients was an extended care facility for seniors.
Our governments must deliver on promises for expanded palliative care for all, and housing for the chronically ill and disabled. This access is surely also a charter right.
I have carefully considered the letters and conversations with my constituents who have expressed a wide range of views and perspectives on the matter of medically assisted dying. What I found discouraging is the lack of full understanding by many I have spoken with, and the misinformation being provided to them about the implications of the Supreme Court decision, and in particular, those who have expressed opposition to the enactment of a law on providing medical assistance to the dying.
I hosted a meeting in my constituency with my colleague, the MP for Victoria, the co-chair of the special joint committee, to provide an opportunity to understand the background to Bill C-14, including the ruling by the Supreme Court, the report of the special joint committee and the tabled bill.
I have been deeply impacted in my views by meetings with a constituent suffering deeply with a fast-paced diagnosis of ALS, already unable to speak and desperately hoping to be able to gain assistance in his death when he determines it is the right time for passing.
I have heard from constituents concerned that the bill reduces the rights of Canadians to choose an assisted death, while others expressed concern the bill would increase risks to the disabled. I must share that by far the majority of views expressed to me, including at my public forum, have expressed concern that the bill does not go far enough in upholding the directions by the Supreme Court to uphold the constitutional and charter rights of Canadians.
How well does Bill C-14 address these key needs and concerns? The bill does set forth a basic framework for decriminalizing medically assisted deaths, including right of access. However, instead of following the recommendations of the Special Joint Committee on Physician-Assisted Dying to adopt the clear and precise terms set forth by the Supreme Court to determine access to medically assisted death, this bill would add further onerous, and frankly nonsensical qualifiers. Most notable is the requirement that a person's natural death has become reasonably foreseeable. Surely that is the case for every human being on this earth.
The Carter family, who was the subject of the Supreme Court ruling, has spoken out strongly against these added criteria. Worse, it is the opinion expressed by numerous legal experts that these additional criteria lack legal certainty and would inevitably force already suffering patients to return to the courts or to travel overseas or to kill themselves. None of these options present a compassionate alternative or uphold our constitutional and charter rights.
I would like to share briefly some words that a constituent sent me:
Nineteen years ago, I watched my 87-year-old mother spend three weeks in severe pain as cancer ate her alive, begging to be put out of misery. The proposed law on medically assisted dying is 19 years too late, but at least it will spare others in similar condition. Unfortunately, it doesn't cover those whose death is not imminent but who have medical conditions that are causing them intolerable suffering. That must be rectified before this law is passed.
A second widespread concern expressed to me is the failure of Bill C-14 to provide for advance directives. I am aware from my discussions with Alberta officials that this is a matter of grave concern to Albertans, many of whom are erroneously of the belief that their personal directives cover medical intervention. Many of my constituents have asked me to demand that this right be extended. Again, I quote from a constituent's letter:
I would like to have the ability to have an advance directive that would stipulate the conditions under which I would want to have my life ended. At the point I would want assisted death, I may not have the mental or physical capacity to restate my wishes. If this bill passes without the proposed amendments, my only option will be to go to the river valley some minus-30 night and freeze to death. This, of course, will create stress on my family, the community, and police as they search for my body.
Others have expressed concern that the law would fail to prohibit hospitals or other institutions from denying access to medically assisted death on the grounds of religious beliefs. While they accept that individual medical practitioners should be extended that right, they strongly believe there should be a duty to refer to another practitioner, and preferably for the delivery of services within the same institution. This would be the compassionate decision, given the dire state of many who would be making this request.
While the Special Joint Committee on Physician-Assisted Dying agreed to a waiting period between the request and delivery of the services, many have expressed concern that Bill C-14 would require a 15-day wait period. Much more preferable would be a waiting period as determined by the medical practitioner, based on the circumstances of each case. I can speak from personal experience that to require a suffering sibling to hang on with severe pain for more than two weeks after making the decision to let go is nothing less than cruel and unusual punishment, and surely offends one's charter rights.
The bill will provide protections to practitioners and afford protections for the disabled. What it would fail to do is extend clear rights to Canadians to determine their own fate within reasonable parameters. Equally disappointing is the failure of the current government to include in its budget the promised dollars for palliative care for all Canadians.
I will vote for this bill at second reading to be considered by a committee. However, I implore the government to ensure that our concerns, the concerns expressed by our constituents and by all Canadians, be considered by the committee members who are undertaking simultaneous review, and to give fair and full consideration to any recommended amendments.
