Madam Speaker, I appreciate this opportunity to discuss the Government of Canada's commitment to establish a framework for medical assistance in dying.
On April 16, I hosted a town hall meeting for the residents of Don Valley East on this matter. As we know, this is a very emotional and personal matter. It was important for me to listen to my constituents' concerns and to ensure that their concerns were heard. Some of my constituents wanted dementia and Alzheimer's to be included, others wanted advance directives, and some wanted protection for the vulnerable.
In order to ensure that there is no confusion on what this bill is all about, I am taking this opportunity to speak on the matter.
Being part of the Abrahamic tradition, I had to park my own beliefs and listen to my constituents and ensure, as a parliamentarian, a balanced approach. Some of my constituents thought that this bill does not go far enough. Others felt that we should not allow it. To help my constituents have a say in this matter, I have asked them that when this bill goes to committee to make a submission to the justice committee.
The Supreme Court of Canada's decision in Carter has significant implications for provincial and territorial governments, and touches many Canadians in a very personal way. A number of individuals have already been granted exemptions by provincial superior courts to access medical assistance in dying. This is in keeping with the conditions set out by the Supreme Court's decision to extend the timeline for its ruling to come into effect to June 6, 2016. It is now time for us to establish a legislative framework for medical assistance in dying to legally become part of the options available to Canadians at their end of life.
Bill C-14 would provide Canadians with greater autonomy over their health care at the end of life, while also providing protection to health care providers and to individuals who may be vulnerable. It would provide provinces and territories with a strong foundation for implementation.
Canada is not the first to implement medical assistance in dying. In Europe, for example, three countries have legislated access to medical assistance in dying: Belgium, the Netherlands, and Luxembourg. In the United States, four states have legislated access.
Where Canada is unique is in the jurisdictional complexities we face. In Canada, the federal government has exclusive jurisdiction over criminal law. However, health care is a shared jurisdiction between the federal, provincial, and territorial governments. Primary responsibility for the provision and delivery of health care services rests with individual jurisdictions. The provinces are responsible for hospitals, the delivery of health care, and regulation of the medical profession, among other things.
As provinces and territories bear ultimate responsibility for the implementation of medical assistance in dying, the scope of the federal legislation has a significant impact on them.
That is why our government has been working collaboratively across governments, while at the same time respecting jurisdictional roles and responsibilities.
When health ministers met in January, they came to an agreement that a robust and consistent regime across the country is in the best interests of Canadians. Health Canada has also engaged in ongoing discussions with health officials in the provinces and territories to hear their views on many aspects of this important issue.
By establishing national eligibility criteria and safeguards, this bill will help ensure consistency across the country as well as respect the underlying criteria of the Canada Health Act.
The proposed legislation will set out who is eligible to receive medical assistance in dying and the safeguards that must be adhered to for medical practitioners to be protected from criminal responsibility.
Provinces and territories cannot modify these Criminal Code exemptions through their own legislation or regulations.
However, the provinces and territories can legislate or introduce policy measures with respect to aspects of medical assistance in dying under their jurisdiction. This could include identifying any special training for offering medical assistance in dying, specific forms to be filled out, or how the cause of death should be recorded.
However, in order to respect the principle of accessibility upheld in the Canada Health Act, provinces, territories, and regulatory bodies would need to consider the implications that any additional guidelines or regulations would have for patient access.
The bill gives the Minister of Health the authority to make regulations about the information to be collected and the processes for collecting it. Working with provinces and territories will be critical to determining how a pan-Canadian monitoring mechanism can be put in place, the types of information to be collected, and the reporting requirements among other elements.
In reviewing the bill, I see that the government has taken into account the concerns of some health care providers; that is, the protection of their conscience rights. The Supreme Court was clear that providers should not be compelled to provide medical assistance in dying. However, the government is also aware that the exercise of such rights may constitute a barrier to access for those who are seeking it.
To address these issues, the government will work with provinces and territories to support access to medical assistance in dying, while respecting the personal convictions of health care providers. This could include, for example, a pan-Canadian system that would facilitate access for patients to willing providers of medical aid in dying.
Throughout the consultations on medical assistance in dying, we heard loud and clear from Canadians calling for more resources for quality palliative and end-of-life care.
With Canada's aging population as well as growing rates of chronic disease, we must consider ways to support the improvement of a full range of options for end-of-life care. This includes better integration and expansion of access to services at home, including palliative care.
Medically assisted dying is a complex and important issue for Canadians and requires collaboration across jurisdictions to ensure that we have a framework that fits within our uniquely Canadian context.
I would therefore like the bill to go before committee where our collective thinking and robust consultation will hopefully result in a better bill, which is satisfactory to all. I think the bill at least provides a foundation for our continued collaboration.
