Mr. Speaker, I am pleased to rise today in support of Bill C-7, which proposes amendments to the Criminal Code's medical assistance in dying regime, in response to the Superior Court of Quebec's Truchon decision. I will provide the context for the change.
As we know, in September 2019, the Superior Court of Quebec struck down the federal and Quebec criteria that limit the access to MAID based on circumstances where death is reasonably foreseeable. The court, whose ruling only applies in Quebec, suspended its declaration of invalidity for six months, until March 11, 2020. On February 17, the Attorney General of Canada filed a motion to request a four-month extension to give Parliament the time needed to implement a response and ensure that the law across the country is consistent as it relates to the federal MAID regime.
I will provide a brief overview of the amendments to the Criminal Code that are being proposed under Bill C-7.
First, on the eligibility criteria, the bill would repeal the reasonably foreseeable natural death criteria and exclude persons whose sole underlying medical condition is a mental illness. Second, with regard to safeguards, the bill would create two sets of safeguards, depending on whether a person's death is reasonably foreseeable, while easing some existing safeguards and adding new ones for persons whose death is not reasonably foreseeable. Finally, the bill proposes to allow for a waiver of final consent on the day of the procedure in specific circumstances.
How did these changes materialize? The development of this legislation was informed by the Truchon decision; available Canadian and international reports, such as the December 2018 report of the Council of Canadian Academies; the experience of existing international regimes; and our government's recent consultation on MAID, held in January and early February.
The Minister of Justice, the Minister of Health and the Minister of Employment, Workforce Development and Disability Inclusion, along with their parliamentary secretaries, hosted several federal MAID round tables across the country. These events were attended by experts and stakeholders, including doctors, nurse practitioners, representatives from health regulatory bodies, legal experts, representatives of the disability community, indigenous representatives and other key stakeholders. They shared their experience and insight into MAID and its implementation in Canada over the last four years.
In parallel to these efforts, our government heard from over 300,000 Canadians who participated in the online public survey on MAID between January 23 and 27, 2020. There was an unprecedented number of respondents, reflecting the significance of this issue for Canadians. This kind of input is invaluable to government and, I am certain, was seriously considered by the ministers in the development of the bill.
I would like to provide a personal perspective on the issue of MAID in its previous iteration.
In 2015, when the Liberal government came to power, it was tasked by the Supreme Court to amend MAID. A special joint committee was established, involving both Houses and all parties. The special joint committee conducted an enormous amount of consultation and came up with a proposal. The then minister of justice and minister of health were presented with this proposal. Through intense discussions and consultations, the proposal was amended.
In my riding of Don Valley East, I did a consultation in the sanctuary of the Donway Covenant United Church. Various constituents, as well as other members from across Toronto, participated in the town hall. Members of CARP, the Canadian Association of Retired Persons, were also on the panel. It was an emotional meeting. I clearly remember one of my constituents, who was non-verbal and had to use her communication board, telling me that she wanted advance directives while she was lucid but could not predict whether she would be lucid in the foreseeable future.
In 2019, I had to do another presentation at a church in another riding. Here, overwhelmingly the audience was against the phrase “foreseeable future” and also wanted advance directives.
I am glad to see that some of the changes requested through consultations have now been incorporated. I look forward to the five-year review that is scheduled for June 2020 to see the discussions around advance directives.
I will now go to the bill itself and some of the changes it proposes to the eligibility criteria.
With regard to the proposed Criminal Code amendments in relation to eligibility, the bill proposes to make two changes to the current set of eligibility criteria for MAID. First, it would repeal the reasonable foreseeability of natural death criteria from the list of eligibility criteria in response to the Truchon ruling. That is good news for some of my constituents in Don Valley East. The legal effect of this amendment would be that those whose natural death is reasonably foreseeable and those whose natural death is not reasonably foreseeable would be eligible for MAID if they met all other eligible criteria.
Second, the bill proposes to exclude people whose sole underlying medical condition is mental illness. Many practitioners, stakeholders and experts have identified increased complexities regarding individuals seeking MAID whose sole underlying condition is mental illness. I suggest that this could be an item for Parliament to look at it in its upcoming mandatory five-year review of the MAID regime.
The Council of Canadian Academies' experts group issued a report in 2018 on the same issue and could not come to a consensus on this question. The Government of Quebec has also announced that access to MAID for cases where mental illness is the sole underlying condition would be suspended and that a broad consultation process would be conducted on this issue.
Regarding safeguards, the public needs to know some of the safeguards that will protect the vulnerable. With respect to the applicable safeguards proposed, the proposed Criminal Code amendment would create two different sets of safeguards depending on whether a person's natural death is expected in the near term or not. The first set of safeguards would continue to be tailored to persons who have a reasonably foreseeable death where risks are reduced. The second set of safeguards would be tailored to persons whose death is not reasonably foreseeable and would address the elevated risks associated with the diverse sources of suffering and vulnerability that could lead a person who is not nearing death to seek access to MAID, such as loneliness, isolation, lack of adequate supports and hopelessness.
Bill C-7 proposes to use the reasonable foreseeability of natural death standard to determine which set of safeguards applies to a particular case. This standard would also determine whether a person who is assessed and approved for MAID but who risks dying before the day of the procedure can give consent in advance. I will be discussing that proposal shortly.
How will these safeguards be applied? Specifically, it would require that a MAID request be witnessed by one independent witness instead of two, and it would allow individuals who are paid to provide either health or personal care to act as an independent witness.
On the advance consent or directives, the bill proposes amendments that would allow people who have a reasonably foreseeable natural death, and who have been assessed and approved for MAID, to retain their ability to receive MAID if they lose the capacity to consent.
The bill represents a significant paradigm shift in Canada's legal landscape with regard to medical assistance in dying. I call on members to support this important legislation and send it to committee for further review.
