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Tuesday, May 3, 2016

Emblem of the House of Commons

House of Commons Debates



Tuesday, May 3, 2016

Speaker: The Honourable Geoff Regan

    The House met at 10 a.m.



[Routine Proceedings]



Auditor General of Canada

    I have the honour to lay upon the table the spring 2016 report of the Auditor General of Canada.
    Pursuant to Standing Order 108(3)(g), this document is deemed to have been permanently referred to the Standing Committee on Public Accounts.


Government Response to Petitions

    Mr. Speaker, pursuant to Standing Order 36(8), I have the honour to table, in both official languages, the government's response to four petitions.

Committees of the House

Fisheries and Oceans 

    Mr. Speaker, I have the honour to present, in both official languages, the second report of the Standing Committee on Fisheries and Oceans in relation to its study of the main estimates for the fiscal year 2016-17.


Canadian Bill of Rights

    She said: Mr. Speaker, I would like to thank the member for Desnethé—Missinippi—Churchill River for seconding this bill. The bill would amend the Canadian Bill of Rights to include the right to proper housing for all at a reasonable cost and free of unreasonable barriers.
    Having a roof over one's head is a basic necessity. People who live on the streets do not know where they will sleep that night, whether they will eat, or where to find shelter from the bitter cold. It is much harder for them to find work, and their lives are very precarious. This affects their physical and mental health.
    In Canada, at least 235,000 people experience this every year. Canada has recognized the right to housing internationally. It must do so in its own federal laws as well.

    (Motions deemed adopted, bill read the first time and printed)


Secure, Adequate, Accessible and Affordable Housing Act

    She said: Mr. Speaker, this time I would like to thank my colleague from North Island—Powell River, who is seconding this important bill.
    The bill calls on the government to develop a national housing strategy. Canada is the only G8 country that does not have one.
    The current government talks about a strategy, but the process to implement such a strategy is crucial. It is not enough to simply consult the provinces, territories, municipalities, aboriginal communities, and housing groups. It is too easy to consult them, but then completely ignore the recommendations that are not to the government's liking.
    Instead, the government must work in partnership with all stakeholders to reach a satisfactory agreement that is flexible enough to meet the varied needs of our distinct regions.

    (Motions deemed adopted, bill read the first time and printed)


Genetic Non-Discrimination Act

    He said: Mr. Speaker, it is a great honour to give first reading to Bill S-201, an act to prohibit and prevent genetic discrimination. I want to thank my hon. colleague, the member for Madawaska—Restigouche, for seconding this.
    The bill would create a new genetic non-discrimination act that would prohibit all service providers from demanding genetic testing or requiring that a person disclose the results of past genetic testing. It also provides for a complaint procedure for federal employees facing disciplinary actions because of genetic testing, and adds genetic characteristics as a prohibited ground of discrimination under the Canadian Human Rights Act. The protections in the bill would enable Canadians to access medical advances in genetic testing without the fear of negative consequences or repercussions on them and their families. It would empower Canadians to have better health.

     (Motion agreed to and bill read the first time)


Human Rights  

    Mr. Speaker, I rise today to present an electronic petition calling on the federal government to establish an independent judicial inquiry into Canada's treatment of Afghan detainees since 2001. It was initiated by Craig Scott, former MP for Toronto—Danforth and professor at Osgoode Hall Law School, and is signed by over 700 Canadians. The petitioners want an investigation into the facts, the conduct, and decisions of Canadian officials, as well as a public report assessing whether Canada complied with international human rights law. In tabling this petition today, the government will now be required to provide a written response within 45 days. I know many Canadians are expecting that the government will take these concerns seriously.

Physician-Assisted Dying  

    Mr. Speaker, I have the honour of presenting two separate petitions today, one from the people in my riding and the surrounding area, and another from British Columbia; Sherbrooke, Quebec; St. Catharines, and other areas in the Niagara Peninsula. All of these petitioners call on the government to draft legislation that will include adequate safeguards for vulnerable Canadians, especially those with mental health challenges, clear conscience protection for health care workers and institutions, and the protection of children under age 18 from physician-assisted suicide.

Public Safety  

    Mr. Speaker, it is fitting that during Iran Accountability Week on the Hill, I rise in the House today to present a petition put forward by the Canadian Coalition Against Terror and signed by dozens of Canadians, who call for the Government of Canada to maintain a listing of the Islamic Republic of Iran as a state sponsor of terrorism, pursuant to section 6.1 of the State Immunity Act.




    Mr. Speaker, you will not be surprised to learn that I have a petition on housing calling on the Government of Canada, in collaboration with the provinces, territories, municipalities, community partners, and other players to maintain and expand the right to housing and the federal investment in social housing. This would include renewing the funding for long-term agreements. Some agreements have already expired, and people are in need. I have hundreds of signatures of people calling on the government to pay special attention to this.


Public Safety  

    Mr. Speaker, I have two petitions. The first one is on the same note as my colleague from Parry Sound—Muskoka, where the petitioners call on the Government of Canada to maintain the listing of the Islamic Republic of Iran as a state supporter of terrorism, pursuant to section 6.1 of the State Immunity Act, for as long as the Iranian regime continues to sponsor terrorism.


    Mr. Speaker, in the second petition, the petitioners call upon the House of Commons to pass legislation which would recognize preborn children as separate victims when they are injured or killed during the commission of an offence against their mothers, allowing two charges to be laid against the offender instead of just one.

Impaired Driving  

    Mr. Speaker, I am honoured to present a petition from constituents in Langley, British Columbia, who believe that the impaired driving laws in Canada are much too lenient and should be changed. They call on Parliament to change the charge of impaired driving causing death to vehicular manslaughter. They believe that a person who has been convicted should have a driving prohibition, and that there should be mandatory sentencing if the person causes death while driving impaired, with a minimum five-year sentence.

Questions on the Order Paper

    Mr. Speaker, the following questions will be answered today: Nos. 75 and 77.


Question No. 75--
Mr. Mark Strahl:
     With regard to “A Special Report on Wild Atlantic Salmon in Eastern Canada” prepared by the Minister of Fisheries and Oceans’ Advisory Committee on Atlantic Salmon: (a) what scientific analyses were completed by the Department of Fisheries and Oceans on each of the 61 recommendations contained in the report; (b) which of the recommendations identified in (a) have been implemented in whole or in part; (c) of the recommendations identified in (b), what was the cost of implementation both on a one-time and ongoing basis; and (d) when are the remaining recommendations of the Advisory Committee on Atlantic Salmon, in whole or in part, expected to be implemented?
Hon. Hunter Tootoo (Minister of Fisheries, Oceans and the Canadian Coast Guard, Lib.):
     Mr. Speaker, in response to (a), initial analysis of all recommendations has been undertaken by departmental scientists and other subject area experts to determine available scientific evidence, activities already under way, stakeholder views, as well as jurisdiction’ roles and responsibilities of various partners and provincial governments.
    In response to (b), amore detailed analysis of the report is currently under way. Initial review indicates that, to a large extent, the recommendations reflect many of DFO’s current activities in support of salmon conservation. As such, many of them are either already being advanced or will be during 2016 and subsequently on an ongoing basis. Some notable highlights include the following: (a) review of the wild Atlantic salmon conservation policy in partnership with members of the Atlantic Salmon Advisory Committee. This review will address a number of key recommendations made within the report; (b) continuation of departmental efforts to press for reduced international harvesting through fora such as the North Atlantic Salmon Conservation Organization, NASCO, particularly for harvests off western Greenland; (c) continue to engage with France, St- Pierre-et-Miquelon, to reduce its catch and indicate Canada’s desire to see it accede to NASCO; (d) creation of collaborative venues to coordinate and work collaboratively with university researchers, non-governmental organizations, private researchers, in an effort to identify, prioritize and promote collaboration and information sharing on wild Atlantic salmon research; (e) engagement with provinces and first nations on recommendations related to their interests or jurisdictions; (f) explore the use of innovations in technologies and intelligence to improve and strengthen enforcement efforts; (g) use the precautionary approach framework and its various elements to determine harvest levels; (h) work with groups like the International Council for the Exploration of the Sea, ICES, on scientific research on the composition of mixed stock fisheries and genetic estimates; and (i) continue to evaluate the annual and multi-year approaches to the management of stocks on a case-by-case and province-by-province basis through annual workshops and consultation processes.
    In response to (c), the report of the Ministerial Advisory Committee on Atlantic Salmon and its recommendations generally align with Fisheries and Oceans Canada’s current program of work for wild Atlantic salmon conservation. As such, it is expected that many of the recommendations can be advanced incrementally, and over both the short and long terms, within existing departmental resources.
    In response to (d), DFO will take actions to implement recommendations under its mandate, when such recommendations are supported by the best available science. In some cases, the department will develop and review options to determine the best path forward to implementing the recommendation. It is recognized that, in some cases, other departments, jurisdictions, and partners may have lead or supporting roles in implementations. For recommendations, such as those focusing on the food, social and ceremonial fishery, FSC, DFO will continue to work with aboriginal partners and indigenous groups, while ensuring that FSC access is not unduly compromised.
Question No. 77--
Hon. Gerry Ritz:
    With regard to the Minister of International Trade and her negotiations with the United States on softwood lumber: (a) when did formal negotiations on a new Softwood Lumber Agreement commence; (b) how many negotiating sessions have been held to date; and (c) who were the participants of those negotiations in Canada, the United States or elsewhere?
Hon. Chrystia Freeland (Minister of International Trade, Lib.):
    Mr. Speaker, in response to (a), the softwood lumber agreement has been in focus since the Minister of International Trade assumed office on November 4, 2015.
    Negotiations and discussions between officials from Global Affairs Canada and officials from the Office of the United States Trade Representative have taken place on a routine basis. The Minister of International Trade regularly raises this issue with her counterparts in the United States and, in conjunction with her parliamentary secretary, continues to consult widely with domestic stakeholders, including industry representatives and provincial governments, in order to ensure an outcome is achieved that will benefit all of Canada.
    During the March 10, 2016, state visit to Washington, D.C., the Prime Minister and the U.S. President publicly expressed their interest in a long-term agreement. Both leaders tasked their ministers to intensively explore all options and report back in 100 days on the key features that would address the softwood lumber issue.
    In response to (b), discussions include regular phone calls and in-person meetings. In addition to bilateral meetings held in Washington, D.C., the minister has also had bilateral meetings and discussed the issue with her U.S. counterparts while in Davos, Switzerland, and Nairobi, Kenya.
    In response to (c), various staff and officials in the Ministry of International Trade have been involved in the file, including: the Minister of International Trade; Christine Hogan, deputy minister of international trade; Kirsten Hillman, acting assistant deputy minister, trade agreements and negotiations branch; Martin Moen, director general, North America and investment bureau; Aaron Fowler, director, softwood lumber division; Gilles Gauthier, minister, economic affairs, Embassy of Canada to the United States of America; Colin Bird, minister-counsellor, trade and economic policy, Embassy of Canada to the United States of America; Michael Owen, senior counsel and deputy director, investment and services law division; Alexander Monchez, senior trade policy officer, softwood lumber division; and Zachary Archambault, senior trade policy officer, softwood lumber division.
    In processing parliamentary returns, the government applies the Privacy Act and the principles set out in the Access to Information Act, and certain information concerning the names of foreign delegates has been withheld on the grounds that the information constitutes personal information or would be injurious to the conduct of international affairs.


Questions Passed as Orders for Returns

    Mr. Speaker, furthermore, if Questions Nos. 74, 76, 78, 79, 82, and 83 could be made orders for return, these returns would be tabled immediately,
    The Speaker: Is that agreed?
    Some hon. members: Agreed.


Question No. 74--
Mr. Mark Strahl:
     With regard to Fisheries and Oceans Canada' commitment in the 2016-17 Report on Plans and Priorities to increase the amount of marine and coastal protected areas to five per cent by 2017 and ten per cent by 2020, in part by advancing the Hecate/Queen Charlotte Sound Glass Sponge Reefs, the Anguniaqvia niqiqyuam, St. Ann’s Bank, the Laurentian Channel, and the American Bank towards designations as possible new Marine Protected Areas (MPA) under the Oceans Act: (a) how were these five areas identified; (b) what scientific analyses were completed in relation to the identification of these five areas; (c) what activities are the Department of Fisheries and Oceans proposing to prohibit from taking place in each of these designated areas; (d) what is the expected economic impact of giving these areas an MPA designation; and (e) has Fisheries and Oceans Canada held consultations with those who may be adversely affected economically by the MPA designation?
    (Return tabled)
Question No. 76--
Mr. Scott Reid:
     With regard to E Division of the Royal Canadian Mounted Police (RCMP), in the province of British Columbia, from 2011 to 2015, inclusively: (a) how many of the following were equipped with Automated External Defibrillators (AEDs), broken down by year, (i) all vehicles, (ii) patrol vehicles, (iii) supervisor vehicles, (iv) marine vehicles, (v) other vehicles; (b) for each RCMP jurisdiction and detachment, broken down by year, (i) how many vehicles carried AEDs, (ii) how many occasions were RCMP vehicles dispatched in response to calls for which medical assistance was the primary purpose, (iii) how many occasions were RCMP officers the first emergency services personnel to arrive on scene when medical assistance was the primary requirement, (iv) what was the total number of instances where an AED from an RCMP vehicle was used, (v) with regard to instances where an AED from a police vehicle was used, how many subjects survived, (vi) what was the total number of instances where a Conducted Energy Weapon (CEW) was discharged by an RCMP officer, (vii) what was the total number of instances where an AED from an RCMP vehicle was used after a CEW was discharged by an RCMP officer; (c) what are the annual costs associated with AEDs in police vehicles and what do these costs account for, broken down by year; (d) what was the financial cost of all the AEDs identified in (a); and (e) what are the legislative, policy and regulatory instruments which govern the use of AEDs by the RCMP in British Columbia?
    (Return tabled)
Question No. 78--
Mr. John Nater:
     With regard to federal spending within the electoral district of Perth—Wellington for each fiscal year from 2011-2012 to 2015-16, what is the list of grants, loans, contributions and contracts awarded by the government, broken down by (i) department and agency, (ii) municipality, (iii) name of the recipient, (iv) amount received, (v) program under which the spending was made, and (vi) date?
    (Return tabled)
Question No. 79--
Mr. Blaine Calkins:
     With regard to the government’s decision to resettle 25 000 Syrian refugees, what is: (a) the total dollar value being disbursed to each refugee upon arriving in Canada; (b) the total dollar value the government is providing each refugee on a monthly basis; (c) the anticipated end date for the government’s financial assistance to each refugee; (d) the monthly cost for all refugee temporary housing; and (e) the cost of any and all subsidies provided to Syrian refugees once placed in permanent housing?
    (Return tabled)
Question No. 82--
Mr. Guy Caron:
     With regard to the Natural Sciences and Engineering Research Council of Canada’s PromoScience Program, for 2015: (a) which organizations received funding; (b) how much did they receive, in total and broken down by organization; (c) where are these organizations located, broken down by city?
    (Return tabled)
Question No. 83--
Ms. Niki Ashton:
    With regard to the government's use of temporary help services and contracts: (a) what companies are contracted by the government to provide temporary help services, broken down by department and agency; (b) what is the average length of employment for temporary workers, broken down by department and agency; (c) what mechanisms does the government use to track the work done by contractors across government departments and agencies; (d) how many temporary staff were hired by the government, broken down by (i) province and territory, (ii) year, from 1999-2000 to present; (e) how much is disbursed by the government on average for (i) temporary staff, in terms of annual full-time equivalency, broken down by classification, (ii) permanent staff, in terms of annual full-time equivalency, broken down by classification; (f) what is the percentage change in expenditures for temporary help services and salary costs for indeterminate, term, and casual employees from 2008-2009 to 2014-2015 (in unadjusted dollars, reference 1999-2000); (g) what were the reasons given for engaging temporary help services, broken down by year, beginning from 2007-2008; (h) what were the percentages of contracts allocated for temporary help services for each cost range of less than $20,000, between $20,000 and $60,000, and more than $60,000, broken down by (i) reasons for the hires, (ii) year, beginning from 2007-2008; (i) what is the average age of temporary staff hired, broken down by (i) region, (ii) department or agency, (iii) classification?
    (Return tabled)


    Finally, Mr. Speaker, I would ask that all remaining questions be allowed to stand.
    The Speaker: Is that agreed?
    Some hon. members: Agreed.


[Government Orders]


Criminal Code

    The House resumed from May 2 consideration of the motion that Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), be read the second time and referred to a committee.
    Mr. Speaker, I am here today to talk about an issue that touches the lives of every Canadian—how we die. It is not an issue we usually like to discuss, but with the Supreme Court's decision in the Carter case, it is now at the forefront of our government's political and health agenda. On February 6, 2015, the Supreme Court of Canada unanimously declared that the criminal court prohibitions on physician-assisted dying were constitutionally invalid. Changes will come into effect on June 6 of this year. All governments are preparing to respond.
    Consultations with the public have made it clear that there is extensive support for the provision of medical assistance in dying. An Angus Reid research poll that was published earlier this month found that 90% of Canadians surveyed think that some form of assisted dying should be allowed. The government takes the Supreme Court of Canada decision seriously.
    It is a deeply felt and sensitive issue for all Canadians, and we understand it is essential that implementation of this new legislation be undertaken with careful consideration. That is why the government has developed a framework based on empathy, appropriate protections for vulnerable Canadians, and the need for choice. Careful consideration has been given to the eligibility criteria, substantive and procedural safeguards, and recommendations for monitoring and reporting.
     I also want to make it clear, however, that medical assistance in dying is not to be the only choice for a peaceful, dignified death. No matter where people stand on the issues surrounding medical assistance in dying, they all agree that we must improve palliative care. Palliative care is a multidisciplinary approach to health care for individuals and families who are living with a life-threatening disease as well as other conditions. It focuses on improving quality of life through the prevention and relief of physical and psychological suffering, with treatment plans tailored to the needs of the patient and the family.
    Reports about the status of palliative care in Canada suggest that the delivery of and access to palliative care and hospice care varies greatly across Canada. This is due to differences in regional demographics, societal needs, organization of health care services, and levels of funding.
    When asked, most Canadians indicate that they would prefer to die at home in the presence of loved ones. There is clearly a need to bridge this disconnect and for all levels of government to support the needs and desires of Canadians at the end of their lives to receive the most appropriate, timely, and compassionate care. The gaps in palliative care have been raised repeatedly over the years by a number of organizations. It is very clear that Canadians are looking to their governments for leadership to close these gaps.
    In the past, palliative care in Canada has been delivered primarily in hospitals by specialists, and largely to cancer patients in the last stages of their illness. While many people still associate palliative care with hospitals and cancer patients exclusively, it can be delivered to a variety of patients and in different settings, including long-term care facilities or even one's own home.
     It is estimated that the health system is currently unable to provide palliative care to 70% of those who could benefit from it. This is why our government is taking immediate steps to address this gap and work with the provinces and territories so that more Canadians have access to the care options that are right for them when they need them.
    The government is currently funding the Pallium Foundation of Canada to support training in palliative care to front-line health care workers, and this initiative is complementing a previous initiative called the way forward. This is aimed at integrating a palliative-care approach throughout the health care system and across a range of providers and settings.
    The federal government has also supported a number of initiatives to improve public awareness: health care professional education and training, national best practices, and standards and research. Federal investments in research also expand the depth and breadth of understanding of end-of-life-care issues and how best to address them.


    Recently, the federal government provided $14 million over two years for the Canadian Foundation for Healthcare Improvement to support applied health services research, as well as the foundation's work to identify savings and efficiencies in the health care system, including a palliative care component. In budget 2016, the government also committed to making compassionate care benefits easier to access, more flexible, and inclusive for those who provide care for seriously ill family members, and more flexible parental leave benefits to better accommodate unique family and work situations.
    As with other health care services, delivery of palliative care is mainly the responsibility of the provinces and territories. While each province and territory has some level of palliative care services, with some moving ahead with frameworks or strategies, there are wide variances both within and between jurisdictions. Many are focusing on integrating palliative care with other types of care across settings and services. However, Canadians' ability to access palliative care remains mixed, depending on where one lives.
    The Government of Canada has committed to developing non-legislative measures that would support the improvement of a full range of options on end-of-life care. In the discussions with provincial and territorial governments toward developing a new health accord, our government has committed to provide $3 billion over the next four years to improve home care, including palliative care.
    I firmly believe my own experiences with end-of-life care are not unique from those of thousands upon thousands of Canadians. Losing my grandfather John, my mother, Gaye, and my Aunt Babs is something that has never left me. These people were titans in my life. My mom and Aunt Babs taught me everything I know about being passionate and determined, about giving of oneself to others, and about what it means to be a woman. They both had such a profound effect on every day of my life. I am here totally because of their legacy of excellence.
    Both of these women, who were so strong and committed to family and community, were so harmed as human beings by diseases that ravaged them. I learned what it meant to sleep on the floor day after day because they were afraid to be alone. I learned how to administer morphine and Ativan and that, if they even whimpered, I was to give more, as that meant they were still being torn apart inside.
    I learned how to raise or lower a home hospital bed. I learned how important palliative care is, to have access to it, but these are things I wish I had never had to learn. From all of them, I learned in those last days that there was no peace; there was only pain. There was no dignity, only terrible uncertainty. There was not nobility in their suffering. I learned pity.
    I am proud to stand in the House today and express my support for this critical piece of legislation. Not only does it respond to the decision by the Supreme Court of Canada in terms of amending the Criminal Code, but it also provides an excellent framework to facilitate the necessary changes to our health care system, which responds to this decision.
    Our government has listened to Canadians. Our government has listened to the experts. We have developed an approach that we believe reflects this input. It is now time to move forward with this legislation so that individuals, families, and health professionals have more options for end-of-life care, including medical assistance in dying.


    Madam Speaker, I want to thank my colleague for her gracious words in describing what she has gone through. As she said, many people have gone through those tough times.
    I have a question. The minister, yesterday, stood in the House and stated that there were $3 billion for palliative care, yet there was nothing in the budget. I am wondering if the member can explain where those dollars will come from and how they will be allocated.
    Madam Speaker, the budget did indeed include $3 billion for home care. As the member may know, the minister has spoken a number of times in the House about her negotiations with the provinces and territories regarding how this framework for health care in general across Canada will be determined.
    As I said in my speech, it is the prime responsibility of the provinces and territories and our responsibility as a federal government to work with them to find the best way forward for individuals in the provinces and territories.


    Madam Speaker, I thank the hon. member for her very moving speech on this issue.
    In paragraphs 13 and 14 of the Carter decision, the Supreme Court of Canada referred to the cruel choice faced by patients with degenerative disease. Under the government's current bill, those patients cannot provide advance directives. They have to choose between taking their lives prematurely or suffering for the rest of their lives because they cannot satisfy the conditions under which they could have access to medical assistance in dying.
    Why did the government reject this recommendation? Does the hon. member think that this could be amended at committee stage?



    Madam Speaker, when we look at the Carter decision and the government's response to that decision, it is about finding a balance. As I said in my speech, we listened to Canadians and to the experts. We recognize that June 6 is a very imminent date and that we have found the best solution for now.
    As the member may know, there was a commitment to look at three or four further elements, including advance care decision-making. I believe there is a commitment to work on that, going forward. I welcome the work from the member opposite on that issue.
    Madam Speaker, we have had many comments in the House that the government has not gone far enough with Bill C-14 in being prescriptive about how it would be applied to the different types of medical institutes that are provincially regulated. They are similar to comments about how we would apply climate change legislation provincially, when provincial governments have already started the work on this.
    In light of what Quebec has done already in terms of applying this, could we have a comment on the role between the federal and provincial governments in applying this legislation?
    Madam Speaker, there is a very strong role for the federal government to work with the provinces and territories. There are many questions yet to be answered during the discussions with the provinces and territories, and there are best practices around the world that have been examined and will continue to be examined with respect to implementation.
     I do not believe that, as a federal government, our role is to be prescriptive. It is to provide the tools to help the provinces and territories build the framework for their own situations. In my speech I talked about the access being different depending on where one lives. Sometimes it is about geography. Therefore, we have to address the multitude of options that will be available.
    Madam Speaker, I am thankful to be able to add my voice to the discussion on Bill C-14, medical assistance in dying.
    The Supreme Court of Canada has put what I perceive as an inappropriate timeline on this House in regard to this legislation, because it has come to the conclusion that the Criminal Code of Canada is unconstitutional in making it illegal for anyone to cause the death of another person who consents to die or to assist a person to end their own life.
    In speaking with a very concerned constituent last week who was in law school when the charter was enacted, the comment was made that the university law professors of the day assured a troubled graduating class that what is actually happening today would never happen.
    We are now in a place where, in attempting to guarantee every person their charter rights and freedoms, we are endangering the rights and freedoms of others. A synergy of wisdom and selflessness is needed in balancing what is perceived as best for me in relation to what is best for others. Just because we can, does not mean we should.
    As well, in determining if we should, it seems to me the wise approach would be to look at those who already did, and regret. This would require learning from recent history rather than pretending that what we are doing is somehow progressive, when it has already been proven to be a regressive decision elsewhere.
    The Supreme Court has chosen to ignore its own previous decision on the issue, along with six different parliaments that have previously rejected assisted suicide. It appears that the plumb line is not what is best for society and humanity as a whole, but rather what is the latest progressive trend that is putting the strongest pressure on how we live and relate as a society.
    I have been a pastor's wife, and a caregiver in hospitals and level 4 care homes. I have worked in a mental illness hospital. I have been an education aid for special needs children in kindergarten and high school students.
     I am the daughter of a father with Alzheimer's, the grandmother of a high-achieving grandson with autism, and I have a loved one who is suffering with mental illness. I, too, am well aware of life's challenges. My personal belief is that life is sacred from conception to natural death, and the protection of the most vulnerable in our society must always be the determining factor in how we choose to govern and make laws in Canada.
    This is the expression as well that has been sent to me over and over again from constituents in my riding and across Canada, and today we need to have a debate in this House that is very balanced and presenting all views from all people in Canada.
    Life is challenging, and dying, far more often than not, is difficult for the one passing away and in some ways even more so for those experiencing end of life alongside the individual who is dying. I believe there is value in that as well.
    The misfortunate reality of Bill C-14 is that it will cause far greater grief than it will appease. Making something legal does not make it morally right. People who request a physician-assisted death can be motivated by a range of factors unrelated to their medical condition. These factors can make some people vulnerable to request assisted death when what they want and deserve is better treatment and palliative care.
    It needs to be pointed out that the Belgian euthanasia law does not apply to non-competent patients and it does not allow the deliberate shortening of their lives. The Belgium euthanasia law system, which Bill C-14 mirrors, has been proven to be abused and insufficient to monitor the decision-making process.
    For example, the Journal of Medical Ethics published a research article written by Raphael Cohen-Almagor, a human rights activist and chair of the politics department at the University of Hull. His article “First do no harm: intentionally shortening lives of patients without their explicit request in Belgium” focuses mainly on published data concerning the practice of causing death without patient request in Belgium.
     The research indicates that the practice remains common, resulting in over 1,000 hastened deaths without request each year, or 32% of the cases of euthanasia. Moreover, in almost half of those cases the doctors refused to report the matter to the overseeing body, despite a legal requirement to do so.
     This example clearly shows the legislation is lacking an oversight by an independent third party before the patient is put to death. Sadly, but realistically, the safeguards in Bill C-14 are likely to be insufficient and ineffective in real life conditions.


    Furthermore, Bill C-14 applies to those with physical or psychological illnesses who are experiencing enduring and intolerable suffering as a result of their medical condition. Our focus must first be on raising the quality and availability of high-quality palliative care as the humane way to relieve pain, loneliness, and fear for the end-of-life patient and to provide encouragement, direction, and support for loved ones through the natural process of end of life. Bill C-14 does not require a palliative care route be entered upon first, neither does it require the patient to have tried other treatments before requesting medical assistance to die.
    As well, I am still deeply concerned for our medical professionals who have contacted me in great numbers who could face severe consequences if they do not assist an individual to take their own life, for whatever reason. No one in our country should be forced to affirm or provide a service that goes against their conscience. The federal government's law leaves this crucial issue for the provinces to deal with, allowing even more interpretations of the general wording.
    There should be a structured national system to address the cases when a publicly funded health care organization or separate doctors are unwilling for any reason to provide aid in dying when the patient has requested it.
    Furthermore, the bill extends the amendments to the Criminal Code for medical practitioners, nurses, and registered practical nurses. Such an approach is broader than any other jurisdiction in the world and makes it impossible to create a transparent national system.
    It is necessary to take into consideration the psychological factors that Bill C-14 would actually influence and encourage. The secularism of our courts affirms a premise that everything is socially constructed, and as a result laws greatly shape the ethos of culture, affecting cultural attitudes toward certain behaviours and influencing moral norms. Medical assisted dying laws send a message that in certain conditions suicide is a reasonable and appropriate way out. The problem is that this message will be received not only by those who have painful, terminal illnesses, but also by those who are tempted to think they can no longer go on.
     A study by David Jones and David Paton proved that legalizing assisted dying in other states has led to a rise in overall suicide rates, both assisted and unassisted. This greatly undermines the work of suicide prevention organizations and programs.
    As the Conservative deputy critic for veterans affairs and a member of the veterans affairs committee, I believe legalizing assisted suicide would only increase the challenges of providing mental health care and suicide prevention initiatives for those suffering from post-traumatic stress injuries.
    I agree with my Liberal colleague from Winnipeg Centre who spoke last evening that the government should at the very least postpone legalizing assisted death for at least five to 10 years, until it is absolutely clear what sort of impact it would have in all corners of Canada. His concern is well founded in regard to fighting the suicide spirit that needs to be healed on our reserves in Canada.
    Another report in Current Oncology from 2011 summarized that euthanasia in the Netherlands has changed significantly in the 30 years since it was first adopted. It has shifted from medically assisted dying for people who are terminally ill to those who are chronically ill, from physical illness to those who suffer from mental illness, and then to those who suffer the psychological distress of mental suffering, and now to euthanasia of those over 70 who are simply tired of living.
    The culture now is that euthanasia becomes expected while palliative care and functional hospice is gradually portrayed and felt to be “selfish”. That is a quote from the UK Daily Mail on September 24, 2013.
    This implicates that the bill would not only affect those making a rational and deliberate choice to end their lives, but would also have a significantly wider impact on those who are required to provide such a service or their privilege and right to work in the medical field could be challenged, and also on wider social groups as a whole.
    When facing a choice, which we are with the bill, where should the priority for us as legislators be? The imposition by the Supreme Court of Canada to invoke such controversial legislation, which is proven to be failing in other countries; the approach of the committee to manage witnesses and to make recommendations that go far beyond the Carter decision; and the need to first of all institute high-quality palliative care as an intrinsic value and an actual clear priority of the government are all valid reasons that I feel I cannot support Bill C-14.


    Madam Speaker, I appreciate the views the member expressed in addressing this legislation.
    The question I have is related to the Supreme Court of Canada. Every Supreme Court judge, and it was unanimous, indicated that Canada needed to change the law. There is a void that was created back in February. The Supreme Court gave us a legal mandate of one year. There was an extension granted. There is no doubt that if we believe in the rule of law and respect our Supreme Court that there is a requirement for us to bring forward legislation. The legislation has to pass by June 6 in order to fill that void. There is no option to not fill the void. It is our parliamentary responsibility.
    Does the member believe, as many of us inside this chamber believe, that we do have a responsibility to respond to the Supreme Court of Canada, recognizing that while this might not be perfect legislation, there is that responsibility? To the best of my knowledge, I believe that this legislation meets that criteria. What does the member have to say in regard to that responsibility?
    Madam Speaker, I do appreciate the question, and I expected it.
    I have the greatest respect for our Supreme Court. I have had the privilege of being part of an orientation, going there, and listening. It is not that I do not respect the Supreme Court and its role. However, as a parliamentarian my first responsibility is to Canadians.
    I feel that the initial one-year decision by the Supreme Court was wrong. It is not enough time. Then, for the government to request six months and only be given another four months, I believe that is wrong.
    We are in a situation here in Canada where we cannot get this wrong. Changing things as we go is very difficult, as my friend on this side of the House said last night. We need to do it right.
    My first responsibility is to Canadians. Our first responsibility is to do what is right, regardless of the situation we are facing under pressure. I am not a lawyer. I understand the Charter of Rights and Freedoms has a notwithstanding clause that should never be abused, but perhaps in this situation that is what we should be looking at.


    Madam Speaker, I listen with great interest to the debate on this very important issue.
    However, there seems to be some confusion as to what we have been asked to do by the Supreme Court. This is not an optional measure that we are taking. The government has no option to put this bill in. It has been ordered by the court, and that is how our constitution works.
    I am hearing a rather extraordinary request from the member, which is for the government to invoke the notwithstanding clause. I am not sure that would actually work in this instance. I am wondering if the member would care to elaborate on that.
    Madam Speaker, I am not a lawyer. We all know that. I am speaking from my heart, and I am speaking for Canadians across this country who are very concerned about the responsibilities that we have in coming to a decision on this. Ultimately, I feel our responsibility, first of all, is to Canadians. I understand that it is a difficult situation that I am putting forward.
    I guess I am a politician, because I went through the process and I am standing here today. However, I have to say that at this point in my life it is not about a career, and it has nothing to do with being seen to do what certain people in the House feel we should do. It is to respond to what I believe is right in this circumstance in Canada.
     We have seen where this is severely abused in other countries. We have already heard from our own committee and from people across the House that they want more. The Carter family is not happy. The situation is extremely complex, and I do not believe we should be rushed into a decision.
    Madam Speaker, I am pleased to speak in support of Bill C-14, which would address medical assistance in dying.
    The government has listened very carefully to Canadians and reflected upon the invaluable contributions of the special joint committee of members of the House of Commons, senators, the external panel, the provincial-territorial expert advisory group, and many others throughout our nation.
    The bill appropriately recognizes the autonomy of Canadians to choose medical assistance in dying, while also protecting vulnerable persons and respecting the Carter decision of the Supreme Court of Canada.
    My remarks will focus upon the eligibility criteria and procedural safeguards, which together represent the heart of the bill.
    As the Minister of Justice has stated, the bill is aimed at addressing the issues raised by the Carter decision. The government has committed to collecting and analyzing evidence regarding how medical assistance in dying is working in practice and considering the findings of independent studies into additional issues that were not addressed in the Carter decision, which will be launched after the bill is passed.
    Given the fundamental societal and medical issues that medical assistance in dying raises for our country, a cautious approach is in fact warranted. The stakes are just too high.
    The bill contains five key eligibility criteria.
     First, the bill would also require that the person requesting medical assistance in dying be at least 18 years of age and be capable of making decisions with respect to their health.
    Several witnesses before the special joint committee, including the Canadian Paediatric Society, noted that medical assistance in dying raised unique considerations when it came to young people. Assessing a minor's capacity to decide to seek medical assistance in dying is difficult when the stakes are so high and the decision is irreversible.
    Importantly, the committee also heard that there was in fact no Canadian pediatric data regarding requests for medical assistance in dying from young people or whether pediatricians would be willing to participate in this procedure. Prudence and common sense support further study of this very difficult issue.
    With respect to capacity, this requirement means people must be able to confirm their choice at the time the medical assistance in dying is in fact provided. Therefore, the bill would not permit what are commonly called “advance requests”.
     Permitting medical assistance in dying to be administered to a patient who is unable to express his or her wishes increases the risks of error and abuse. People who cannot express their wishes may want to continue living, even though they made a request at an earlier point in time.
    Simply put, an advance request takes away the right of people to change their minds when they lose capacity.
    The proposed approach also recognizes that physicians and health professionals frequently struggle with interpreting and applying other evidence directives in general. Advance requests for medical assistance in dying would be even more complicated to administer. Clearly, there is a need for further study and evidence concerning advance requests.
    The bill also contains eligibility criteria that people make a voluntary request for medical assistance in dying and that they do so with the benefit of fully informed consent.
    These requirements are common sense.
    Medical assistance in dying must not be an alternative in situations where patients might prefer a different treatment, but are not aware of it or they do not know their diagnosis or its likely trajectory. Nor must it be the product of external pressure or the person's belief that he or she is a burden or unwanted.
    Next, the bill would require that the person be suffering from a grievous and irremediable medical condition. This is defined term that has several characteristics, including the condition is serious and incurable; the person is in an advanced state of irreversible decline in capability; the condition is causing the person enduring suffering; and the person's natural death has become reasonably foreseeable in all of his or her medical circumstances, without requiring a specific prognosis.


    The bill intends to permit medical assistance in dying as a choice for Canadians whose lives are on a path toward their end. As the Supreme Court suggested in various places in Carter, medical assistance in dying is similar in nature to forms of end-of-life care, such as palliative sedation, or the withdrawal of life-saving treatment. This definition is intended to allow for flexibility for physicians and nurse practitioners to consider all of the person's medical circumstance.
    Bill C-14 is clear that no specific prognosis of time remaining is required. Moreover, a person could qualify based on the cumulative effect of multiple conditions or medical circumstances that individually may not be fatal, but when taken together make the person's death reasonably foreseeable. For example, people in medical circumstances similar to those experienced by Kay Carter, Gloria Taylor, Sue Rodriguez, as well the people who have obtained individual constitutional exemptions across Canada since the Supreme Court's ruling this past January, would all be eligible under this bill.
    However, medical assistance in dying is not a solution to all forms of medical suffering. Such an approach would raise unacceptable risks, particularly for vulnerable people throughout our society. Take the example of someone who is exclusively suffering from a physical or mental disability, but who is otherwise in good health and whose natural death is still many years away. Making medical assistance in dying available to people in these circumstances risks reinforcing negative stereotypes of the lives lived by Canadians with disabilities, and could suggest that death is an acceptable alternative to any level of medical suffering or disability. This risks undermining our efforts to combat suicide, a pressing public health problem that affects not only those who die by suicide, but also their families, friends, and overall communities.
    Next, to ensure that Canadians can have confidence that medical assistance in dying is administered appropriately, the bill also contains the procedural safeguards generally in line with those recommended by the special joint committee. These measures would ensure that requests for medical assistance in dying would be made in writing, witnessed by two independent persons, and that there would be a 15-day wait period to guard against people making a decision too quickly, which cannot be reversed. In respect of the waiting period, there would be flexibility for situations where a person's death or loss of capacity was imminent.
    Most important, the eligibility of the person would have to be assessed and confirmed by two physicians or nurse practitioners who are independent of each other. The person would also have the right to change his or her mind about receiving medical assistance in dying, including just before the procedure would be administered. These safeguards will be effective at protecting Canadians but will not be so burdensome that they will impede access.
    Finally, the bill would require that the person be eligible for health services funded by a government in Canada. This requirement exists to ensure that Canada does not become a destination for people from around the world who visit the country solely for this purpose by obtaining medical assistance in dying. However, recognizing that Canadians often move from one province to another or sometimes live abroad for significant periods, the bill includes an exception to this requirement to ensure these people would not be excluded solely because they are subject to a waiting period or residency requirement for public health care.
    Medical assistance in dying is one of the most challenging and complex social and legal issues of our time, particularly given our society's aging population. However, the government has embraced this challenge and has listened carefully to the diverse perspectives of Canadians.
    The bill before Parliament today was crafted with both compassion and clear thinking, and represents thoughtful and principled legislation. It promises the autonomy of Canadians to choose medical assistance in dying, protects vulnerable persons, and respects the Supreme Court's decision.
    I call on members of the House to support this bill.


    Madam Speaker, on at least three occasions now we have heard from the other side the confusion created around the use of discontinuing medical treatment and physician-assisted suicide. These are not at all the same. We all agree, and have agreed for many years, that it is not incumbent on any patient to continue life-extending, life-prolonging treatment.
    Earlier today a colleague of the member commented that there were $3 billion in this budget for home care and palliative care. That comment was incorrect. Would my colleague correct that?
    Finally, would my colleague agree to an amendment in the legislation that would require a palliative care consultation for patients who requested medical assistance in dying so these patients would be provided with the full range of options of treatments and supports available to them? Therefore, people requesting physician-assisted suicide would need to have a palliative care consultation prior to proceeding with their request.
    Madam Speaker, first, in fact there is money allocated in our budget for home care. Within the home care line item, there would be consultations continuing with palliative care and those who administer palliative care throughout the country, as well as mental health care services. In fact, I came from a meeting this morning with the Minister of Health and the Minister of Justice which confirmed those discussions were continuing to happen throughout the nation.
    With respect to the second question about palliative care, the simple answer is yes. Although we are reacting to the Supreme Court ruling and putting in place legislation that is based on giving choice to Canadians, we are not going to end there. We will continue to discuss this issue with Canadians across the country and with that, strengthen those programs before individuals make those decisions.


    Madam Speaker, I listened with interest to the speech from my hon. colleague. He very clearly said that he believed this legislation would conform with the Supreme Court decision in Carter.
    I have read a very spirited and well-reasoned letter recently from Joe Arvay, the lawyer who argued the Carter decision. He very vociferously disagrees with that comment. Specifically, he focuses on the fact that the Supreme Court decision very clearly has said that physician-assisted death should be available to those who suffer purely from a grievous and irremediable condition. Yet, this legislation would go further than that and would add the additional requirement that the death be reasonably foreseeable. Mr. Arvay argued that was an unwarranted and illegitimate extension of the Supreme Court decision. In fact, he argued that the test of reasonably foreseeable death was specifically raised through the court process and rejected at all levels of the courts through this process.
    Could my hon. colleague tell us how he thinks the legislation would conform with the Supreme Court decision when it so clearly contradicts the Supreme Court's statement of the criteria required for access to physician-assisted death?
    Madam Speaker, I did not make a comment with respect to this conforming with the Supreme Court decision. My comment was specific to this legislation giving some substance to an issue in which the Supreme Court left a void.
    We have listened to Canadians. We have heard loud and clear that Canadians want a choice to ensure they make a proper decision after discussing these issues with their physicians, their family, and their friends. With that, as I said in my statement, end of life would have to be foreseeable and would have to be imminent, and those decisions would be concluded then by those discussions between physicians and individuals. The legislation would then support those choices for every Canadian.
    Madam Speaker, I want to begin my remarks by acknowledging the delicacy, sensitivity, and grace that the subject before us requires. The subject matter of this debate, assisted dying, raises issues of the most profound importance, indeed of life and death.
    They engage our deepest sentiments not only as parliamentarians but as humans. They involve our conscience, our morality, our ethics, our values, our philosophies, our spirituality, our individuality, and our dignity. I believe we must approach these issues with the utmost care, compassion, and respect, because Canadians have diverse and deeply held views on this matter, all worthy of consideration and deference.
    The context of the debate is clear: death is feared, suffering is feared, loss of control is feared. With the advances in modern medicine, people today can, and indeed must, contemplate living without an acceptable quality of life, of being alive but not living, of possessing basic bodily functions without agency, without dignity, without hope.
    At the same time, we fear the diminution of the sanctity of life, of the possibility of abuse of the vulnerable among us, embarking on a slippery slope that challenges long-standing foundational tenets of respect for the preservation of human life. This debate is about a fundamental collision of values, one which is based on the instinct to live and to preserve life in all instances, and the other premised on the right to control our inevitable passing as an inherent aspect of our individualism and personal liberty.
    I hope that we treat the issues involved in this debate with the compassion and respect that they deserve, because we must simultaneously balance the notions of death with dignity with life with dignity. There will be no right or wrong here. There is only the possibility of compromise, understanding, and moving forward with as much wisdom and sensitivity as possible.
    In many ways, we have taken an unfortunate path to the present. We are here by virtue of the legal process. It was based on a rights-based analysis and decision engendered by the mandate of a court, quite legitimately, because of a charter-based argument that challenged criminal provisions as violating individual constitutional rights.
    We are not here because of a discussion based on faith, or conscience, or ethics. This has left many Canadians feeling rushed and robbed of the kind of full debate that perhaps ought to have been conducted on a matter of such social depth. As such, we are here debating not if, but how assisted death might best be implemented.
    However, I do take comfort in the fact that the Supreme Court of Canada arrived at its decision unanimously, something that does not commonly occur. This gives me confidence that the most learned jurists in our nation were certain that we, as parliamentarians, can and must construct a system that allows Canadians to seek and obtain the assistance of their medical providers in ending their lives in tightly defined circumstances.
    I would like to address my comments and thoughts on two areas: palliative care, and key aspects of this legislation. I am the health critic for the New Democratic Party and, as such, I approach this issue not only from a values or ethical or moral perspective, but from a health care point of view. I believe one of the most central aspects of the debate before us must revolve around palliative care. If we are honest, we will acknowledge that we as a nation have failed to construct the range and quality of end-of-life care that is essential to provide Canadians with the confidence they need to live their lives to the fullest extent.
    We as a society have been remiss, slow to develop a system of palliative care that is so essential when we contemplate end-of-life issues. If we are to do our best to create the conditions where Canadians avail themselves of assisted death only in the rarest of circumstances, we must focus on achieving a number of things.
    We must create pain-management programs to ensure that we have the widest possible resources to make everyone comfortable, regardless of their medical condition or proximity to end of life. We must develop home care resources to ensure that folks, especially seniors, can live their remaining days in the comfort of their personal surroundings, communities, memories, friends, and families.


    We must construct palliative units across our country that allow people who are approaching their end to have environments that are comfortable, enriching, graceful, and interesting, and where spouses, children, families, and friends can be together in respectful private settings. They should have the very best medical care a developed country like Canada can muster. If we were to invest in world-class palliative care, we would likely see relatively few Canadians seeking assisted death.
    Regardless of where one is placed on this debate, I think we all agree that we should be trying our best to encourage all Canadians to choose to live their lives to the fullest. This bill, the government, and its recent budget have thus far failed to identify and provide the resources needed to make a world-class palliative care system a reality in this country. Talk is not enough, and this must change. As New Democrats, we will work ceaselessly to press the government to allocate the resources necessary to build a world-class palliative care system across Canada. We will press the governments of every province and territory to work together to ensure that this system is available to all Canadians, regardless of where they live.
    I have some key observations.
    I personally believe that competent adults have the right to determine the conditions of their passing in the circumstances identified by the Supreme Court, namely where they face a grievous and irremediable medical condition that they find intolerable, and with a carefully designed and secure process that ensures their wishes can be ascertained with certainty. To the extent that this legislation deviates from that decision, it must be amended.
     If it is truly the case that the prime successful litigant in the Supreme Court case, Ms. Kay Carter, would not be permitted a physician-assisted passing under this legislation, that is patently wrong. I believe we must tread extremely cautiously in this area and move very deliberately.
    While I have listened carefully to those who favour a broad expansion of assisted death beyond the Supreme Court's careful parameters, I do not agree. In my view, care and caution are required in such delicate matters. Very difficult considerations accompany the issues of mature minors, psychological suffering, and advance consent. I believe it is the wisest course to engage fully with Canadians prior to legislating in these areas. We are moving from a society that has observed criminal sanctions for suicide and assisted death for centuries, to one which is constructing a system in response to the circumstances presented to the Supreme Court in the Carter case. In my view, this is sufficient for the moment, and we ought to focus our efforts on ensuring that the Carter principles are properly enshrined in law.
    As the father of a child with special needs, I want to ensure that every vulnerable Canadian is fully protected with respect to all circumstances in this area. I am sympathetic to those who fear a slide down a slippery slope that puts vulnerable Canadians at risk, and I agree that we must ensure tight parameters are in place to prevent this. I believe that we can and must explicitly ensure that medical personnel and institutions have their rights of faith and conscience fully protected. Just as I believe that Canadians who wish to exercise their charter rights to access assisted dying must be respected, so too must those who choose not to be involved in such matters because of their faith or values not be compelled to do so. The constitutional rights of some Canadians must not be enforced at the cost and by the diminution of the constitutional rights of other Canadians.
     I further believe that faith-based health institutions are direct extensions of the faith communities and groups that sponsor them and, as such, constitute expressions of values that are eminently worthy of protection. I believe we can ensure that all Canadians have access to their Carter rights while also protecting the equally important rights of those who may have conscientious objections to participating in any way in them.
    In the end, it is my fundamental conviction that we as parliamentarians can and must craft legislation that reflects the best of who we are as Canadians: people who cherish individual rights and liberties, people who care deeply about each other, people who are compassionate and concerned with justice, and people who are dedicated to making our society one that is ruled by law, by wisdom, and by respect for all.
    I will do my very best to reflect these values as we craft this important legislation for Canadians.



    Madam Speaker, I would like to first thank my colleague for his comments, which will make us carefully reflect on Bill C-14.
    We should reflect on what is at the very heart of the debate on the Carter case and the Supreme Court decision. In one passage of the Supreme Court ruling in Carter, the justices state that the current Criminal Code provisions at the very core of the Carter case protect the vulnerable to such an extent that they constitute almost an absolute protection, which is prejudicial to some Canadians who are not vulnerable and would like to have access to medical assistance in dying.
    I would like to hear what my colleague thinks of the Supreme Court's view as it relates to the current bill.
    What are his thoughts on people who are not vulnerable as defined by the Supreme Court and how this is reflected in the bill?


    Madam Speaker, in many ways, that question gets to the very heart of the matter before us, which is that the Supreme Court has clearly and carefully ruled that competent adults in Canada who are suffering from grievous and irremediable conditions ought to be allowed the ability to choose their end of life and get assistance from their medical professionals to do so.
    Where this issue gets very difficult is when we consider the extensions of that decision, when we talk about whether mature minors ought to be able to access those same conditions, even if they are not vulnerable. It is about people suffering from a psychological or mental health condition, and whether those conditions are in and of themselves sufficient to warrant access to physician-assisted death, even if they are not vulnerable. Finally, there is the issue of advance consent, which I think many Canadians agree with in principle, but I believe raises very difficult issues of implementation.
    I am one who agrees with the government in terms of moving very carefully in this legislation. I am mindful of the fact that many civil liberties groups feel that the legislation could have been more broad and extended physician-assisted death to groups beyond the Carter decision, but I believe we must move and tread carefully in this area. The issues are so important, and Canadians are so engaged in this, that it is better that we move correctly than that we move quickly.


    Madam Speaker, I want to thank my colleague for his speech, and I want to especially thank him for his commitment to protecting the conscience rights of health care workers and institutions. I am wondering if he would agree to an amendment that would actually guarantee those rights in the legislation. It is clear that the legislation wants to take a pan-Canadian approach for the availability of physician-assisted suicide. I think it is equally important that we have a pan-Canadian approach in terms of protecting the conscience rights of health care workers and institutions.
    Second, I was pleased to hear his commitment to protecting the vulnerable. There are some safeguards listed in the bill as it relates to independent witnesses, independent doctors, and so on. I am wondering if my colleague would also agree to an amendment that would include within the regime a pre-judicial or some type of prior review that would ensure that the independent witnesses who claim to be independent, and the doctors, are actually facing up to that fact.
    Madam Speaker, I would like to thank my hon. colleague for those thoughtful points. They also raise fundamental issues that will be discussed at committee. I could not be clearer than I was in my speech in saying that I believe the conscience rights of those who do not want to participate in assisted death, medical practitioners and institutions, ought to be explicitly protected. I am certain amendable to the form it takes, whether that is in the legislation or otherwise, but what is important is that the principle is respected.
    With respect to the member's second question about additional safeguards to ensure that the vulnerable are protected, again, I agree with him fully that the principle of protecting the vulnerable has to be a core foundational aspect of this legislation. I would be willing to look at any other procedures that may work, whether it is by amendment to the bill or otherwise, to accomplish that.
    Madam Speaker, I rise today to speak to Bill C-14, the medical assistance in dying bill.
    To me, it is legislation that reflects where society is today. It is the right one for where the majority of Canadians are, and provides a strong foundation on which to build. It recognizes the inherent and equal value of every life, and honours the dignity and autonomy of an eligible person to choose medical assistance in dying under well-defined rules and conditions.
    The introduction of this bill is big and represents a fundamental change in how we as Canadians view the right to life, liberty, and security of the person in Canada.
    I confess that this is not an easy issue for me to talk about, but it is an important one to the residents of Davenport, the riding I am honoured and proud to represent. We as a society do not talk very much about death. It makes us nervous, and so this bill, which creates a framework to enable access to medical assistance in dying in Canada to those who are eligible, is a particularly sensitive topic.
     I want to acknowledge that I have a large Catholic community in my riding, and many who believe that only God can decide when one dies, that death should be left in God's hands. On the other side, I have a number of groups within Davenport that think the proposed legislation does not go nearly far enough. Recognizing the blessed diversity of opinion, I invited community leaders to meet with me to discuss Bill C-14, to hear from them their specific concerns.
    What I found was that I had to remind many of them that in February 2015 the Supreme Court of Canada unanimously, all nine members, voted to strike down the sections of the Criminal Code that made it illegal for anyone, including a doctor, to cause the death of another person who consents to die, or to assist a person to end his or her own life. I reminded them that the Supreme Court proclaimed that the prohibition on physician-assisted dying infringes on the right to life, liberty, and security of the person in a manner that is not in accordance with the principles of fundamental justice.
    The Supreme Court gave the government a certain amount of time to introduce legislation. That date is currently June 6, which is why we are here today. Just as an aside, I was curious to see how many times the Supreme Court actually voted unanimously, and it has done so only 35 times since 1979.
    There was no question that medical assistance in dying would become legal in Canada. What had to be determined is what kind of legislation we were going to introduce.
    The Supreme Court's decision meant an important shift in our society's perception of personal autonomy. It signalled that a person's sense of dignity is intricately tied to how one perceives his or her quality of life. The decision to allow Canadians the choice of medical assistance in dying sheds light on the evolving role of our health care system and the role of patients in decision-making.
    Canadians are looking to their doctors and nurses to provide health care, and to help them maintain their quality of life. However, when that quality is no longer attainable, Canadians want to know that their health care providers will also help them when their choice is a dignified end to their lives.
    In addition to the consultation, I have received many letters from residents in Davenport. There are those who believe there should be no legislation at all, others who think that the proposed bill is not strong enough in protecting the conscience rights of doctors or in protecting the most vulnerable, and a further group who worry that the legislation does not go far enough, that we as a government have been too narrow in our interpretation of the Supreme Court decision. I will address all these concerns in the next few minutes.
     Let me first address those who do not believe there should be any legislation. What many may not understand is that if the Liberal government does not create a new law by June 6 of this year, it means medical assistance in dying is legal if it is conducted in a way that adheres to the considerations outlined by the Supreme Court in its Carter ruling. Canadians would then not have any national framework and no law, which in my opinion would lead to a wild west, where it would be up to any one person's interpretation of the Carter decision and a situation that I believe would be open to abuse.
    In introducing Bill C-14, the Liberal government purposely created legislation which as narrowly as possible adhered to the Supreme Court decision. It is narrow because this bill is meant to be a first step. It is meant to ground the legislation properly.
     The legislation would do three things. It would allow physicians, nurses, and those who help them provide assistance in dying to eligible patients without the risk of being charged. It would also provide safeguards to make sure that those who receive medical assistance in dying are eligible, can give informed consent, and voluntarily request it. Finally, it would lay the foundation for the Minister of Health to make regulations to establish a process for monitoring and reporting on the use of medical assistance in dying.


    I will pause for a second to reiterate the first point, because as mentioned, many have written to me to express their concern that the legislation as drafted does not protect the conscience rights of doctors. I want to be clear that there is nothing in the legislation that compels any medical practitioner or authorized nurse practitioner to provide medical assistance in dying or to refer a patient to another medical practitioner. The legislation is meant to balance access to medical assistance in dying while respecting the personal convictions of health care providers.
    The legislation is also clear on who is eligible. A person has to be mentally competent, 18 years of age or over, make a voluntary request, and give informed consent to receive medical assistance in dying. They have to have a serious and incurable illness, disease or disability, be in an advanced state of irreversible decline in capability, experiencing and enduring intolerable suffering as a result of their medical condition, and be on a course toward the end of life. Death would have to be reasonably foreseeable in all of the circumstances of the person's health.
    Protective measures are also a key part of the legislation to ensure that patients eligible have given informed consent. Patients have to make a written request for medical assistance in dying and have it signed by two independent witnesses. Also, two independent medical opinions have to confirm that the patient meets all the criteria. These first two criteria are intended to ensure that requests for medical assistance in dying are truly voluntary, that they reflect the wishes of the patient and are not made as a result of external pressure or coercion.
    Too many of my constituents have said to me, “My dad was in the hospital. We kind of felt forced that maybe we would want to sort of end things.” I said that this legislation does not help with that. The patient has to make a written request. It has to be signed by two independent witnesses, and there has to be two independent medical opinions.
    In addition, the second criterion also helps to reassure the medical practitioner who would provide medical assistance in dying that he or she is acting within the scope of the law and consistent with reasonable medical knowledge and skill.
    The other criteria for patients to be eligible are that there is a mandatory 15-day waiting period; the patient has the right to withdraw a request at any time; and consent must be confirmed immediately before medical assistance in dying is provided. It is a very thoughtful protocol with very strong safeguards.
    As part of this legislation, the foundation is also laid for the Minister of Health to establish a process for monitoring and reporting on the use of medical assistance in dying. We need to know, and Canadians need to be satisfied, that the system is operating as planned to respect the autonomy for eligible individuals while protecting vulnerable people.
    Public trust and transparency in the implementation of medical assistance in dying are essential. This monitoring and reporting system will also be able to signal any issues or unexpected consequences.
    Monitoring would also ensure that high-quality comparable Canadian data are generated so that any future discussions about changes to the medical assistance in dying system could be made based on the best possible evidence. Indeed, there will be a review of the legislation in five years, which could bring about changes that reflect the data gathered in this period.
    For those who believe that this legislation has not gone far enough, there is a commitment to independent studies into three key issues that the Supreme Court of Canada in Carter declined to address. The first was the eligibility for persons under the age of 18. The second is the advance request. The third is requests for medical assistance in dying solely on the basis of mental illness.
     It is also important to mention that palliative care, ensuring that all Canadians live as well as possible until their death, is equally important to this government. Just yesterday the Minister of Health stood in this House to reaffirm our commitment to $3 billion over four years for home care.
    The minister is working hard with her counterparts across Canada on the next version of our health care accord, and high-quality palliative care for all Canadians is a key part of their deliberations.
    I also should mention that one of the great positive side effects of introducing this legislation is that we are having a wide discussion on a national level. We need to be discussing this issue fully and we need to be understanding it.
    In closing, I want to quickly thank and commend the great work that was done by the Special Joint Committee on Medical Assistance in Dying under the great leadership of my colleague, the MP for Don Valley West. I also thank the Minister of Justice and the Minister of Health for their excellent work in introducing this legislation.
     Bill C-14 is meant to be a legislative foundation on which we will build moving forward . It recognizes the inherent and equal value of every life, and it honours the dignity and the autonomy of an eligible person to choose medical assistance in dying under well-defined rules and conditions. It is the right legislation for Canadian society today, and I will be supporting this legislation.


    Madam Speaker, again we hear about the $3 billion for palliative care. We have yet to find it in the budget. There is some language around home care, but there is no identification of palliative care. Could the member please clarify that?
    Madam Speaker, I can understand why there is some confusion. We have reaffirmed our commitment. We made a promise and we continue to be committed to $3 billion over four years for home care. It has not been introduced in the 2016 budget, but we have reconfirmed our commitment to $3 billion over four years.
    Also, the minister has been very clear that high-quality palliative care for all Canadians is a key part of her current deliberations with her counterparts, the provincial ministers of health right across the country. I have great faith and hope that something will be brought forward in due time.


    Madam Speaker, the debate on medical assistance in dying is certainly very important.
    Although the bill is being brought forward very quickly, some amendments are needed, especially for some of the definitions that are a little vague. From the beginning we have heard that a natural death must be reasonably foreseeable. Doctors cannot even agree on what this means. The government has not been able to define what is a reasonably foreseeable death.
    Can the member shed some light on this? Will there be clarifications at the committee stage to fix this? The greater the uncertainty, the more difficult it will be for professionals to make clear decisions and ensure that there are no abuses.



    Madam Speaker, there is a very clear list. It is a very thoughtful list of criteria of who would be eligible for medical assistance in dying. We have put a safeguard in place where two independent medical practitioners would have to give the same opinion. We have done that to help reassure each of those medical practitioners who want to provide the medical assistance in dying that he or she is acting within the scope of the law and consistent with reasonable medical knowledge and skill. They act as a bit of a check and balance on each other in terms of interpreting the list of criteria of who would be eligible for medical assistance in dying.
    Madam Speaker, I want to begin by congratulating my colleague on her excellent presentation on a very difficult issue that is clearly troubling for all of us here in the House.
    One of the things I continue to hear from many people in Humber River—Black Creek is about elderly people feeling that their families are not interested in seeing them just wither away, and how do they know they are protected. We know all of the answers are here, but the challenge is to communicate and give that level of confidence to Canadians.
    I would be interested to hear how my colleague plans to ensure the people in her constituency understand what is required before any kind of action could be taken to end someone's life.
    Madam Speaker, this is something that very much weighs on me. I want to do a huge communication effort. I felt that there was not an understanding that there was a Supreme Court decision and a law had to be enacted.
    My objective is to do a series of interviews with a number of local newspapers and radio stations to make sure people are as educated as possible on this issue.
    Madam Speaker, I must say at the outset that the prayer we began our session with this morning, that we would be mindful of making good laws and serving Canadians, has never meant so much to me, and I think many of my colleagues here today, anytime it has ever been said from the Speaker's chair.
    I would like to thank my colleagues and members opposite for their thoughts and words on this deep, ethical, moral, legal, and religious question. While I may not agree with all the points that have been made thus far, I do not doubt for one second that the comments of all members are truly heartfelt, genuine, reflective, and respectful.
    Unfortunately, I do not have time to address all the concerns of the bill, such as, but not limited to—as my colleague the member for Lethbridge has so eloquently articulated—the poisonous change in our cultural mindset the bill will likely encourage, reducing the value of life to a measure of ability or function rather than its inherent worth and dignity, and causing Canadians who would never have considered taking their own life before to do so.
    As the member for Scarborough—Guildwood mentioned, the bill would be under expansionary pressure from the day it comes into effect, and where we could end up is troubling.
    The peril that I do not think has been fully addressed is that in which those in vulnerable communities could find themselves.
    As I said, because time is limited, I am going to focus upon two issues, but again, my serious concerns are not limited to these alone. First is the regrettable absence of more discussion and action on palliative and hospice care as a precursor to this legislation. Second is the need and the duty of all members here to respect and protect those physicians and health care professionals who object on conscience.
    Before I get into these two points, I want to offer my reflections on where we have come from on this issue.
    It was only six years ago that we debated the same issue and voted down the private member's bill, Bill C-384, of a former member of this House. It should be noted that this was the second attempt at the same private member's bill by the former member, who had previously introduced Bill C-407.
    I will say that I voted against and spoke out against the bills, not only because of my own personal convictions, but also because of my steadfast belief that those bills did not uphold the moral obligation we have as parliamentarians to protect the vulnerable and the inherent dignity of all life.
    Bill C-384 and Bill C-407 were seriously flawed because they sent us down a path of unintended consequences. They were that slippery slope that has so often been spoken of here in this chamber, regarding the debate of ethical dilemmas that our families, doctors, and health care workers would face.
    My reservation then is sustained today. Why is there not more emphasis on palliative care?
    Is it not better to support quality palliative and end-of-life care for Canadians, so they will never need to think that euthanasia or assisted suicide is the only option, or better option, for their suffering?
    Is it not our duty to uphold the value and dignity of life in this manner?
    In my own home community of Hamilton, we have outstanding organizations like Emmanuel House and the Dr. Bob Kemp Hospice, which work on a daily basis to make end of life better for people. I know hospices are doing outstanding work in all the communities across this country.
    I recognize that, in the view of the Supreme Court's Carter decision, we are faced with a new reality, one where we need to respect its decision vis-à-vis the charter rights of those in dire circumstances while still ensuring the dignity of life is upheld. However, I am very concerned that there was no further investigation, no rigorous effort to enhance palliative care and invest in hospice construction, in advance of this legislation or in conjunction with it.
    While the federal government's response to the Supreme Court's Carter decision makes reference to the need to support improvements of a full range of end-of-life care options, it does little about it, other than acknowledging it as a non-legislative response.
    I do not think that is good enough, and I believe all Canadians do not think that is good enough either.
    Instead of a vague reference to a multi-year health accord that would include home care and palliative care as one option, where was the commitment in the throne speech? Where was the commitment in the budget?
    If the commitment is serious, why is it not backed up with funding?
    This is the missing piece. If we are going to go down the legislative path of physician-assisted dying because of charter rights, then we in this place have a duty, and the Government of Canada has a duty, to have first acted upon palliative and hospice care.


    That was the viewpoint of two Senate studies, which I cited back in 2010 when I spoke out against Bill C-384. First, in 1995, there was the Special Senate Committee on Euthanasia and Assisted Suicide that in its report, “Of Life and Death”, made a number of recommendations to improve access to palliative care services, standards of care, and training of health care professionals.
    In 2000, the Standing Senate Committee on Social Affairs, Science and Technology tabled another report, titled “Quality End-of-Life Care: The Right of Every Canadian”, which again recommended a strategy and vast improvements to palliative and end-of-life care, as well as support for family caregivers, home care, research, and surveillance.
    It breaks my heart, and I know the hearts of all members in the House, that people are suffering. Just this past summer, in the middle of the election campaign, I watched my own younger brother succumb to the ravages of lymphatic cancer, and I was grateful for the care, understanding, and compassion of everyone at Emmanuel House, the hospice where he stayed in his final days.
    I know that this bill attempts to address those individuals who have given up hope; yet I believe there are, most often, better ways to address their suffering. It is our obligation to do everything possible with palliative and hospice care, to give a modicum of hope, comfort, and peace to those suffering at the end of their lives and to their families who are also suffering. Once again, I believe this discussion should have preceded this bill.
    The final point I want to touch on today is one that I know other members have already raised, but please allow me to amplify their concerns. That is the protection of physicians' conscience rights and, quite frankly, those of the other health care professionals and caregivers on a doctor's team who might be placed in the circumstances that this bill would allow.
    First, I do not think there is a shred of doubt that we must offer clear and indisputable protections to those who object on ethical, moral, or religious grounds. In these matters of life and death, that is more than the right thing to do; it is the only thing to do.
    Second, I believe that, to send this important signal to the medical community, families, individuals who are suffering, and all Canadians, these conscience protections for physicians must be included in the bill itself, and not just in the preamble. The bill needs to include a punitive measure for those who would seek to pressure, force, or coerce anyone to assist someone in taking his or her life.
    I am thankful for the opportunity to offer these reflections. I know every member of the House will be doing a lot of thinking, soul searching, and prayerful consideration as we grapple with this legislation. I sincerely hope and pray that we continue to do so with extreme caution and care. God bless Canada.


    Madam Speaker, I would like to highlight a couple of points.
    One is, of course, that this legislation is before us because of a unanimous decision by the Supreme Court of Canada, which means that it is the responsibility of all parliamentarians in the chamber to ultimately do what I and most believe is the responsible thing to do, which is to pass legislation. We have a deadline of June 6. There is a great expectation that the bill will be going to committee stage at some point, and my question is related to that.
    The member referenced the importance of there possibly being amendments to the bill. The Government of Canada is, in fact, open to ideas, suggestions, and presentations at the committee stage, and I am wondering if the member wants to comment on how important it is that the bill goes to committee in a timely fashion so that the committee is able to do some of the things that might be of benefit if the legislation is improved. I am sure the member will find that the government is willing to improve the legislation. No one on this side is going to oppose healthier and stronger legislation.
    I also recognize the importance of the bill going from the House to the Senate, keeping in mind June 6. I am wondering if the member would provide comment on what he believes would be important for getting the bill out of second reading stage in a timely fashion, so that we can do some work on it at committee stage, and if he has some thoughts on the committee stage and the process of getting it all done by June 6.
    Madam Speaker, I think that is exactly the reason this debate is not only an emotional one but a profoundly intense one. The fact is that we have this June 6 date looming over us while we are dealing with such a huge question; that of life itself. It is a question that the Province of Quebec took six years to deal with. It is a question that the country of Belgium took 10 years to deal with. However, we have to deal with it now in such a short time frame, and I understand the expeditious manner in which we have to proceed.
    That said, I think it was incumbent upon the Liberals, prior to tabling this legislation, that their own principles that they mentioned in their own platform should have been part of this legislation or should have even preceded this legislation in the sense of making sure that every Canadian had the better option, the option to be able to go to a place where they are loved, and for those people who do not have any family, places where they could get relief from their pain and be with people who care for them right to their last days. That was not included in this legislation.
     I hope the Liberals would be open to making sure that part of their infrastructure dollars would be set aside for hospice construction, and that they would also be negotiating specifically with provinces right now to delineate funds specifically for palliative care so that the service is enhanced rather than it going into the general fund of provinces and not seeing the light of day to serve people who need it.



    Madam Speaker, the Conservatives who serve on the special committee did not agree with each other. Four of them disagreed with the committee and expressed a dissenting opinion. They eloquently expressed their concerns, which included the need to give Canadians better palliative care. They said it was important to expand access to palliative care, as part of the medical assistance in dying initiative.
    Could my colleague elaborate on this and tell us what concrete measures this government can take to give more Canadians access to good palliative care at the end of life?


    Madam Speaker, I articulated some of it, but I will say that I am a person who is dedicated to the separation of jurisdictions. In case there are some members who might think that I was suggesting that the federal government would impose some kind of regime in regard to the operation or execution of health care, which is a provincial jurisdiction, I was not saying that.
    What I was saying is that, certainly, the current Liberals have been willy nilly with the till already, committing billions to other things. I think that, on this very important question, they could take some of those infrastructure dollars that they have already committed and set aside those dollars for hospice construction. They should then make sure, in their deliberations that they are having right now with the provinces in regard to a health accord, that they make it very clear that any future expansion of funds would be based on a good accountability in regard to the increase of palliative care across the country.


    Madam Speaker, I listened closely to all of my colleagues.
    Yesterday, I participated in the committee's hearings. This is my first opportunity to speak in the House.
    I have just 10 minutes, but I would like to start by saying that everyone here is caring. Everyone is concerned about the well-being of people who are at the end of their lives, and everyone wants the best for them. However, just because we want to care, that does not necessarily mean that we do what is best for people. We are not necessarily doing what is best for someone if we infringe on a person's autonomy and self-determination.
    In the moral sense of the term, human dignity is connected to respect for self-determination. That should be the basis of our debate. Yesterday, in committee, I heard people say that we should consider a person's dignity in relation to their illness. They were talking about whether the person is wearing diapers, which is just frightening. Only that individual can make judgments about their own quality of life, and we cannot compare one life to another.
    By way of introduction, since Bill C-14 is quite similar to part of the Quebec law, I would like to provide some context regarding the basis of that law. At the request of medical specialists and other civil society groups in Quebec, in the fall of 2009, the Quebec National Assembly created a deliberative space in order to give people the opportunity to express their views on an issue that could not be more personal: their own end of life.
    From that moment on, the status quo was no longer an option for Quebec parliamentarians. Five years later, on June 5, 2014, the National Assembly passed Bill 52, The Act Respecting End-of-Life Care. One aspect of that act is medical assistance in dying.
    This work was guided by two premises. First, my death, like my life, is my own. Second, the autonomy bestowed on a person by law through the principle of self-determination and its corollary rule of free and informed consent, which applies in biomedical contexts, is never questioned throughout that person's life, even in times of weakness or extreme emergency. Why then would things be any different at the end of a person's life?
    Why would a person's right to self-determination be taken away because he or she is terminally ill? On what grounds would that be done? Is there any more personal and unique time in a person's life than the moment of death? What more could we wish than for a person to be able to calmly and peacefully pass on into death without any fear of suffering or any actual suffering? Is that not what we all hope for and what we would wish for any human being?
    The consensus that was reached in Quebec was to make these premises part of a continuum of care, so that palliative care and euthanasia, two realities in the history of this issue, would no longer be set in opposition to each other. Why pit palliative care and euthanasia against each other? This question has been implicit in many of my Conservative colleague's speeches, because unlike in Quebec, we did not hold a debate on the right to die, which used to be associated with passive euthanasia.


    People had to fight for the right to die. At the time, paternalistic doctors tended to focus on the curative aspect, and people were dying from the chemotherapy, not the cancer. Over the years, there has been a shift from passive euthanasia to palliative care. Human beings have thus acquired the right to die.
    Palliative care is about taking a holistic approach to end-of-life care. This concept was developed by Cicely Saunders, in England, and dates back to 1967. Why should a request for assisted dying arising out of a positive experience of care near the end of one's life be considered a failure? The dying process has started and is irreversible.
    A person might wake up one morning and decide that he or she is ready to give up. A person might also decide that that is not the case and that he or she wants to go on living, and die a slow death. The Quebec legislation in no way precludes one or the other, because it places end-of-life care in a continuum of care.
    For more than 30 years, palliative care was considered the only way to die with dignity at the end of one's life. It became apparent that such care did not meet every need. Most requests for medical assistance in dying are made as part of the process of palliative care. Very rarely does a person who receives a terminal diagnosis from a doctor immediately request an injection. If so, it all depends on the stage of the cancer. The patient might be put on anti-depressants and told to get his or her affairs in order. There are things that a person needs to do before dying.
    One of the difficulties with Bill C-14 is that it groups together two realities under medical assistance in dying. One is covered by Quebec, namely euthanasia and end-of-life care, which includes palliative care; the other is assisted suicide. This choice is causing the conceptual confusion that leads to the impasse in our debates.
    Assisted suicide is not euthanasia. The difference is that a person can be at the terminal phase of a degenerative disease without being near death. A person can suffer tremendously without being in a situation of reasonably foreseeable natural death.
    The Supreme Court has asked legislators to provide a framework for assisted suicide. This is what the Supreme Court told us in section 7:
    Insofar as they prohibit physician-assisted dying for competent adults who seek such assistance as a result of a grievous and irremediable medical condition that causes enduring and intolerable suffering, ss. 241 (b) and 14 of the Criminal Code deprive these adults of their right to life, liberty and security of the person under s. 7 of the Charter. The right to life is engaged where the law or state action imposes death or an increased risk of death on a person, either directly or indirectly. Here, the prohibition deprives some individuals of life, as it has the effect of forcing some individuals to take their own lives prematurely, for fear that they would be incapable of doing so when they reached the point where suffering was intolerable.


    That is what we have been asked to do, and that is what we need to figure out.


    Madam Speaker, we have heard a great deal of discussion about the legislation itself. However, one of the important components of the whole debate is the concern that we heard this morning related to palliative care. I argued yesterday, and I am carrying it forward today, that it is important that we as a federation recognize that in dealing with palliative care this is what Canadians are concerned about no matter what region of the country they are in. Whether it be British Columbia, Nova Scotia, Quebec, or Manitoba, people are genuinely concerned about palliative care.
    In dealing with the issue of palliative care, would the member not agree that there is a federal responsibility to work with our provincial counterparts to deliver the best type of palliative care to all of the different regions of our country because that is what people across the country want?


    Madam Speaker, people see palliative care as the answer to dying with dignity, but that care can be difficult or impossible to access, unfortunately.
    I am talking about palliative care as it should be. That does not mean putting sick people in beds in hallways and leaving them to die. It means holistic care delivered by specially trained staff along with adequate pain management, which was not allowed sometimes. Patients were not receiving the dosage they needed because it was thought that a high dosage could cause death.
    Quebec has dealt with that. The province has a framework for palliative care as end-of-life care. Health care is under provincial jurisdiction, and Quebec is a leader on this. I think this bill needs an equivalency clause so that the federal law will not result in duplication, thereby changing the way Quebec's law works.



    Madam Speaker, I believe that at the beginning of his comments my hon. friend talked about what dignity is and said that dignity is up to the individual to decide. If you decide you have dignity, then you do, and perhaps if you decide you do not have dignity, then you do not. I find this definition rather troubling. First, there is no regime of assisted suicide proposed here or anywhere else that defines dignity in this wholly subjective way. It still tries to say that a person who has these physical or psychological symptoms can have dignity and someone without those symptoms cannot. It would seem that the typical understanding of dignity in this legislation and elsewhere does look for these external markers.
    I liked what my colleague from Portneuf—Jacques-Cartier had to say yesterday about dignity being intrinsic to all human beings, because if we interpret dignity in the subjective way that the member has, I wonder where that leaves any efforts at suicide prevention. If a person said, regardless of his or her external circumstances, that he or she does not have dignity, then where does that leave efforts to tell that person that he or she does have intrinsic dignity and that he or she should not take his or her life? I wonder what the member thinks about the implications of his account of dignity for anyone in a difficult situation, anyone who might want to take his or her life.


    Madam Speaker, I think it is a shame that my Conservative colleague is confusing suicide with assisted suicide.
    Things can change for individuals who are contemplating suicide, but those seeking assisted suicide are suffering from serious and incurable illnesses and intense suffering that will never go away. That is a big difference.
    What I said was that people might want the right thing, might want to do the right thing, but that does not necessarily mean they are doing the right thing. Taking away a person's independence and self-determination is not doing the right thing. Taking away a person's independence is taking away their dignity. A person's dignity is rooted in self-determination, even when that person is vulnerable.


    Madam Speaker, it is good to be here today to speak to Bill C-14. One of the principles we have in the House is that legislation is best built on a very solid foundation, and this bill does not have that.
    What the Supreme Court ruled years ago on the Rodriguez case was very clear. However, just over a year ago, as with so many other decisions and so many other directions, the Supreme Court reversed itself. If it had really good underlying reasons for doing that, it would have been fine, but the justification for it was very interesting. It was a mistake in perception as set forward by the Supreme Court. The justices called it a changing matrix of social and legal facts which brought them to their conclusion. I and others are concerned that this makes our laws, including the interpretation of charter rights, dependent upon the opinions of a very small group of people. I will talk a bit more about the matrix of social and legal facts in a few minutes.
    From my perspective, this is not an improvement. Many of my colleagues on both sides of the House have shared their concerns about Bill C-14, with some supporting it and others opposing it. However, a number of things are missing in the bill, and we need to have further discussion about. I heard a few comments earlier about the timeline, how pressured it was, how we needed to get this done and that this basically was prohibiting us from taking the time needed to discuss these things a bit further and with a bit more depth.
    There is no clear definition of what irremediable means. The bill talks about that being the requirement for someone to qualify for physician-assisted dying.
    I am concerned about the expansion of this process to nurse practitioners, so it would not just include physicians. People have asked why medical personnel are even involved with this. They have asked whether there is not some other place this can be done so people do not have to be concerned that when they go into the hospital for medical care, rather than receiving a positive side of medical care, they receive a very negative side of it.
     There is a criminal exemption for those who perform euthanasia, but there is no protection for those who do not want to participate. A number of people are very concerned about what is called conscience rights and the lack of protection for that in the legislation.
    There is a lack of clarity around psychological conditions and how that may come into play with this issue. One of the things that really concerns a lot of people is the lack of a vulnerability assessment, taking the time to find out if people are being pressured or whether there is some vulnerability that is bringing them to the point where they have made a decision that may be wrong for them.
    Some people have called for a prior judicial review. There is no mention of that in the legislation.
    Also, there is a lack of clarity on data collection. This has been an issue in a number of areas. Will we see good data collection? Will someone keep a good set of records on what goes on with this process?
    We often have heard the concern that there is no clear commitment to palliative care. We just heard a member from the government talk about this. The Liberals made this commitment during the election campaign. They felt it was within their jurisdiction to promise $3 billion toward palliative care, but now, in the House, we hear them talk about how other jurisdictions are responsible for this. It sounds as if the Liberals are trying to avoid their responsibilities for this.
    I would like to go back to the Supreme Court decision. It turned back the former position. It reversed it and it left us with an open field when it came to the issue of assisted suicide or assisted dying. The only thing the Supreme Court said in its ruling on Carter was that the person needed to consent and that the person needed to have a grievous and irremediable medical condition causing enduring and intolerable suffering. If we look at that, we see it leaves that whole area very open.
    As I said earlier, good legislation should have a good foundation. I do not believe this does because of the Supreme Court decision. The foundation is the Carter decision and it hardly qualifies as a stable base on which to create good legislation.
    I do not suppose we will get this done today, but we will come back at another stage on this bill. However. I would like to take a few minutes to talk a bit about the Supreme Court's recent decision in Carter v. Canada. It obviously is a very controversial decision and touches on a sensitive issue for many Canadians because there are very deeply held beliefs on both sides of this issue.


    The Supreme Court acknowledged that the prohibition on assisted suicide was in general a valid exercise of federal criminal law. It also decided that the law went too far and it did not apply in cases where a competent adult with a grievous medical condition could consent to the termination of his or her life. I believe this decision is disturbing for a number of reasons.
    The first is that the court ignored parliamentary consensus. In its decision, it claimed that the reversal from its earlier position in Rodriguez v. B.C. was necessary because of a different matrix of legislative and social facts. Yet, the purported differing matrix ignores the clear and unchanged parliamentary consensus opposing assisted suicide.
    Between 1991 and 2012, nine private members' bills were introduced in the House of Commons, all seeking to amend the Criminal Code to decriminalize assisted suicide or euthanasia. Six were voted on and all of them failed to pass. When considering the matrix of legislative facts, the court gave weight to legislative developments in Belgium, Switzerland, Oregon, Washington, and the Netherlands, but it completely ignored the legislative record of Canada's Parliament.
    Second, the court found no societal consensus in Canada on this issue. In her decision at the trial level of Carter v. Canada in the Supreme Court of B.C., Justice Smith wrote, “As to physician-assisted death, weighing all of the evidence, I do not find that there is a clear societal consensus either way”. Clearly whatever the change in that matrix of legal and social facts entails, it did not include a clear consensus from the people of Canada”.
    This lack of consensus remains unchanged in the 22 years since the Rodriguez case in which the court stated, “No consensus can be found in favour of the decriminalization of assisted suicide. To the extent that there is a consensus, it is that human life must be respected”.
    Clearly, the court found no consensus among western countries. While insisting again this matrix of legislative and social facts had changed since the last Supreme Court ruling on the issue, it acknowledged that physician-assisted dying remained a criminal offence in most western countries. Regardless, it chose to align itself with the minority of jurisdictions that allowed it.
    I believe the court misinterpreted Parliament's objective in prohibiting assisted suicide. In its ruling, it put significant weight on the parliamentary objective of two sections, section 241(b) and 14 of the Criminal Code, which prohibit assisted suicide. The court asserted that these sections were put in place only to fulfill the state interest in protecting the vulnerable. However, in the earlier court case with Rodriguez, the court had said the objective of this section was not simply “protecting the vulnerable”, but also “preserving life”.
    It had written, “In this case, it is not disputed that in general s.241(b) is valid and desirable legislation which fulfils the government's objectives of preserving life and protecting the vulnerable”. This position was reaffirmed several times.
    By insisting that in Carter the purpose of section 241 was only to protect the vulnerable, the Supreme Court was able to conclude that this prohibition put people outside this class and that there were people who did not need to be protected by it. The court's conclusion was that the current law was over broad and grossly disproportionate to its objectives. That allowed it to say that Parliament needed to establish safeguards to ensure that those who truly wanted to be euthanized would be able to do that.
    That interpretation tramples on the intention of Parliament to preserve life. Had it considered the full purpose of these sections of the Criminal Code rather than just that one objective of protecting the vulnerable, I think the outcome would have been very different.
    I would make one final point before my time runs out. The court really leaves the definition of irremediable open to patient interpretation. The court decided that irremediable did not require the patient to undertake treatments that were not acceptable to them. In other words, although treatment may be available, the condition still qualifies as irremediable if the treatment is not acceptable to the patient.
    I wanted to express my concerns. However, I think we will come back to some of the things the Supreme Court touched on as well in terms of the right to die being conflated with the right to life and some of the other issues.


    Mr. Speaker, I want to highlight the fact that the Supreme Court of Canada unanimously decided that Canadians suffering intolerably had the right to request assistance to end their suffering. We respect that decision of the Supreme Court of Canada, as we think all members of the House would.
    The issue before us is not if Canada should have medical assistance in dying, but rather how we make it available. It is important to recognize, given the sensitivity of the very issue we are debating today, that we have until June 6 to deal with the issue. If we do not deal with the issue, it will be most inappropriate as parliamentarians, representing Canadians from coast to coast to coast. There is an obligation for us to meet that void that has been put in place by the Supreme Court of Canada.
    Would the member at least acknowledge the fact that we have to pass some legislation? Are there any possible amendments the member would like to see to make it easier for him to support the legislation?
    Mr. Speaker, my point was exactly that. It is the court that has brought us to this point, and the timeline is the court's timeline.
    As one of my colleagues pointed out a little earlier, that deadline prohibits us from dealing with these issues as fully as we probably should. We have not had any discussion about the implications of the Supreme Court decision. We have never sat down and had those discussions.
    The government has come forward, under pressure, with legislation that many people feel is inadequate. One of the areas I find very troubling is the lack of conscience protection, and I mentioned that a little earlier.
    Many people in the disabled community are very concerned about the fact that there is no vulnerability protection. They do not want to see a development of peer pressure in society where people feel somehow obligated to participate in this activity.
    There is a number of issues around this. The timeline we are on is not helping us to discuss and resolve those issues among Canadians.
    Mr. Speaker, following up on the question of my hon. colleague on the government side, I share his concern that we seem to be moved toward filling a legislative gap because of the Supreme Court decision, which is very true.
    On the other hand, it strikes me as the realistic situation that if we do not have legislation in place by the June 6 date given by the Supreme Court, then we would be in the untenable position of having a legislative vacuum. There would be absolutely no provisions concerning assisted death at all. The Supreme Court has found that the provisions of the Criminal Code that govern this matter are unconstitutional and only suspended the application of that judgment until June.
    Does my hon. colleague have any thoughts about how we could bring in appropriate legislation and also avoid the untenable situation of having a legislative lacuna in Canada?


    Mr. Speaker, one of the things is that we are here. We are having the debate and discussion, and we are having it within the established timeline. We are trying to do a good job of setting up the guidelines and the safeguards on this issue.
    The reality is that the acceptance of assisted suicide and euthanasia is not universal across the country. It was not something that was decided by the elected members of the House, those who are here to represent the people. It was decided by the Supreme Court of Canada. It made the decision that we had a charter right to this in Canada, so we needed to move forward with this legislation.
    However, the Parliament of Canada needs to take some time to do this carefully to ensure we do it correctly for people.
     There is a number of other things I had to say. One of them would have been about the slippery slope that countries find themselves on when they move into this area. We need to have a discussion about that as well. I do not hear members talking about this.
    Mr. Speaker, I am privileged to rise in this chamber in support of Bill C-14, medical assistance in dying.
    I am in favour of the bill, not only because it was mandated by the Supreme Court of Canada, but for very personal reasons. I believe it is a bill, a policy, that respects the rights of individual Canadians who are suffering unbearable pain. It respects their right to die a peaceful death.


    I rise today to speak in favour of this bill on medical assistance in dying, not because of the Supreme Court's decision to strike down the criminal law banning medical assistance in dying, but rather for very personal reasons.


    To begin with, the bill refers to medically assisted dying. It is not referred to as medically assisted suicide. My common definition of suicide, and I believe it is society's definition, is intentionally taking one's own life when death is not imminent. In the case of Bill C-14, there are clear conditions that would qualify an individual for medical help in dying. This would include, of course, the reality that death is imminent for that individual.
    Henceforth, I believe we should stop calling it suicide because it is clearly not suicide in the common form of our understanding. I also believe that there is no parallel with the very sad and tragic suicide epidemic that is occurring in indigenous communities across our great country. In my mind, one is an apple and one is an avocado. They should not be compared.
    The whole debate around medically assisted death is deeply personal and has led to some very emotional discussions. For me, it has led to much personal reflection. Like many Canadians, like many people in these chambers, I have seen too many family members and friends suffer excruciating pain needlessly when death was imminent.
    Very personal for me was an experience last August 2, the same day that the federal election was called, when my mother passed away. She was 96 years old and she had been living alone for the last 20 years. She had been living bedridden and in pain in a care home for the last five years.
    My mother was a religious person and had a special relationship with her god. She prayed every day. She scolded me for not attending church as often as I should. Over the last 20 years her body deteriorated, but her mind and hearing stayed sharp. Over the last 10 years, my mother shared with me her desire to have her life end. Medical advances had helped her to live longer, but her quality of life had severely deteriorated. She had become completely bedridden in the last five years and, in the last four years, malignant masses and tumours had developed throughout her lower body. Constant pain set in, and pain protocol was established. My mother, tough as nails, continued to breathe, pray, and hope that God would come and take her away. The praying and hoping continued for years and years.
    My mother was of sound mind. She was a religious person who was at peace with her god. Families, nuns, and a priest would visit her faithfully. They gave her comfort, but she continued to express to me that she wanted to die peacefully and comfortably. She wished that there was a way to end the unbearable physical pain that could no longer be managed regardless of the care she received. I wish she could have had that choice, and she should have had that choice.
    My personal feeling is that the legislation does not go far enough. I would have preferred that those who are experiencing enduring and intolerable suffering, with no chance of ever improving during their lifetime, be allowed the opportunity to access medically assisted dying, under the strict conditions that we have imposed in the bill.
    However, I also understand that the legislation shifts the paradigm in such a profound way that in the future we will be making reviews. The law will be improved, and evidence will be collected. I hope that myths will be dispelled, and individual human dignity, self-determination, and choice will be nurtured further.



    This choice is the basis of our discussions today. We hope to offer this choice to individuals who, in their last moments on earth, are experiencing intolerable physical suffering as a result of a grievous and irremediable medical condition. The debate is not about suicide. It is about trying to ensure the dignity of the dying person. We make choices about the care we receive throughout our life, and it is unfortunate that this choice is taken away from us at the end of our life.


    It is true that the Supreme Court's decision in Carter v. Canada made physician-assisted death legislation necessary. I believe many of us have spoken to the fact that the timelines are anything but ideal. Would I have preferred to have another six months of debate, consultation, and discussion in order to make this reality? Of course, I would have preferred that. I believe every member in these chambers would have preferred that.
     However, it is also true that there are people who feel that this legislation does not go far enough. There are also people who are opposed to physician-assisted death entirely. I have had many discussions with constituents on this issue.


    I represent Saint-Boniface—Saint Vital, a riding with many Catholic constituents, and they have all made their views very clear.


    Everyone, regardless of their position in this debate, wants to ensure the protection and dignity of individuals. The notion of dignity, which has come up several times in these chambers, is highly individual. Personal history, personal beliefs, and personal health situations all define what dignity means to the individual, and I might also add the right to self-determine.


    Dying with dignity is a personal choice that needs to be respected. This bill is necessary. As a society, we must make sure that the best care possible is available to all our fellow Canadians.


    This is an important moment in our history, where consultation has not only played an important role in the past but will play an important role into the future. I applaud the government for undertaking vast consultations across Canada and abroad to ensure that this legislation defends people's choices and freedoms in a way that protects the most vulnerable. It also supports personal convictions of health care providers.
    I further congratulate the government on taking the time to continue the very important consultations and discussion surrounding mature minors, people who suffer from mental illness, and people who would like to arrange advance directives.



    I would like to add that I fully support the government's commitment to a full range of options for quality end-of-life care, including palliative care, an area in which the St. Boniface Hospital, in my riding, is a leader. This bill establishes responsible measures to promote a standard approach to medical assistance in dying across Canada. It recognizes the inherent value and the equality of every human life.


    The proposed legislation sets the framework for medically assisted dying across the country. It also provides a review in five years. It is balanced, responsible, and a very compassionate response to a very difficult, very personal issue.
    Mr. Speaker, I thank the member for his speech, and particularly for having the courage to share some of his personal story and interactions with dying. These personal stories help us to add context.
    Unfortunately, because of the lack of palliative care that we have in this country, there are many cases where a person may think or be told that their pain is not manageable when in fact their pain is manageable. This is why I think we need a greater emphasis on palliative care and pain management.
    I want to ask specifically about dealing with palliative care in the context of the legislation before us. We have heard that there is a commitment, not in this budget but at some point in the future, to make investments in palliative care. Most of us think that is a good thing. The problem is that individuals do not have access to quality palliative care, and yet there is no allowance in the legislation requiring that they be offered palliative care before pursuing the option of assisted suicide or euthanasia.
    I wonder if the member would support an amendment, as was recommended this morning in committee by an association representing palliative care doctors, to ensure that people would be offered palliative care, and that people would not opt for euthanasia simply because they do not have access to palliative care.
    Mr. Speaker, I met extensively with the St. Boniface Hospital in my ward, and with the Archbishop of Saint Boniface. There is certainly no argument from me that palliative care is extremely important in this whole topic.
    We committed, post-election, $3 billion over the course of four years for improved home care, which is tightly connected to palliative care. We also have to take the health minister at her word when she says that palliative care is an absolute priority in her term as health minister. A lot of it is about partnerships with the governments across Canada.
    I agree that palliative care needs to be improved. We need to improve the budgets on palliative care, and I support that notion.
    Mr. Speaker, I would like to congratulate my hon. colleague on a thoughtful and sensitive speech. I also share his distinction between suicide and assisted death. That is an important distinction that all parliamentarians would do well to keep in mind.
    I have two quick questions for him. First, he mentioned palliative care. I am the health critic for the New Democrats. I have pored over the budget of the government, and we know that the $3 billion promised during the election campaign by the Liberal government for home care is simply non-existent in the budget. I would like his comments on that and how he feels we can build a world-class palliative care system without a government that is prepared to put money behind it.
    Second, in terms of the Supreme Court decision, it clearly said that assisted death should be available to anybody who suffers from a grievous and irremediable condition. This legislation includes additional criteria beyond the Supreme Court's instructions, including requiring that death be easily foreseeable. That has led to the perverse situation where Ms. Carter, the litigant in that case, likely would not be able to avail herself of assisted death, even though she successfully won the case. I wonder if he has any comment on the legislation in that regard.


    Mr. Speaker, I think the hon. member would agree that the bill being introduced, and that will be adopted, is profoundly shifting the paradigm on this issue. There are people who think it goes too far. There are people who think it does not go far enough. However, the reality is that it profoundly shifts the paradigm on the issue of medically assisted dying. It will be reviewed in five years, and I think there will be ample opportunity to improve it. I am confident that will happen.
    On the palliative care commitment, it is quite clear that there is $3 billion over four years. I was sitting in this seat when the health minister made a commitment to improve palliative care service over the next four years.


    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.


    Mr. Speaker, I have two specific follow-up questions. The member alluded to the government's commitment on home care, but we need to be clear that there is a big difference between palliative care and home care. Home care is the care that someone receives in their home to support their ongoing independence—it could be at varying stages—and palliative care is specifically the care for those who are dying.
    I wonder if the member could clarify what kinds of investments we will see in palliative care, especially since neither of these things were in the budget.
    Second, I want to ask him about contemporaneous consent, because the concern I have is that if we were to move down the road of having advance directives in this legislation, we would have a very different consent there than for sexual consent. In the context of sexual consent, of course, we require contemporaneous consent.
    Why would we have a lower bar for consent when someone is choosing to die than for someone who is choosing to engage in sexual activity?


    Mr. Speaker, I would like to begin by answering my colleague's question about money for home care and palliative care. I heard the minister say several times that palliative care is a priority for the government, a crucial priority that the government plans to invest in.
    The government's pledge to invest $3 billion in home care over four years comes at a time when most of the people receiving home care are at the end of their lives. I completely agree with the member: palliative care should be and is a priority for this government.



    With regard to his question concerning consent, my mind is not made up on advance directives, but I think there is a difference between consent in terms of sexual relations and consent when people know they have a debilitating illness that will prevent them from consenting further down the road. I think the distinction is clear.
    However, my mind is not made up on that subject. I wish to hear more about advance directives and I am glad that the government has decided to study that question further.


    Mr. Speaker, I appreciated my colleague's remarks.
    Yesterday, the Barreau du Québec stated that the reasonably foreseeable natural death provision in the bill is not consistent with the Carter decision or the right to life in section 7. Ms. Carter would not have had access to medical assistance in dying unless reasonably foreseeable natural death were interpreted as having to do with age, which is an absolutely unnecessary distinction here.
    I would like to hear my colleague's thoughts on that.
    Mr. Speaker, I thank my colleague for his excellent question.
    As I mentioned in my speech, I agree with the Barreau du Québec on that. I think the notion of reasonably foreseeable adds a criterion that did not exist in the Carter decision. Unfortunately, it places people who are suffering from a serious and incurable illness and experiencing suffering that is intolerable in situations where, if they are not terminally ill, they cannot receive medical assistance in dying.
    That is one aspect of the bill that I personally have a problem with. Still, I think it is a step in the right direction, which is why I urge all members of the House to support this bill at second reading so it can go to committee.
    Mr. Speaker, I thank my colleague from Louis-Hébert for his very clear speech on an issue that is so personal for many of us.
    Almost everyone here in the House who is participating in this debate has similar stories from their own lives.
    In my case, my grandmother was no longer able to teach downhill skiing at the end of her life. After teaching it for nearly 70 years, she started falling, until her injuries were too serious for her to survive them.
    I do not think this came under the canopy of medical assistance in dying or assisted suicide. I find that circumstance unacceptable. We need to fix this lack of dignity.
    Is my colleague worried about the legal vacuum that would exist if this bill is not passed within the prescribed time frame?
    Mr. Speaker, I would like to thank my colleague for his question. In fact, we must avoid this legislative vacuum for Canadians.
    That is why I believe voting for this prudent bill is the right thing to do. It is a step in the right direction, and it could go further.
    This issue was debated in Quebec for years. Canada is just beginning to debate it, and I believe that the debate will have to continue for the next few years. The bill provides for a review of the act in the first five years.
    We must have this debate, and we absolutely must present Canadians with a law before June 6, 2016.


     Mr. Speaker, today I rise to discuss Bill C-14.
     As we well know, Bill C-14 is the government's response to the Supreme Court ruling in the Carter decision last February. The court gave the government a total of 16 months to form legislation, so here we are in the House today, debating the bill.
     I was pleased to see that the bill included many recommendations provided by my Conservative colleagues in their dissenting report from the special joint committee report on this issue. However, I do not believe the bill in its current form is good enough.
     I have benefited from listening to my colleagues' speeches, and appreciate the passion each has shown as they discuss Bill C-14 in the House. Indeed, I have made my own consultations with various interested parties in my riding of Richmond Centre, and look forward to sharing them with you.
    We have received many suggestions and comments on the legislation, both from parties that believe the bill is too restrictive and those who believe it is not restrictive enough. Indeed, I am rather impressed that there was significant public interest on this bill, and I would like to continue to encourage people in Richmond Centre who have not given their thoughts on this matter to write to myself or my office.
     My voting position on second reading will be carefully considered from a balance of available information, including from the consultations I have held with interested stakeholders in my riding.
     To begin, I would like to share some of my personal experiences. During my time as the Minister of State for Seniors, I had the opportunity to work with many groups who are devoted to protecting our most vulnerable and ensuring quality palliative care. The unfortunate reality is that there are many seniors who are not provided with effective end-of-life care. Instead, they are subject to elder abuse and are often pressured into making decisions to avoid becoming a burden to their families. This is tragic. It is absolutely imperative that we ensure that there are safeguards to protect seniors against such elder abuse.
    A potential safeguard to protect financial abuse of elders, which is a very common and unfortunate form of elder abuse, is to simply prohibit any independent witnesses from financially profiting at all from the will or the estate of those who requested physician-assisted suicide. This was actually a recommendation from a group of constituents I met with recently. They pointed out that in the bill, the independent witnesses that have to sign the documentation to enable the physician-assisted suicide only have to know or believe they are not a beneficiary under the will of the person making such a request. Again, this is simply not enough.
    Back in my riding of Richmond Centre, I have been an active member of the Richmond Rotary Club. This club was instrumental in building the first hospice in Richmond. It was there that I and my fellow Rotarians witnessed first-hand the benefits quality palliative care can bring people. Life is valuable at every stage. One of my primary concerns with physician-assisted suicide is that it will only complicate end-of-life decisions. Individuals who are sick or need additional care will see themselves as a burden, and choose death to avoid placing further expectations on family members.


    Instead, we need to be supporting family caregivers and demonstrating that every life is valuable.
    As others have noted, there was no allocation in the budget for palliative care services. This is totally and absolutely unacceptable. This issue is quickly becoming more about access to death than access to life. It is absolutely essential that the government make a commitment to strengthen palliative care and encourage citizens to seek such care first. Palliative care provides death with true dignity and not a forced death, which is what physician-assisted suicide is.
    Last year, I had the opportunity to meet with organizations such as the Council for Canadians with Disabilities, the CCD. I met with its representatives to discuss their concerns and the importance of protecting individuals with disabilities. More recently, they were able to appear as witnesses at the special joint committee to discuss their views on possible legislation. The CCD was very concerned with the recommendations provided by the committee and commented, “The permissive approach would put vulnerable people at risk”.
    We cannot ignore the needs of our most vulnerable. It is crucial that the legislation reflect the concerns of groups such as the Council for Canadians with Disabilities to ensure all Canadians are protected.
    I would like to share a few of the comments I have heard from my constituents over the past several months. I will emphasize that my repeating these comments in the House today does not mean that I endorse all of them, but rather, this is a reflection of the variety of comments received. I know as an elected figure this may be hazardous as I may be quoted out of context; however, it is my duty to ensure that these voices are heard.
    A primary theme as a result of my consultations is that Bill C-14 would only decriminalize the act of physician-assisted suicide as performed by medical practitioners.
    I will add that there would be no effects or changes to the Canada Health Act, nor would it instruct our provinces to provide this procedure as something to be covered under provincial medical insurance plans. In my home province of British Columbia, this is the medical services plan, the MSP.
    In general, there seemed to be a considerable amount of confusion about whether the provincial governments would actually provide this procedure and whether they would indeed pay for it.
    One stakeholder group mentioned it wished to invoke the notwithstanding clause to maintain the previous provisions of the Criminal Code. This group found the terminology of what constituted a terminal illness to be a slippery slope and that unendurable pain could be mitigated with quality palliative care. As it realized that this was generally not a realistic approach with the existing government, it also mentioned that it was hoping for a robust protection for health care providers and facilities to act according to their conscience.
    There were many other comments, but I have only 10 minutes for this speech, so I will state again that I have been pleased with the amount of interest we have received from engaged citizens and stakeholder groups on Bill C-14. I will be making my voting decision after giving the people of Richmond Centre the maximum period of time to send their feedback.
     I would like to end my speech with a short story. Many members of my family are health professionals. Even among those who are young, many desire to grow up to be doctors or nurses. When I ask my young nieces and nephews why they want to be a doctor, I always receive the same simple answer, “I want to save lives.”


    Mr. Speaker, the member is concerned about access to death versus access to life. On the timeline we are working with, imposed by the Carter ruling, is precisely access to death that we are addressing here. I do not believe there is anyone here who is opposed to looking at palliative care.
    For me, freedom to life is very much like, and as important as, freedom of religion. Freedom of religion includes the freedom to be religious in any manner we choose, just as it includes the freedom from religion. Freedom of life includes the freedom to live, but it includes the fundamental right not to live. The latter is not a right that should be exercised lightly, and it is extremely important to have processes in place, as this bill proposes to do in line with the Carter decision.
    I believe we should make every effort as a society and as a Parliament to make every person's life as good as possible. Indeed, that is a principal obligation of government. I believe that the decision of when to end one's life is a decision that belongs to the person whose life is ending, and only that person.
    Does my colleague agree that the best defence of life we can provide is by getting this law through on deadline, avoiding a legal vacuum, even if it means revisiting the issue later?


    Mr. Speaker, I know I am not alone in stating that the time frame set out by the Supreme Court was not sufficient. Sixteen months is not nearly enough time to adequately examine evidence, consult with Canadians, and prepare well-drafted, careful, and sound legislation. I do not think it is appropriate to approve legislation simply because it is good enough or we are on a time crunch. It is never our responsibility to rush legislation. We represent our constituents to ensure a better and safer Canada.


    Mr. Speaker, I have mixed feelings about the Conservative member's speech.
    On the one hand, the Conservatives are complaining about not having enough time to debate the issue. As everyone knows, it was the Conservatives who opposed the opposition motion to create a multi-party committee to study the Carter decision. This would have started the ball rolling on a study of medical assistance in dying. Therefore, they are part of the reason why debate and studies on the issue were delayed.
    On the other hand, I agree with the member that we need more palliative care and that financial resources must be allocated to palliative care. Many people want to stop their suffering, but they do not necessarily want to die right away or to access medical assistance in dying. Above all, they want the pain to stop.
    Today, the Liberals say that they are prepared to allocate $3 billion over four years. However, there are no timelines.
    I would like to hear what the member has to say about that.


    Mr. Speaker, I heard the Liberals say that they wanted to commit themselves to $3 billion over four years. However, it is not in the budget. If it is not in the budget, where is the money? The most important thing is to not make empty promises, but to really keep their promises and take real action.
    I appreciate the fact that my colleague from the NDP also stressed the importance of palliative care. It is exactly the same message that this is an option for end-of-life choices. Ending one's life by force is not the only choice.
    Mr. Speaker, my colleague referenced the government's supposed commitment on palliative care, but it is actually worse than that, because the Liberals have said palliative or home care. One of the members pointed out quite rightly that palliative care can happen in the home, but these are not the same thing. There are many kinds of home care that are very much essential which are not the same as palliative care.
    I would say it is important that we deal with palliative care, not just separately maybe sometime in the future, but specifically in this legislation. The federal expert panel, which the previous government set up, was clear that people cannot be construed to have consented to euthanasia or assisted suicide unless they had an option of palliative care available to them.
    I would like the member's comments on that.
    Mr. Speaker, there is indeed a very clear distinction between home care and palliative care.
     Palliative care is about helping the relatives, the friends and families of the one who is terminally ill and who is expecting to die. It helps them go through the end-of-life period of time together in a positive way so that it is a good end-of-life option. That is unlike home care, which is only for helping seniors get up, do their washing, do their dishes, and other things. There is definitely a clear distinction between home care and palliative care, especially hospice homes.
    Mr. Speaker, I am pleased to speak to Bill C-14, which would enact a federal legislative framework to permit medical assistance in dying across Canada.
     Medical assistance in dying is a deeply personal issue for all Canadians, as we have witnessed. As parliamentarians, we must consider a diverse range of views on this complex issue. I know that we all take this responsibility very seriously.
    The starting point is, of course, the February 6, 2015 decision of the Supreme Court of Canada in Carter v. Canada. The court unanimously held that the criminal laws prohibiting physician-assisted dying interfere with liberty and security of the person by denying grievously and irremediably ill individuals the ability to make decisions concerning their bodily integrity and medical care, and leaving them to endure intolerable suffering.
    The court also held that the laws deprive some people of life by forcing them to end their lives prematurely for fear that they would be incapable of doing so when they reached a point where their suffering was intolerable. The court accepted that the criminal prohibition on assistance in dying furthers a pressing and substantial legislative objective, that of preventing vulnerable individuals from being induced to die by suicide against their will in a moment of weakness.
    However, the court concluded that a permissive regime with properly designed and administered safeguards was capable of protecting vulnerable people from abuse and error, and that the absolute prohibition went farther than necessary to achieve its objective. The court appropriately left the task of designing this new regime to Parliament.
    The proposed legislation responds to the Carter ruling by enacting a new legal framework for access to medical assistance in dying, including the safeguards that the court called for in order to minimize the potential for errors and abuse.
     The court did not define the term "grievously and irremediably ill", but the proposed legislation does define it in a manner that is consistent with these circumstances. Specifically, the person must be in an advanced state of irreversible decline in capability. The person must have a serious and incurable medical condition. The person must be suffering intolerably. The person's death must have become reasonably foreseeable, taking into account all of the person's unique medical circumstances.
    Canadians would have the comfort of knowing that they would be able to get the assistance they need if they are suffering intolerably when their capacity declines as they approach the end of their lives.
     Like so many honourable members who have stood in this house to debate this difficult legislation, I have my own personal story that makes this issue all the more relevant. My mother, Eleanor Anderson, spent over 10 years in a wheelchair after suffering a massive stroke at the age of 69. She had to learn to walk, talk, eat, everything right from scratch. Then it happened again, another stroke five years later. She fought back again, but with each stroke a little more of her was taken away.
     She never wanted to feel helpless. During those years in a wheelchair, my mother would try her best to do everything on her own, whether it was dressing, loading the dishwasher, or simply wiping down the kitchen counter. During those years, she never wanted our sympathy.
    Despite her tenacity, she knew the day would come when she could not fight any longer. She made it very clear to my father, to me, and my brother that if the time came and she was not able to do much more than lie in a bed, she wanted to drift away peacefully. As expected, what we all feared eventually happened.
    She continued to have small strokes, losing mobility and function with each one, to the point that she could no longer sit up in her wheelchair, talk, or even eat. We were not even sure if she knew any of us anymore. She pulled out the feeding tube that kept her alive, to the point where the doctors said they wanted to insert a tube in her stomach. That was not the life my mother wanted, and so we said no. We had to let her go. Doctors agreed it was best, and said she would only last a few days.
    We asked that she be moved to palliative care at another hospital. Ironically, they said they could not move her because she would not make it, that she would die en route, and so she lay in that hospital bed, and we watched her slowly starve to death.


    She would last 12 days, and her death was anything but peaceful. It was the most excruciating experience I have ever been through, and nothing prepared me or my family for her death. I know my mother would have agreed that this legislation is a step in the right direction. She would have wanted to be able to communicate her desire to die with dignity. However, she would have also wanted her family to follow through on her wishes.
    Twelve years later, my dad said to me, after catching an infection, “I just want to close my eyes and not wake up”. That is exactly what happened. He was gone two days later. He got his wish. However, I know that many people are not as fortunate, and it is for those people that we must be prepared to lend our voice.
    Health Minister Jane Philpott said this in her speech to the House:
...every person, every story, is unique. However, much is shared in common: the hope to die in peace; the desire to be respected; and to have personal autonomy and dignity honoured by family and health care providers alike.
    Minister Philpott went on to say that her experience as a family physician reinforced her sense that we must—


    Order, please. I try to make a point not to interrupt the member when that happens. However, we have a Standing Order that suggests we not use other members' names in the House. That includes when ministers are being quoted. I realize that the hon. member did not put it that way in this case, but even if a member's name appears in a citation, for example, we avoid that. If the member would substitute the minister's title or her riding name, then she is good to go.
    Mr. Speaker, the minister went on to say that her experiences as a family physician reinforced her sense that we must “uphold the principles of palliative care, as well as respecting the rights of patients to make their own decisions about their care as they approach the end of life”.
     Earlier this year, the minister met with provincial and territorial health ministers in Vancouver to launch discussions on a new multi-year health accord. Through the health accord process, our government will be making significant investments totalling $3 billion dollars to help deliver more and better quality home care services for Canadians. We expect that support for palliative care in a variety of settings, where patients can receive the ongoing care they need and deserve at the end of life, will be one of the priorities going forward. I agree that there is no doubt that care at the end of life should be there when people need it. We want all Canadians to have access to the best care possible.
    The issues in this area are complex. However, I strongly believe that Bill C-14 has struck the right balance between competing rights and policy objectives.
    I call on members of this House to support it.
    Mr. Speaker, I would like to ask the member about the concept of advance review by a competent legal authority. One of the concerns I have with this legislation is that we have various criteria, some of which I think need to be more specific, but there is no mechanism for ensuring that complex legal criteria are met. What some have proposed, and there has been some agreement from at least one member on the other side, is that if we had a system in place where there was someone with not just medical but legal expertise reviewing it to say, yes or no, the criteria are or are not met in this case, that would be a good way of ensuring that vulnerable people, the people who do not consent or do not meet the criteria, are not being pushed into it or receiving euthanasia or assisted suicide without the law being followed.
    Would the member agree with me that an amendment to ensure some kind of advance review by competent legal authority would be an effective way of improving this bill?
    Mr. Speaker, under the proposed legislation, two independent health care professionals would need to evaluate the circumstances of a patient's health. If I understand correctly, the member is saying that we should go one step further and have someone from the legal community also be a part of that. I think that is up for discussion, something that certainly should be discussed at the committee level. That is why I hope this will be moved forward.


    Mr. Speaker, I thank my colleague for her speech.
    This topic goes to the core of our values and our ways of life.
    The Quebec bar recently confirmed that if the bill were passed as drafted, it would be unconstitutional. What does my colleague thing about that?



    Mr. Speaker, this is obviously a decision that all of us have to make individually and take in all of the information that we are hearing, not only from what we have so far from the committee but also what is happening across the country, and certainly what has happened in Quebec. I think that is something to which we all need to listen and be open.
    Mr. Speaker, I would like to thank the Parliamentary Secretary to the Minister of Transport for sharing personal stories, because that does help to understand the background we are coming from when we are trying to deal with this issue.
    We have heard a lot today and yesterday about the balance between safeguards and providing this right. Perhaps the member could provide us with some better insights into which safeguards give her the most comfort with this legislation.
    Mr. Speaker, safeguards are necessary, because there are the vulnerable in our society whom we must protect. Therefore, it is important for us to have different steps of safeguards.
     Each person who is going through this journey of death is different. I think we do need to have safeguards in place, and certainly the safeguards would be different in different situations.


    Mr. Speaker, what does my colleague say to people who claim that under the existing bill Ms. Carter would not have had access to medical assistance in dying?


    Mr. Speaker, this is one area where I think there is a point of discussion. Some people would say that she would have met the criteria of the four areas. It is something on which I think it is necessary to have a debate.
    Of course, in Ms. Carter's position, where she was at her end of life will be different from someone else. However, I truly believe, in looking at the legislation, that she would have been able to have assisted dying under this legislation.


    Mr. Speaker, I think it is very important to rise to speak to Bill C-14, today and on other days of debate.
    As my colleagues probably know, I am a health care professional. I still work at the hospital a few times a month, mainly in emergency and intensive care. This is important to me. End-of-life care is very important, which is why I supported a motion that my colleague from Timmins—James Bay moved during the previous Parliament. That motion dealt with a national palliative care strategy.
    To begin, I would like to highlight two or three points from the Supreme Court decision that I think are particularly important to this discussion. The decision states:
...the prohibition [of medical assistance in dying] deprives some individuals of life, as it has the effect of forcing some individuals to take their own lives prematurely, for fear that they would be incapable of doing so when they reached the point where suffering was intolerable.
    And by leaving them to endure intolerable suffering, it impinges on their security of the person.
    It is important to mention that the Supreme Court decision underscores the government's responsibility to address the suffering that people experience. It is also important to understand the difference between suffering and pain. Pain is a physiological reaction to stress, such as an injury. Suffering has to do with an emotional experience.
    Take, for example, a very painful event such as childbirth. That pain is associated with a positive emotional experience, the birth of a child. That event does not necessarily cause suffering, but it does cause significant pain.
    A person might also have a minor injury that can cause extreme suffering because of the emotional experience associated with it. I think it is important to make that distinction.
    These days, we have excellent therapeutic ways to alleviate pain. Opiates were long used, but now we also have patient-controlled analgesic pumps. We can even offer continuous palliative sedation, similar to what intensive care patients receive when they are intubated to ensure that they do not feel any pain. There are a number of extremely effective ways of alleviating pain, in addition to non-pharmacological methods. We have a good range of treatments to offer patients who are in pain.
    It is possible to alleviate the suffering that comes with an emotional experience such as the end of life or an end-of-life diagnosis without resorting to medical assistance in dying. In that case, palliative care is an option. The bill applies to adults with a serious and incurable illness, disease, or disability who are in an advanced state of irreversible decline in capability and whose natural death has become reasonably foreseeable.
    Obviously, we are talking here about people who are at the end of their lives, people who need palliative care. The purpose of palliative care is to ease the suffering of both the patient and the family. Palliative care helps ensure that people are cared for properly, and that they have the help they need to get through the grieving process and the hardship associated with illness.


    We want to take away all the pain, but we also want to provide support for the family.
    Optimal palliative care helps not only the patient but also the whole family, so that the patient's death can be as peaceful as possible for everyone involved. We are going about things the wrong way by providing medical assistance in dying when the palliative care offered in Canada is not yet optimal.
    When palliative care facilities are underfunded and need to try to drum up donations every year, they are unable to offer optimal palliative care. Most of these facilities can only take patients who are expected to die in less than three months. However, people can often live much longer than that with a terminal illness and they need a lot more support.
    Moreover, in many rural areas, palliative care beds are reserved through surgical units. That means that nurses who are taking care of palliative care patients also have to take care of seven or eight other patients. Nurses are therefore unable to respond quickly or spend as much time as they should with the families, and the patient's death does not go the way he or she would like.
    For people who do not have the means or who do not want to die at home, unfortunately the hospital is often the only other option when palliative care beds are not available. This is not an easy experience, and it can create suffering because patients do not always have all the support they deserve.
    There has been a lot of effort in recent years to remove some natural processes from hospitals. One example would be the birthing centres that have been set up. The thinking is that it would be better for mothers to go through pregnancy and childbirth a little more naturally in a setting other than a hospital, as long as there are no medical complications.
    The same thing is being done with death, which is a natural process. It is being taken out of hospitals to make the experience much more positive, in a place other than the medical setting of a hospital.
    Hospices try to remove all traces of hospitals. They have hospital beds, but they try to use the patients' own bedding, have large windows, and help patients forget that they are not at home.
    Unfortunately, no matter how hard the palliative care facilities work, they are often underfunded. For example, the Maison du bouleau blanc, in my riding, has four beds, only two of which are subsidized. It therefore relies on donations to maintain its other two beds. It has a large room with big windows and a shower, but this is the only room that the facility has been able to convert to an ideal palliative care room.
    These people cannot afford nurses. The people who work there are extremely dedicated practical nurses. However, they have some legal limits. For that reason, all the protocols regarding doctors working with palliative care facilities had to be updated, in order to ensure proper care for the patients.
    We could address a number of shortcomings and avoid making the patients suffer. If someone who receives a terminal diagnosis knows that they will receive good palliative care as their condition worsens, they may not choose to take their own life prematurely. This would therefore help protect the right to life.
    However, as long as do nothing on palliative care, we are working backwards. We cannot reverse the life-based medical model to allow for medical assistance in dying if our palliative care services are not as good as possible or accessible to all Canadians, regardless of where they live, even if they live in a remote region.


    Since I am out of time, I would be happy to take questions from my colleagues.
    Mr. Speaker, I thank the member for Abitibi—Témiscamingue for her extensive remarks on palliative care.
    As she may know, I was a member of the Special Joint Committee on Physician-Assisted Dying, and we talked a lot about palliative care. We also talked about how, for some people, that is not enough. Even though they have access to palliative care, they want the right to medical assistance in dying.
    Can the member help me think of some ideas for people who want medical assistance in dying? They do not want palliative care; they want medical assistance in dying.
    What safeguards does she think we should put in place for them so we can give them that right?
    Mr. Speaker, as I said in my speech, the government chose to leave people who are not at the end of their lives out of Bill C-14.
    In some cases, individuals might want medical assistance in dying. One example that comes to mind is people on hemodialysis, an onerous and time-consuming treatment. After 10, 15, or 20 years of such demanding treatments, people might be worn out and might want to stop. All patients have the right to refuse treatment. A patient who refuses this treatment will die in the short term, but continuing to receive the treatment will not cause death. That means that the patient's end of life is not reasonably foreseeable, and he or she may therefore not be covered under this bill. People may want medical assistance in dying, but some of them are not covered under this bill as written. That must be fixed.
    I think we should concentrate on palliative care first and foremost. Allowing medical assistance in dying makes no sense unless we have optimal palliative care in place.



    Mr. Speaker, I thank the member for her eloquent remarks, specifically around the importance of palliative care. We have heard from the NDP some agreement with what we have been saying, which is on the importance of palliative care as well as conscience protection. We have actually heard the Liberals in some instances, and in different ways, saying that these things are important as well.
    My view would be that we need to make sure that these things are included in this legislation, that we have protection for a right for someone to access palliative care, and a right of conscience. We hear reassurances from the government that it cares about these things as well, so let us get this into legislation so that Canadians and those of us who are voting on the bill can have certainty that those rights will be protected.
    Would the member agree that we need amendments specifically in this legislation, not just separate funding commitments, but amendments in this legislation, to ensure that people will be offered palliative care and that there will be protection of conscience?


    Mr. Speaker, I agree that it makes no sense to guarantee the right to medical assistance in dying without guaranteeing the right to receive optimal, high quality palliative care. Both options have to be on the table.
    For example, someone who is diagnosed with advanced cancer could be offered medical assistance in dying. They know that option is on the table. However, palliative care might not be available in their region. They would have to relocate and spend their dying moments far from their family. They are not being offered a full choice. If we really want to be consistent in terms of what we are putting on the table, then both rights have to be guaranteed to end-of-life patients.


    Mr. Speaker, indeed this is a heavy subject for most Canadians. Physician-assisted suicide is definitely weighty. There were laws that we thought were sufficient, but it is as a result of the Supreme Court deciding the law is not sufficient that we are in this predicament today of having to find some alternatives.
    I will be speaking to some different issues. I would not say they are of the highest importance to me. I will speak about those issues a little later. However, I want to talk about a few of the issues that are not talked about as much. One of them is on page 11 of the bill, called “Deeming”. I will read from the act itself. It states:
    For the purposes of this Act, if a member of the forces receives medical assistance in dying, that member is deemed to have died as a result of the illness, disease or disability for which they were determined to be entitled to receive that assistance
    I will go to the next page, where it again says “Deeming”. This time it states:
    For the purposes of this Act, if a member or a veteran receives medical assistance in dying, that member or veteran is deemed to have died as a result of the illness, disease or disability for which they were determined to be entitled to receive that assistance
    I mention that today as a former member of the veterans affairs committee, which dealt with PTSD, with veterans who have experienced trauma as a result of war, as well as relatives who have suffered trauma and PTSD as a result of war. I am concerned about this clause in a dramatic way, due to the potential for it to be used as a way out for families. It could be a means of financial assurance, if the member decides it is a way out, that could provide sustenance for his or her family.
    I feel it would open a door that was previously closed to members. We certainly respect the ones who have passed as a result of suicide, but I am concerned that this opens the door wider, to making it a somewhat legitimate exercise and to potentially doing it for families to receive benefit. We should be looking at more ways to help members of the forces and veterans with PTSD rather than giving them a doorway out.
    The second issue I would say is a more significant argument for me, and that is the issue of compelling. Compelling has different forms. Compelling, as we heard from physicians who are friends of mine, and nurses, could be a doctor compelling a nurse to deliver a life-ending drug. Can a patient compel a doctor to end that patient's life? Does a senior feel compelled to end his or her life to lessen the financial burden to the family? Does a senior feel compelled to end his or her life to make room for others in hospital rooms and beds in our country?
    I feel that there are a lot of arguments. I will first talk about the argument of a physician compelling a nurse. Certainly there is discussion within the bill to allow physicians to have the freedom to do what they wish to do based on their religious beliefs, or the basic belief that life is sacred and not wanting to take part in assisted dying. Most of us fully understand the way that the Supreme Court can be used as a tool. A citizen could use the Supreme Court as a tool if a doctor refused service.
    If a doctor refused to assist a person to end his or her life, it would likely end up in a court, which I am sure will happen if this bill passes the way that it is. Doctors could be held to account, if a law is enacted that they have a responsibility to perform that duty for Canadian citizens. Likewise, if doctors feel compelled to perform that service, which is what we heard in testimony from doctors directly, doctors do not actually give the injection or do the duty of ending the life. It is passed on to another member of the medical staff, usually a nurse, and that person will be compelled by a doctor's order to deliver the life-ending treatment or drug. Those are huge issues, and any one of those breaks in the chain could potentially end up in a court. A particular member of medical staff would be ordered to enforce that care.


    I will move on to the more general compelling of seniors and people who are ill in our society. I have two senior parents. May dad is 82 and my mom is 72. The last thing I would want would be for them to feel like they are a burden on our system. They have contributed all their lives. To this day, my dad still works as a carpenter out in the shop. He pays his taxes. A senior should not feel like he or she needs to end his or her life based on a health care system that needs more space or is just too expensive.
    I love my parents, but that is not always the case across Canada. Different families do not agree as much as I do with my parents and there are frictions within families. Would some of these frictions within families be used to compel seniors to possibly end their lives because they have been made to feel they are a burden on our system? Certainly these are the what-if cases, but with 30 million people, these cases will arise, if they have not arisen already. It is deeply concerning to me that this is even an option.
    Much has been said of late about the suicides in Attawapiskat and suicide in general and what the feelings are about suicide. I do not think we can sugar-coat it. We call it end of life and some other groups have called it different names, but it is suicide. It is the ending of someone's life.
    What concerns me is an example of what could potentially happen. A group of individuals who feel they do not want to be on Earth anymore go into a physician's office and based on a psychiatrist's exam and review, they are warranted to end their lives. I am concerned this opens the door wide to an acceptance of suicide as a somewhat acceptable form of living in this world or ending one's life in this world. It is a huge concern for me.
    Lastly, I will speak about why I do not think we need to be in this situation. It goes back to the notwithstanding clause. I had a conversation with a judge on a plane ride home to Vancouver. My comment to the judge was that as members of Parliament we were checked every four years during an election. Often we would see many different faces in this place. The people of Canada have checked us. Some have made it back and some have not. We see some new faces. They made it here because the people spoke.
    What check is on the judiciary of our country? The response from this Supreme Court justice was that there was a check, the notwithstanding clause.
     I know it is yeoman's work to even try to get this kind of law into some kind of acceptable form because of so many diversities, but we already have a law. It is the job of 338 members of the House of Commons to enact laws. It is the job of the Supreme Court to uphold those laws. My concern is that there seems to be a usurping of our particular body by the Supreme Court. I would challenge the government to look into that. It should look into whether we already have a law. A lot of us still accept the law for what it is. Rather than having a discussion about reforming and rewriting what is already there, we need to go back and really think seriously about it.
    I certainly agree with most people here that palliative care needs to be better in Canada. We have all had passionate arguments about the sanctity of life. I believe all were created equal in this place.
    However, we need to seriously think about either rewriting the law as it was, as Canadians have sent us here to do, or upholding the laws that are already in place by previous bodies of elected people to the House. We need to honour this place. This is the place where we make laws. It is not just we 338 individuals. We have been sent here to represent over 30 million people, and their voices need to be heard loud and clear.
    It is a tough argument to have in this place. There are many issues on both sides that we all feel very passionate about, in whatever form that is, but we need to consider seriously upholding the laws currently in place.


    Mr. Speaker, we need to emphasize the fact that the Supreme Court decision was made unanimously by all the sitting Supreme Court judges, which says a lot. Therefore, when the member makes reference to using the notwithstanding clause, I would caution him.
    So that people understand this, because the member seemed to give this a lot of attention, access to medical assistance in dying would only be available to those who would meet certain conditions: they must be mentally competent adults who are in an advance state of irreversible decline and capability; have a serious and incurable illness, disease, or disability, and experience enduring and intolerable suffering caused by their medical condition; and whose deaths have become reasonably foreseeable, taking into account all of their medical circumstances.
    This law is better than the alternative, which is no law. The member has specifically expressed his concerns with the legislation. I would strongly suggest he share those concerns with the standing committee to see if there are ways in which we can deal with some of those.
    Mr. Speaker, the fact the member has spoken to me, means he is exercising that right of the citizens who sent him here. He likely represents about 100,000 people, based on riding size. I represent 107,000 people. If seven or nine individuals supersede an elected body that represents 30 million, then we disagree on numbers.
    The member talked about certain definitions. Correct me if I am wrong, but we are all in certain phases of decline. We all are going to meet our end someday. My concern is that such an open definition would apply to any individual on this planet. Again, once we open it up that wide, we open it wide up for abuse.


    Mr. Speaker, I am very confused by the Conservatives who keep raising the use of the notwithstanding clause. Could the member perhaps flesh out how he would see this going forward?
    If we are going to at least discuss this, I would like to hear some idea about how the member thinks we could start this process of using a notwithstanding clause to override the Supreme Court decision.
    Mr. Speaker, on the notwithstanding clause, I do not know if it has been used. Somebody can correct me if I am wrong on whether it has been used or not. However, it should be used very carefully.
    My point is that we need to ensure that the governing body that represents the citizens of Canada in creating laws for this place and for the country is supreme in its ability. That is what we are sent here to do. Because a body of judges has said otherwise, I do not think changes our responsibility to our country and to our citizens. This is why I support it.
    I was not aware of anybody else suggesting the notwithstanding clause. This is a personal opinion. However, we need to ensure this place remains sacred and we represent what Canadians say to us.
    Mr. Speaker, my colleague has talked about the notwithstanding clause and, realistically, that would be anathema to the current government. The Liberals' attitude seems to be that one cannot even disagree or hold a different point of view than that of the Supreme Court.
     However, at the same time, the government needs to accept responsibility for, in fact, in some ways, going much further than the court decision. We have things like the reasonable but mistaken clause, which would allow someone to escape prosecution for taking someone's life who maybe did not consent if that person had a reasonable but mistaken belief that the criteria were met. The court referred to that there is nothing in its decision that should infringe on conscience, but yet we see the legislation has no protection on conscience.
    Could the member comment on the fact that the government is not just implementing what the Supreme Court directed, but is actually going much further, and it needs to take responsibility for that?
    Mr. Speaker, I think the member is referring to the Carter decision. What we have seen are problematic issues with the current bill. It has gone far past what the Carter decision said it would wish to see.
    Again, I implore the government to consider rethinking this bill, maybe splitting it into different issues, so it addresses conscience rights and compelling somebody to do something they do not want to do.
    Canadians care deeply about this issue. I hope the government takes our discussions back to committee, and approves some amendments at the very least.
    That this question be now put.


    Mr. Speaker, I would ask for clarification as to exactly what the intent of the question being put is. I am unclear on the intention. Does this mean closure on debate on the issue? Perhaps you, Mr. Speaker, could answer that.
    I realize this might be a new procedure for some. Certainly, it has been a while since we have had something like this before the House.
    I invite members, if they have questions on the procedural side of this, to speak with the Table. Essentially the motion that this question be put does not in any way prohibit the continuation of debate. We are still in debate, now on the motion.
     The member for Moncton—Riverview—Dieppe used her 10-minute time to put the motion before the House. She still has five minutes for questions and comments, after which we will proceed with regular debate and whoever is next in order.
    That was the hon. member for Brantford—Brant's question. We will now go to the hon. member for Moncton—Riverview—Dieppe for her response.
    Mr. Speaker, we have been debating this bill for quite some time. The simple response is that we want this healthy debate to continue for the next period of time, however, we also want to see this move on to the work the committee needs to get done.


    Mr. Speaker, if I understand correctly, the motion is that the question be now put. I want to know if there are specific concerns because we had agreed to continue the debate this evening and tomorrow evening. What changed?
    Mr. Speaker, I thank my colleague for the question.
    This does not mean that the debate cannot continue. We are even prepared to sit this evening into the wee hours of the morning to ensure that every member of the House has the time to debate this subject that is so very important to everyone.
    Mr. Speaker, that does not seem very clear to me as a way to operate.
    First, none of the leaders was notified. I do not see why the government is suddenly moving the previous question when according to the motion moved by the parliamentary assistant, we expected to debate the bill tonight until midnight and tomorrow.
    If this changes nothing, why is this motion being moved like this, without warning? I would like to say that there are already many members who cannot speak in the House, including those in my party. So far, I have had only 10 minutes of speaking time in total on behalf of my party. I do not see why the government is moving the previous question this afternoon, without telling anyone.
    Mr. Speaker, I thank the hon. member for his question and his comments.
    Once again, all of us in the House recognize that the time and the issue being debated are very sensitive. We have until June 6 to act. That is why we want to give every hon. member in the House the opportunity to debate this bill. We also want to make sure that the bill is studied in committee. That is very important to moving the bill along.


    Mr. Speaker, I am wondering if the member could confirm the realization that the Supreme Court of Canada decision, which was unanimous, said that we have to have the legislation in place by June 6. Members are going to be able to continue to debate this. There are still discussions and negotiations taking place to facilitate more debate, and we are anxious to see that. However, it is important to recognize that the bill has to get through the committee stage and ultimately to the Senate.
     I would hope the member would agree that a responsible government would ensure there is timely passage of this bill, because we are talking about a unanimous decision that was made by the Supreme Court of Canada, and it has to be dealt with by June 6.



    Mr. Speaker, I thank the hon. member for his question and his comments.
    That is basically it. Once again, we want to make sure that every hon. member in the House will have an opportunity to debate this bill. However, we are all aware that we need to move to the committee stage because we want the bill to be passed.


    Mr. Speaker, I must say despite the justification offered by the House leader and the hon. member, this is an extraordinary disruption, even though members were assured that debate would continue. As the member should know, the justice committee is now in extended sittings, from early morning to late night, and is still hearing witnesses. Expediting this bill now, changing the schedule now, is not going to change the course or the receptiveness of the committee to consider what eventually we send to committee.
    I think this is extraordinary and bizarre in that it is normally the business of the House leaders to confer in the normal business of Parliament while debate continues, as the government assured us it would. We are still wondering why the member has taken this side track in the midst of debate.


    Mr. Speaker, once again, we want to encourage a healthy debate in the House and ensure that all members have the right and the opportunity to speak to this bill. We want to ensure that the bill goes to committee since we have a deadline to meet.


    Mr. Speaker, I did not mean to start off my remarks by commenting on this situation of closing debate and calling the question, but this is an absolute shambles, and is making a mockery of what is supposed to be an important debate among members. Most of us have the right to have a free vote on this issue. The Liberals are making a mockery of this place, and I for one am not impressed at all.
    To get back to the topic at hand, it is important that we have meaningful debate on this issue. I want to participate on behalf of me and my constituents, and I am sure there are many other members of Parliament who want to do the same thing.
     This is very important legislation for our country, and of course members of our Conservative caucus have been very active in the run-up to this debate. We have had some serious reservations leading up to how this bill was to be written. Those reservations were expressed in a dissenting report from the special joint committee that studied the subject. Now, many of us are relieved that the legislation echoed some of the recommendations included in the dissenting report, such as certain limits on minors, and of course, many of us do believe there has to be, according to the Supreme Court ruling, some provision in our law for dying with dignity. However, we do have some concerns, and I am going to express my own, regarding aspects of this bill.


    Unfortunately, this bill opens the door to assisted suicide for people with mental health problems, and that worries us.


    This bill includes a provision for psychological suffering. This would open a large door. I am worried about how this would apply to the mentally ill. How would this be applied in reality? Are we going down some slippery slope by including this provision for psychological suffering? I am sure there will be an approach to amend this particular section, but right now the amendment to the Criminal Code would add that illness, disease or disability, or that state of decline causes them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions that they consider acceptable. This is the concerning provision, and I echo my other colleagues who have raised this issue as well.



    Quebec has come up with its own legislation on assistance in dying. In Quebec's law, only people aged 18 and over with a serious and incurable illness who are in an advanced state of irreversible decline in capability can request medical aid in dying.


    The attending physician must ensure that his or her patient has clearly consented to physician-assisted dying, ensuring among other things that it is not the result of external pressure, providing the patient with a full prognosis on the condition and possible treatment options along with likely consequences. The physician, under Quebec law, must also ensure the continuation of consent with interviews with the patient held at different times, spaced by a reasonable time having regard to the patient's condition. I would say that these are appropriate safeguards in the Quebec law. I would like to see similar safeguards in the Canadian law.
    Another concern to us is in relation to the rights of conscience of physicians and health institutions.


    We are very concerned about the conscience rights of medical personnel.


    As mentioned in the dissenting report, section 2 of the Canadian Charter of Rights and Freedoms guarantees all Canadians freedom of conscience and religion. The dissenting report clearly states that there was near unanimous agreement among the witnesses that physicians who objected to taking part in physician-assisted dying for reasons of conscience should not be forced to do so. Although not obliged directly by this legislation to provide PAD, physician-assisted dying, the obligation to refer patients through an effective referral infringes on the spirit, and I would say the letter, of section 2 of the charter. I therefore believe that such a regime is unnecessary and note that Canada would be the first jurisdiction in the world to require an effective referral regime.
    I believe there are better models that would protect the charter rights of physicians and provide access to physician-assisted dying, but under this legislation, physicians who conscientiously object to physician-assisted dying are required to provide information to their patients on how to access PAD and to advise the government of his or her patient's request. I believe this is unfair to the physician and this legislation does not sufficiently protect physicians' rights. I also believe that health care institutions that object to offering physician-assisted dying and related services should be exempted in accordance with the Supreme Court's determination that individual collective aspects of freedom of religion and conscience guaranteed under the charter are indissolubly intertwined.
    In my home province of Ontario, the current policy of the College of Physicians and Surgeons is that it is a requirement not only to refer, but also to provide services that are within the standard of care of an emergency situation. Therefore, passing this legislation without conscience protection would mean that PAD would enter the standard of care and would fit within the existing policy framework of the College of Physicians and Surgeons in Ontario. It means that in my jurisdiction, there would be an effective right to force the physician to be part of this process even when she or he does not want to be part of the process. This is a major and grave concern to me and to physicians in my constituency as well.
    The other issue that should concern us is whether this legislation respects the Carter decision and would it survive a charter challenge. I would say there is sufficient and grave cause to understand that this may not be the case. I would put it to my hon. colleagues, if we cannot pass legislation that could survive a charter challenge, why are we going through this process in the first place? Again, it makes a mockery of the situation.
     I am hopeful that the government, as the bill moves forward, would accept amendments to ensure that everyone's charter rights are respected whether they be physicians or medical personnel, and that the charter rights of vulnerable persons be respected as well. We owe it to Canadians to get this right the first time, to protect the conscience rights of physicians and health professionals while respecting the parameters of the Carter decision.



    Canadians expect us to work hard and do this right.


    I want to acknowledge that the other point raised by my colleagues is a good one. Where is the palliative care money, the $3 billion in funding for palliative care? There is no mention of it in the budget. As they say sometimes in politics as in life, the devil is in the details. Where is the funding going to come from? How is it going to be allocated? It is absolutely imperative the government take decisive action on palliative care.
    That ends my comments on the bill, but I want to reiterate that the shenanigans that went on before I rose are absolutely unacceptable to free and democratic debate on an issue of conscience for many members of this House, for all members of this House. I object to the motion being put forward in the way that it was. I object to the process that is being put forward by the government as it tries to shut down debate of members who want to advance their positions and those of their constituents.
    Mr. Speaker, innovative models across Canada are integrating palliative care approaches across the nation in a variety of settings, including the home, incorporating advance care planning, preparing more health care, including more providers to deliver palliative care, recognizing the importance of family and friend caregivers and their needs, along with other good practices throughout our great country.
    Other than palliative care which the member mentioned at the end of his comments, what other services besides those that are being practised today throughout our nation would he recommend be put in place for this program?
    Mr. Speaker, I thank the hon. member for his thoughtful question. Indeed, as a former provincial minister of health and federal minister of health, I think it is important that we find ways to integrate and coordinate our care for the individual. That is absolutely correct.
    I would also, though, mention to the hon. member that in my consultations with those in the palliative care infrastructure in my riding, they were not exactly thrilled with the prospect that they would be associated with physician-assisted dying. They see themselves as a final resting place before death, as a place of hope, as a comfort place, rather than a place where this debate over physician-assisted dying would be the focus.
    I think we have to be careful. I think we need more palliative care; however, we also need a process by which we get to the right conclusion and the right part of the health care system.
    Mr. Speaker, I appreciate the comments from the hon. member for Parry Sound—Muskoka.
    Perhaps the motion which was just moved is not to limit the debate and the comments coming from this side. Over the course of the debate and the discussion we have had over the last day and a bit, we have also heard some dissenting remarks from the government side, as well. Perhaps the motion is not just to stifle the debate on this side but also to stifle it within the government's own party.
     I wonder if my hon. colleague feels the same.
    Mr. Speaker, that same thought had crossed my mind. I was originally supposed to be speaking at 3:20 p.m. It is nowhere near that time now. The only conclusion I could come to is that hon. members on the Liberal side of the House were declining their speaking spots. Maybe there is some great dissension going on in the Liberal caucus right now over the bill, that all of a sudden the bill is not as popular as the manipulators on that side of the House thought it was going to be and now they want to shut down debate not only for those of us on this side of the House, but on their own side of the House as well. I find the whole thing outrageous.


[Statements by Members]


Women's Floorball Championships

    Mr. Speaker, today I rise to recognize a world-class sporting event that will be taking place in the riding of Bay of Quinte.
    From May 4 to 8, the city of Belleville is proud to be hosting the under 19 women's floorball championships. Over 400 athletes from 15 different countries will be participating in the first tournament ever played on North American soil.
    This event will not only contribute an estimated $3.8 million to the local economy, it will showcase the power of women in sports and the growing international popularity of floorball. The hope is that this sport will make its Olympic debut in the 2024 games.
    The community support for this event has been inspiring. As MP for the riding of Bay of Quinte, I want to welcome all of our international visitors and wish Team Canada the best of luck.




    Mr. Speaker, when I was at the opening of the 13th edition of Portneuf's environmental film festival, I said that I would make a member's statement to get the word out about this unique event that is held in my riding.
    Due to unforeseen circumstances, I have to split this time. Last Sunday, a fire marred the face of downtown Saint-Raymond de Portneuf. First, I would like to tell the victims of that fire that they have my full support. I want them to know that my thoughts are with them at this difficult time.
    I would also like to commend the city's firefighters and those from neighbouring municipalities for their efforts, which made it possible to contain the damage. I would like to tip my hat to Mayor Daniel Dion, who showed great leadership in this situation. The good news is that nobody was seriously hurt.
    I know how strong the people of Saint-Raymond are. They have always shown that they are able to roll up their sleeves and deal with this sort of situation. We are a strong community and we will get through this together.


Engineers without Borders Canada

    Mr. Speaker, for sixteen years Engineers without Borders Canada has been helping people in developing countries to use technology to improve their lives.
     Engineers without Borders Canada was founded in 2000 when two Waterloo engineering graduates wrote a mission statement on the back of a paper napkin in a coffee shop. It had no money, no people, and no resources. Today it is one of Canada's most respected development organizations.
     On May 17, I will welcome a delegation of youth leaders from Engineers without Borders Canada to my Hill office. We will discuss how people in my riding of Don Valley North can support social innovation in Canada and help end global poverty in Africa.
     Engineers without Borders Canada is an organization that deserves our support.


World Press Freedom Day

    Mr. Speaker, I am very proud to rise today in the House of Commons to mark World Press Freedom Day. We are lucky here in Canada to enjoy a free press. Unfortunately, that is not the case for everyone around the world.
    Many people still have to fight for freedom of speech and, by extension, freedom of the press. I would be remiss if I did not mention the courage and determination of Ensaf Haidar, a resident of Sherbrooke and the wife of blogger Raif Badawi, who, I would remind everyone, is still in a Saudi Arabian prison, simply for expressing his opinion. He has been there for too long. Ms. Haidar is in Ottawa today to mark this occasion.
    On this special day, I would like to remind my parliamentary colleagues and all Canadians that we have a duty and a responsibility not only to protect fundamental rights on our soil, but also to act as leaders on the international scene in order to promote and guarantee those same rights all around the globe.
    Happy World Press Freedom Day.


Bone Marrow Donation

    Mr. Speaker, Noor Deol was born in Brampton and grew up like most boys, full of energy and optimism for the future. But in 2010, Noor was diagnosed with cancer, more specifically, acute lymphoblastic leukemia.
     Noor's cancer has been very aggressive. Chemotherapy has not been an effective treatment. Noor needs a bone marrow transplant now.
    For more than five years, Noor's family has desperately been appealing to people across Canada and abroad, hoping to find a match. The problem is that while there are 350,000 registered bone marrow donors in Canada, 71% are Caucasian, while only 4.8% are South Asian. Noor's best chance of finding a match is among South Asian males aged 17 to 35.
     Like so many, I pray for Noor and urge my fellow Canadians and all people around the world to register with OneMatch or a similar organization abroad. Signing up requires only a simple and painless cheek swab, and could save Noor Deol's life and restore his health for the future.


Vision Health

    Mr. Speaker, May is National Vision Health Month. Given that 75% of visual impairment is preventable if detected and treated early enough, I would like to share a few facts on what this is costing Canadians and why immediate government action is required.
    One in four school-aged children in Canada has a vision problem. Vision loss costs Canada $19.1 billion or $550 per resident, costing Canada more than diabetes and cancer combined. It extends right across the economy. Higher absenteeism, lower employment rates, loss of earnings, premature retirement, and premature death are more common among people with vision loss.
    Despite the alarming costs of vision impairment, the Liberals have no plan and no money to deal with vision health. While countries like Australia and the U.K. are formulating strategies to promote eye health and prevent avoidable blindness, Canada remains on the sidelines.
    I urge all members of this House to join me in calling upon the Liberal government to take a leadership role in promoting vision health.



    Mr. Speaker, I would like to take the opportunity today to address the people in my riding of Thérèse-De Blainville, who are asking me whether they can count on the government to help Bombardier. I want to reassure them and all Canadians, especially Quebeckers, that our government recognizes the importance of the aerospace industry and, therefore, Bombardier, to our country.
    Our government is in negotiations with Bombardier in order to get the best results for both Bombardier and Canadians.
    I would like to acknowledge the efforts of all my Quebec colleagues and MPs from the rest of Canada on this file. We are working hard and with determination to support the government so that it can back the aerospace industry and its businesses and workers.


Ontario East Economic Development Commission

    Mr. Speaker, I rise today to acknowledge the outstanding work of the Ontario East Economic Development Commission. It is a membership-based organization with more than 125 members, representing all the communities of eastern Ontario, including my riding of Northumberland—Peterborough South. It is governed by a volunteer board and a small management team, who are in the gallery today.
    This is the economic delivery model best suited to today's business environment: lean, nimble, and highly adaptive, one that can thrive in the face of rapid change. Ontario East is about partnership, collaboration, and collective action. It is a grassroots organization, highly networked and dedicated to the common goal of economic renewal for the region. It works to retain business, attract business, and most importantly, create jobs.
    I thank the organization and hope that it keeps up its good work.

Ovarian Cancer Awareness

    Mr. Speaker, ovarian cancer is the most fatal women's cancer in Canada. It is estimated that this year 2,800 women will be diagnosed and 1,750 will die from the disease, that is five mothers, daughters, and sisters who we will lose each and every day this coming year.
    There is no screening test, the symptoms are easily confused with less serious conditions, and the result is that ovarian cancer is usually detected at a very late stage. These facts are troubling because most Canadians are unaware of the risks that this cancer poses.
    Ovarian Cancer Canada has launched a campaign to make Canadians more aware of ovarian cancer. There is also an immediate need for research dollars. This is why I am calling upon the federal government to invest in research to ensure women fighting this disease have the tools they need to beat it.
    Please join me in increasing awareness by joining the fight on May 8 for World Ovarian Cancer Day.


World Press Freedom Day

    Mr. Speaker, on this World Press Freedom Day we must honour the vital role that the independent press plays in fostering democracy around the world.
    Journalistic freedom ensures accountability and encourages the transparency of governments. It is at the heart of every healthy, dynamic democracy.


    We cannot take this freedom for granted, and we must respect and maintain journalistic freedom both at home and abroad. Censorship, harassment, intimidation, and even violence are too often experienced by journalists as they fulfill their critical role on behalf of citizens in their countries.
    In Canada, we are fortunate that our freedoms of opinion and expression, including freedom of the press, are enshrined in the Charter of Rights and Freedoms.



    These values must be shared, and Canada must do everything it can to promote freedom of the press around the world.


    Journalists must be able to report the truth freely without fear of repercussions, and we must do all we can to support them in that pursuit.

Ovarian Cancer Awareness

    Mr. Speaker, I am pleased to welcome representatives from Ovarian Cancer Canada, including friends and neighbours, who are in Ottawa today to promote increased research to fight ovarian cancer.
    There are 2,800 Canadian women diagnosed with ovarian cancer each year and 55% will die from the disease within five years. Without a screening test and with symptoms that are easily confused with other less serious conditions, ovarian cancer is usually detected at too late a stage.
    The five-year survival rate for ovarian cancer is just 45%. If the cancer is found and treated before the cancer has spread, the five-year survival rate climbs dramatically to 92%. Research for early detection and treatment is critical.
    On behalf of the many affected Canadian women, their families and friends, please join me in helping Ovarian Cancer Canada increase awareness for its cause by joining the fight this May 8 on World Ovarian Cancer Day.


    Mr. Speaker, B'nai Brith Canada has just released its annual audit of anti-Semitism in our country, and the results are alarming.
    Although the level of anti-Semitism has remained relatively constant over the past five years, the nature of incidents has changed. While spray-paint vandalism, crudely drawn swastikas, holy site desecrations, and violent events are down, there has been striking growth in social media anti-Semitism.
    The audit points out that social media has a much broader reach than the old form of hate and that it is much more difficult to remove once such anti-Semitic content is posted. The B'nai Brith findings are similar to the Toronto Police Service report that Jews continue to be the single most-targeted victim group in the city of Toronto.
    Anti-Semitism has no place in Canada. I call on all members of the House to join me in condemning this pernicious form of hatred.


    Mr. Speaker, for more than three decades, B'nai Brith has published an annual audit on anti-Semitism to educate and advocate ways to reduce this form of hatred and intolerance against the Jewish community.


    Anti-Semitism was widespread and overt in 2015. There were a number of violent, indiscriminate attacks around the world, in various locations such as synagogues, public markets, and the streets.


    Here in Canada, there were 1,277 incidents of anti-Semitism recorded, with offenders moving increasingly online as the forum of choice for spreading their hateful message to a wider audience.
    Prejudice against one community is prejudice against all communities.
    I commend B'nai Brith in playing a vital role in combatting hate through education. I encourage all members to read the 2015 annual audit. It is essential that we see anti-Semitism as a challenge to be overcome together through our shared values of diversity and inclusivity.


Dairy Industry

    Mr. Speaker, since early this morning, because of the Liberal government's inaction, a few hundred dairy farmers have decided to set up a blockade in front of a dairy processing plant in Montreal. The producers' spontaneous demonstration shows that they really are at the end of their rope. This government's inaction is simply causing a crisis that is escalating. This could have been avoided. The only party responsible in this matter is the federal government, because it is still not enforcing the compositional standards for cheese.
    The government has been telling us for months and weeks that it is in the process of consulting and speaking with the industry. However, we know what the solution is. It is simple, it costs nothing, and it can be applied right away. We know that the government will unfortunately vote against the NDP motion, but I sincerely urge the government to act today and enforce the Canadian standards. Let us stop diafiltered milk.




    Mr. Speaker, I am proud of the steps that our Conservative government took in trying to coax Iran into halting its nuclear ambitions by way of an aggressive sanctions program. The Iranian regime truly felt the impact of global sanctions on Iran; so much so that Iranian President Hassan Rouhani called the day sanctions were lifted “a golden page” in the country's history.
    Iran has a long history as a vicious actor in the Middle East: exporting terror globally, supplying military assistance to Assad in Syria and to Hezbollah and Hamas, as well as routinely threatening the destruction of our friend and ally, Israel. A commander of the IRGC said as recently as March, “Even if they build a wall around Iran, our missile program will not stop”.
    Any Liberal plan to abandon sanctions against Iran would overturn our principled stand by the previous Conservative government. The evidence is clear: the Tehran regime commits horrible human rights violations against its own people and supports terror throughout the Middle East and incitement against Israel.
    The Conservatives still see Iran for what it is and would rather judge Iran by its actions than by its words.

Mental Health Week

    Mr. Speaker, I am honoured to #GetLoud during Mental Health Week in support of mental health and well-being for all Canadians.
    Mental health is often considered secondary to physical health. This is wrong. Mental health is essential to our overall health.
    Our government has stated the importance of access to mental health care. As a high school chaplain, I have witnessed how people's lives were devastated when mental health services were inadequate. As well, the need for mental health supports is acute among our seniors and indigenous peoples.
    Caring for mental health contributes to strong communities. Hamilton's CHML radio has inspired dozens of organizations to shine the light on mental health by lighting up their workplaces in green this week. I applaud the ongoing and often heroic efforts of all mental health advocates in my hometown of Hamilton, Ontario.
     I urge my colleagues from all parties to work together to provide access to the mental health resources and supports required for all Canadians to reach their full potential.


[Oral Questions]



    Mr. Speaker, while the Prime Minister was once again doing push-ups for the cameras yesterday, his Minister of Finance was doing some of his own verbal gymnastics back here.
    He was trying to explain how a healthy Conservative surplus turned into a Liberal deficit. It turns out that we are just “stuck in this whole balanced budget thing”. He is right, and we are proud of it.
    My question to the Prime Minister is simple. Is he actually ever planning to balance the budget?
    Mr. Speaker, I thank the member opposite for giving me an opportunity to talk about the Invictus Games and the extraordinary work this government is doing to support veterans and to ensure that there is an opportunity for all Canadians to cheer on the extraordinary valour, courage, and strength of Canadian veterans.
    Obviously, on the issue of economic growth, we made it very clear during the election campaign that we are going to be investing in communities, we are going to be putting more money in the pockets of the middle class and those working hard to join it, because fiscal responsibility and, indeed, balanced budgets are important.
    Mr. Speaker, we have all heard of March madness.
    Here is what the Liberals did in March, by their own budget numbers. They took the $7.5 billion surplus we left them, spent every dime of it, and then spent another $5 billion on top of that, in one month. It is reckless, it is irresponsible, and every Canadian is going to have to pay it back.
    Does the Prime Minister understand that it is actually not his money to spend? It belongs to hard-working Canadians.
    Mr. Speaker, is it reckless and irresponsible to be lowering taxes for the middle class while raising them on the wealthiest 1%?
    Is it reckless and irresponsible to be giving a Canada child benefit that is more generous to nine out of 10 Canadian families, by doing more for the families who need it and less for the families who do not?
    What, frankly, would have been reckless and irresponsible would be for Canadians to decide to keep the Conservatives in government for one more minute after October 19.
    Let us just skip to the push-ups.
    Mr. Speaker, it is actually the job of the Prime Minister to try, at least try, to keep spending under control.
     The facts are clear. The parliamentary budget officer and the finance department agree that Conservatives left the government a healthy surplus, and the Liberals have blown it.
    Does the Prime Minister understand that this billions in spending actually has to be paid back?


    Mr. Speaker, I am pleased that the member opposite has now discovered what she apparently thinks the job of the Prime Minister is.
     The previous Prime Minister added $160 billion to Canada's debt with very little to show for it. Indeed, for 10 years we had lower economic growth than Canadians needed to have. We had under-investment in our infrastructure in our communities and in public transit.
    That is why this government is committed to making the investments in our communities that Canadians so desperately need, that businesses so desperately need, and putting more money into the pockets of the middle class and those working hard to join it.
    That is the job of the Prime Minister.


    Mr. Speaker, in recent years, the former prime minister had to deal with the worst economic crisis since World War II. It is a good thing that the current Prime Minister did not have to deal with that crisis. We went through very difficult times and we left the house in order, with a surplus of $7.5 billion at the end of February.
    Yesterday, in a flight of rhetoric, the Minister of Finance said: “Clearly, the members from other side are still stuck in this whole balanced budget thing.” Right now, families are filling out their tax forms and must balance their personal finances. Is the Prime Minister able to understand that balancing a budget—
    The right hon. Prime Minister.
    Mr. Speaker, what families all across the country understand is that there is a need for investment in public transit, which had been neglected for 10 years. That is why we announced a $775-million investment in public transit in Montreal. That is why we applaud the potential investment in the new light rail in Montreal that will help people get around, as well as investments in Edmonton, Toronto, and all over the country. The previous government refused to invest in our communities. It was time to put options and growth for Canadians back on the agenda.
    Mr. Speaker, the Prime Minister's statements need to be corrected. We are the ones who did the work on the projects in Edmonton that he mentioned. In the Montreal region, we always worked while respecting provincial and municipal jurisdictions, including with regard to public transit. We delivered the largest infrastructure plan in Canada's history while still balancing the budget.
    Why does the Prime Minister need to run deficits to do what we managed to do while balancing the budget?
    Mr. Speaker, the Conservatives threw the budget out the window.
    The fact is, we have made the necessary investments. For 10 years, there was no investment in public transit, in green infrastructure, or in anything to tackle climate change.
    Canadians elected a government that is ready to invest in the future, in middle-class Canadians so that they have more money in their pockets, and in families. These kinds of investments will create growth, which was neglected in Canada by the previous government for the past 10 years.

Dairy Industry

    Mr. Speaker, enough jokes about the previous government.
    Let us talk about this government. The current Liberal government's failure to take action on the diafiltered milk file is really hurting dairy producers across Canada. They can no longer borrow money, and they are losing hundreds of millions of dollars. The Liberals have been sitting on their hands for six months.
    Will they support the NDP motion and stand up for our family dairy farms?
    Mr. Speaker, we are supporting Canada's dairy industry.
    We are in regular contact with industry representatives to understand the issues and ensure that producers are properly compensated in connection with the free trade agreement with the European Union. We are committed to working with them at every stage of the process to ensure that we protect the industry. We pledged to protect supply management, and that is what we will continue to do.

Canada Revenue Agency

    Mr. Speaker, more talk will do nothing to help family dairy farms. They need action, and that action has to come from the Liberal government. The government has the responsibility and must enforce the rules, period. Why this inaction? It is inexplicable.
    Let us talk about another area where people only get help if they are well connected. Today, members of a parliamentary committee asked that KPMG, which set up this tax sham, be held accountable.
    Will the Liberals support our motion to bring KPMG before the parliamentary committee?


    Mr. Speaker, like all Canadians, we are concerned about the allegations of favouritism within the Canada Revenue Agency. That is why we are working closely with the minister and the department in order to ensure that all Canadians and all companies pay their fair share of taxes. We will make sure this happens now and in the future.


    Mr. Speaker, if the Prime Minister is sincerely concerned about what he just called potential favouritism at the Canada Revenue Agency, will he agree with the NDP to hold an investigation into the KPMG scandal?
     Canadians do not accept that there is one law for the rich and well connected and one law for everybody else. Here we have a clear example, just like the Air Canada case: “You broke the law. No problem. The Liberals will change it for you retroactively if you're rich and well connected”.
    Canadians want the law to apply to everyone. Are we going to have an investigation into KPMG, yes or no?
    Once again, Mr. Speaker, we see that the NDP is always eager to play parliamentary procedure games as opposed to actually digging into the real facts of the issue.
    We are working with the Canada Revenue Agency. We are ensuring that all Canadians and all companies pay their fair share of taxes.
    We know that Canadians expect their government to uphold the rules, and that is exactly what we are going to do.

The Environment

    Mr. Speaker, speaking of parliamentary procedure, in committee today, the Liberals had a chance to vote with us to require KPMG to give the names. Do members know what they did? They used parliamentary procedure to avoid that.
    Let us talk about the Liberals avoiding their responsibility in another key area, which is climate change. They signed Kyoto the last time they were in power and went on to have one of the worst records in the world. This time they went to Paris and said that Canada was back. Unfortunately, Canada was back with the Conservative plan.
    Why is there no plan to reduce greenhouse gases in Canada? Canadians want to know.
    Mr. Speaker, I actually was not a politician when Kyoto was signed, but the member opposite was minister of environment for the Province of Quebec and wears a part of responsibility on what was not done in the past.
    What is being done right now, however, is that we are working with the provinces. We have demonstrated a commitment, internationally and here at home, to engage on climate change, to ensure that we are actually living up to the responsibilities to future generations. Look at us to look at the challenges, but also the opportunities coming in investing in green technology and the real future of Canadian jobs.


    Mr. Speaker, last week the Minister of Finance, when asked about the surplus noted in the “Fiscal Monitor”, said he did not want to focus on the issue. Yesterday in the House of Commons during question period, the minister actually laughed off the concept of restraint by lamenting that the Conservatives are stuck in this whole balanced budget thing. Recently, the National Post noted that this may be the first surplus that a finance minister does not want to talk about.
    Therefore, my question for the Minister of Finance is this. What is so scary about being fiscally responsible?
    Mr. Speaker, our priority is on investing to grow the economy. Six months ago, Canadians chose hope over fear. They chose optimism over pessimism. They chose to make investments to grow the economy instead of balancing the budget on the backs of Canadian families.
    While the members on the opposite side want to tell Canadians that they made the wrong choice, we are moving forward with the right choices, the choices to invest in our economy that will make the future better for Canadians today and tomorrow.
    Mr. Speaker, the finance minister also said yesterday that he was convinced that the Liberal Party was doing the right thing because it is making his children and his grandchildren better off. Now, I am happy for them, but I also worry about the other kids in this country as well, who may not be able to afford the high cost of the minister's borrowing. The minister may have just said that he is comfortable with the choices that he is making, but in reality he is going to be spending on the backs of our children.
    What part of saddling our kids with billions and billions of dollars of debt is making them better off?


    Mr. Speaker, the members opposite would like to focus on our low-growth past. We want to focus on what we are actually doing for Canadian children today.
    We have moved forward with the Canada child benefit, which will help nine out of 10 families with children. It will help them a lot, on average $2,300 per year.
    We are moving forward to help indigenous people. We are moving forward on educational initiatives, with $3.5 billion over five years to improve the situation for indigenous children in our country.
    We have a progressive government that is going to make a real difference to the children of today so they can be better off tomorrow.
    Mr. Speaker, the long list of Liberal promises now includes transparency, thanks to the Minister of Finance.
    The PBO delivered a scathing indictment of the government for its lack of budget transparency. The minister refuses to acknowledge that we handed them a surplus. We know the Liberals jammed as much new spending in last year's budget and books as they could. If he truly wants to be transparent, will the minister tell Canadians how much the March madness spending spree has cost?
    Mr. Speaker, the member opposite is entitled to his opinion. I have had the opportunity to criss-cross the country and listen to Canadians' opinions. They appear to understand quite well what we did with our budget, and they are very positive with the initiatives that are helping Canadians today and tomorrow.
    I also went international. I heard the Financial Times call us a glimmer of hope. I heard The Wall Street Journal say that we are doing the right things on the IMF plan to grow the economy. We are going to make a real difference for Canadians today and tomorrow with the kind of fiscal measures that will grow our economy for the long run.


    Mr. Speaker, we know the Liberals love to talk about facts, so let us look at some facts. Their decision to abandon tax cuts for small businesses will cost the industry $2.2 billion over the next four years. I repeat: $2.2 billion. The more we learn about the Liberals' so-called commitment for small businesses, the more we realize that there is no commitment at all.
    When will the Liberals deliver their promised 9% tax cuts?
    Mr. Speaker, I thank my hon. colleague for the question. We know that the small business tax rate is there to help companies grow and create jobs, but we need to make sure that the small business tax system is fair and being used appropriately. The loophole is allowing far too many people to use this rate to get out of paying personal income taxes that the rest of us pay each and every year. This loophole is costing taxpayers over $500 million a year. We need to fix the problem so that those using the small business tax rate are the small business owners who are creating jobs for our communities.



    Mr. Speaker, yesterday, the Minister of Finance made a statement that was surprising, to say the least. He said, “Clearly, the members from the other side [that means us] are still stuck in this whole balanced budget thing.”
    I can assure this House that, yes, we are and we will always be stuck on having a balanced budget. That is the responsible thing to do. What is also clear is that the minister is stuck on running up deficits one after the other.
    Will the minister change his ways and finally admit that it is detrimental to Canada's future to have such deficits?
    Mr. Speaker, our priority is to invest. Six months ago, Canadians chose optimism, not pessimism. Canadians chose to make investments that will grow the economy, not to have a balanced budget at any cost.
    We will make choices that are good for Canadians and that will grow the Canadian economy, now and in the future.
    Mr. Speaker, the government's approach is irresponsible. It is obvious that the Minister of Finance has completely lost control of public spending. Running up a $30-billion deficit, with more to come, is irresponsible to today's society and especially to our children and grandchildren, who are going to pay for this government's excesses.
    When will the government finally get in touch with reality and stop putting our grandchildren into debt?
    Mr. Speaker, I want to talk about children in Canada. Thanks to our measures, their situation will improve now and in the future. We introduced the Canada child benefit, which will help nine out of 10 families with children by giving them an additional $2,300 a year. Today's children will have a better future because we are making investments today for them.



National Defence

    Mr. Speaker, today, the Auditor General reported that Canada is treating our army reservists like second-class soldiers. They are underfunded, under-equipped, and undertrained. In fact, our reservists were sent into combat without first receiving the proper international mission training. This is all unacceptable.
    Will the minister today commit to give reservists the training they need, the support they are entitled to, and the respect they deserve?
    Mr. Speaker, I commend the hon. member for his concern. I was actually one of those reservists on those deployments who received the training.
     I can assure members that we are accepting all the Auditor General's recommendations. I would also like to say that the Canadian Armed Forces has already started working on improving the training aspect for domestic and international operations, including the recruiting and retention for our reserve force to play a critical role in domestic and international operations.



    Mr. Speaker, today, the Auditor General showed that the government did not implement adequate measures to help veterans suffering from post-traumatic stress disorder.
    The department is not taking the impact on veterans into account when managing its drug program. For once the Liberals cannot blame the Conservatives, since the Liberal budget did not include a single penny for mental health care services.
    When will the Liberals support our veterans and invest in their mental health?


    Mr. Speaker, we accept all the Auditor General's recommendations and are working toward them through the programs that we deliver.
     My mandate letter says to get working on our suicide prevention, as well as our PTSD and mental health centres. That is exactly what we are going to do. We are going to deliver this care in a forthright and profound manner that makes the lives of veterans and their families better.

Ministerial Expenses

    Mr. Speaker, the Minister of International Trade claims that her vanity trip to California was to promote Canadian business interests. However, emails released through access to information paint a very different picture.
    Her staff were scrambling to put a program together and were begging LA Times journalists for an interview. Senior foreign policy and diplomacy officer Dan Pasquini stated in an email, “this visit has only just fallen in our laps”.
    Why does the minister continue to claim the trip was about Canadian business interests when it was actually all about her?
    Mr. Speaker, once again, the Conservatives are trying to create a story where there is none. It is my job to promote Canada in the United States.
     In fact, just yesterday, I was pleased to be in Washington for a trilateral trade meeting with my American and Mexican counterparts. It was my sixth visit to the United States in six months. What I am hearing in the U.S. is that after a lost decade, Canada is finally back at the table.
    I am going to keep going back and doing what the Conservatives failed to do: support trade, jobs, and our middle class.
    Mr. Speaker, in a one-on-one sit down interview with the LA Times, the minister's California dream trip was characterized as a “brief stopover”.
     LA Consul General Villeneuve noted there “seems to be a bit of confusion”.
    The Global Affairs director general of communications was also confused, saying in emails, “What is she doing in LA? Besides the Bill Maher show?”
    Clearly, this was a personal trip built around her TV appearance.
    We know the Liberals are entitled to their entitlements, but are taxpayers not entitled to an honest answer about the real purpose for her going to LA?
    Mr. Speaker, the Conservatives continue to try to create a story where there is none. The media appearances were part of the official visit, along with six business round tables. It is my job to promote Canada to the world.
    However, since the members opposite are so interested in this topic, let me remind them that their own leader, the former prime minister, spent $50,000 of taxpayer money to get himself U.S. media appearances. We do not need to do that; we get invited.


    Mr. Speaker, the story is that the Minister of International Trade needs to be honest with Canadians. She declares proudly that she was in California to promote Canadian business, but her own officials did not even know about the trip until two days before.
    The minister indicates that she met with the lieutenant governor of California and a U.S. senator, but does not mention that it was on the late show with Bill Maher.
    When will the minister just be honest and tell Canadians she went to Hollywood on a personal vanity trip, using taxpayer money?
    Mr. Speaker, unlike the Conservatives, we know it is our government's job to promote Canada to the world.
     When I travel to promote Canada, I am proud to speak to the international media. Just yesterday, I gave an interview to POLITICO in Washington.
    As minister, I would like to list some of the other international interviews I have done. I have done an interview with MSNBC, The Wall Street Journal, The Washington Post, the LA Times, and the Financial Times. I have done three BBC interviews. I have spoken to EU Trade Insights. I spoke to La Libre; Deutsche Welle, the German TV; Bloomberg Television; Handelsblatt
    The member for Elgin—Middlesex—London.
    Mr. Speaker, it is clear that the minister's staff had to scramble at the last minute to find things to do in California to justify doing a late night show on HBO.
    When the minister's own staff is informed that she will be in LA just two days prior to her arrival, how are Canadians to believe it was on government business?
     The Minister of International Trade used taxpayer money to further her personal interests, not the interests of Canadian business. When will the minister pay back the money for this vanity trip?
    Mr. Speaker, the Conservatives continue to try to create a story where there is not one.
    I would now like to share with the House some details of the business meetings I had when I was in California. Here are some of the people I met with: James Haney, senior VP and general manager of City National Bank, recently acquired by RBC; Greg Foster, CEO of IMAX; Creative BC, and Trade and Invest BC, were there; John Chiang, the treasurer of the state of California; and Jeff Gorell, deputy mayor.
    Other meetings I had there included a reception with the Friends of BC, a meeting with Los Angeles economic leaders—
    The hon. member for Vancouver Kingsway.


    Mr. Speaker, at the heart of our public health care system is one simple principle: no one should have to pay out of pocket for health care. Yet, patients all across the country are being charged extra fees for medical services, and the Government of Canada is doing nothing about it.
     Some Canadians have become so frustrated with Liberal inaction, they filed a lawsuit today against the federal government.
     Why will the minister not do her job, enforce the Canada Health Act, and act immediately to put a stop to user fees?
    Mr. Speaker, it is my great pleasure to uphold, along with our government, the Canada Health Act.
    This government is taking federal leadership on health care. We uphold the Canada Health Act that underscores a number of principles, including accessibility, which ensures Canadians will always have access to the care they need, based on that need and not based on the ability to pay.
    I will work with the provinces and territories to ensure that access is always available to Canadians.


    Mr. Speaker, the charging of ancillary fees for health care services is a problem that has been going on in Quebec for years, and the government has done nothing to stop it.
    Now, a huge coalition of groups, including the FADOQ, the Québec Medical Association, and the FIQ, are taking the Government of Canada to court to make it enforce the Canada Health Act.
    Will the minister do her duty, enforce the law, and put an end to ancillary fees?
    Mr. Speaker, we fully support the principles of the Canada Health Act, which seeks to ensure that all Canadians have reasonable access to medical and hospital services that are medically necessary based on need, not ability to pay.
    I am committed to working with our partners to strengthen our universal public health care system while upholding the principles of the Canada Health Act.


Agriculture and Agri-food

    Mr. Speaker, my question is for the chair of the Standing Committee on Agriculture and Agri-food and has to do with the committee's agenda. All members of the House know that the dairy industry is an important economic driver in Canada.
    Can the chair of the Standing Committee on Agriculture and Agri-food talk to the House about the committee's agenda, specifically with respect to diafiltered milk?
    Mr. Speaker, I am pleased to inform my colleague from Brome—Missisquoi that I received a notice of motion from the member for Fundy Royal, calling on the committee to adopt a report that recognizes the government's support of the dairy industry, that recognizes the impact of the importation of diafiltered milk, and that calls on the government to meet with dairy industry representatives in the next 30 days in order to find sustainable solutions to modernize the industry.


Ministerial Expenses

    Mr. Speaker, we all know the Minister of International Trade's sole purpose for being in LA was to be on television.
    Yesterday, when the government House leader tried to defend the minister's unplanned vanity trip, he said, “The minister signed important agreements during her visit to California”. If that is the case, will she table these important agreements immediately, keeping in mind that credit card receipts and the waiver for Bill Maher do not count?
    Mr. Speaker, once again the Conservatives are trying to create a story where there is none. I have already listed the business meetings I held in California. However, unlike the Conservatives, who do not like the media, we understand it is our job to talk to the media at home and abroad.
     I want to point out that I appeared in the media in California with some important Canadian partners, Senator Angus King of Maine, and the California Lieutenant Governor Gavin Newsom.
    Mr. Speaker, they all happened to be sitting on the same panel show, so they do not count as individuals.
    Either the minister signed important agreements or she did not. If she did, then she should table them right here so we can all have a look at them.
     We know her own bureaucrats were in the dark, with 500 pages of emails in two days trying to figure out what she was doing there and why it would cost $20,000 to have her there.
    Is the House leader going to stand and apologize for misleading the House yesterday if there were no signed agreements?
    Mr. Speaker, what we are not going to apologize for is having an international trade minister who travels around the world promoting Canadian commercial interests in the United States and in other parts of the world. We are proud of the work she is doing for Canadian jobs and ensuring that Canadian companies are able to compete globally. She will continue to do that.


International Trade

    Mr. Speaker, yesterday, the Leader of the Government in the House of Commons told the House that the Minister of International Trade had signed important agreements during her visit to Los Angeles.
    Would it be possible to see which agreements?
    Mr. Speaker, once again, the Conservatives are trying to create a story where there is none. It is my job to promote Canada abroad.
     Since the opposition is so interested in this issue, I will repeat that they should keep in mind that it was their own former leader who spent $50,000 of taxpayer money to pay a consultant to find American interviews.


    We do not have to pay Republican hacks to organize media appearances—
    Order, please. The hon. member for Lévis—Lotbinière.


    Mr. Speaker, the Conservative government concluded the trans-Pacific partnership, and we know that many businesses in the regions of Quebec will benefit from the economic spinoffs of this trade agreement.
    Can the current government provide some reassurance to the Quebec regions by confirming that it will not tamper with any of the measures that are of significant importance to Quebec?


    Mr. Speaker, our work on CETA removes all doubt as to our commitment to free trade.
    However, we promised to consult Canadians on the TPP. Our government has held over 250 consultations on the TPP. None of the member countries have ratified the TPP yet.
    We know that the Conservatives do not believe in public debate, but we do.


Status of Women

    Mr. Speaker, on a single day, three out of four Canadians seeking help from a domestic violence shelter are turned away. Many more women fleeing violence cannot even access a shelter because none exist in their region. The Liberal budget did not have sufficient funding and offered no money for a comprehensive national action plan.
    We need to address this problem at its root. Will the government adopt a national action plan, with adequate funding, and finally end violence against women?
    Mr. Speaker, I thank the colleague across the floor for her unwavering efforts to address gender-based violence.
    As the member well knows, we in fact do have plans for a comprehensive gender-based federal strategy to end violence against women. More than that, we are very proud of our investments in shelters, transitional homes, and affordable housing that will affect women in a tremendous way to move forward in a safe and productive manner and will have effects for generations to come.

Foreign Affairs

    Mr. Speaker, in 2010, a mere six years ago, the House unanimously supported an NDP motion calling for Canadian engagement in negotiations for a global convention on nuclear weapons, and to kick-start the Canadian diplomatic initiative to prevent nuclear proliferation.
    The Prime Minister has publicly promised to re-engage Canada with the United Nations and to seek a seat on the Security Council.
    What, if any, commitments did Canada make yesterday when he and the Minister of Global Affairs met with the United Nation's High Representative for Disarmament Affairs?
    Mr. Speaker, indeed, Canada wants to help with disarmament in all of its facets. This is what I have said to the High Representative.
    The approach we want to take is to focus on the Fissile Material Cut-off Treaty. This is the best way for Canada to go ahead and make progress with our allies. We will focus on that, and we will count on the contribution of all members in this House on this important challenge that we have to face.


    Mr. Speaker, the cat is really out of the bag now. It was reported today that talks between the Liberal government and Iran to re-establish diplomatic ties are well under way.
    Despite the minister's protestations in the House yesterday that Iran will remain listed as a state sponsor of terror, it is clear that the Canadian government is on the fast track to normalize relations with Tehran. The government seems determined to cave in to this odious regime's demands.
    How can the government negotiate with a state sponsor of terror?
    Mr. Speaker, under the former government, Canada was alone in having an empty chair with a lot of countries when it disliked the regimes, which was the wrong approach. All our allies are asking us to stop this wrong approach, and it is what we will do with Iran.
     In order to see progress on human rights and progress on the protection of Canada's interests and the interests of our allies, including Israel, Canada will engage with Iran with open eyes, step by step.
    Mr. Speaker, in February, the Minister of Foreign Affairs and the Minister of International Trade announced that Canada was positioning for commercial trade in Iran.
    Yesterday, the minister told us the Liberals have no current plan to delist Iran as a state sponsor of terror.
    Exactly how does he think he can negotiate these two diametrically opposite courses? Can he tell us when he expects to sit down for a business chat with his terror-sponsoring, human-rights-abusing Iranian counterpart?


    Mr. Speaker, every day, every week, we have different business people, governments, that are going to Iran. They are negotiating for their national interests in Iran with open eyes, to make sure that the nuclear program of Iran will not be militarized. I think it is the right approach, our allies were right to do so, and Canada will join them.
    Mr. Speaker, the Baha'i faith was founded in Iran, but Baha'is in Iran today face significant persecution, which includes executions and the destruction of holy sites.
    We are well aware of Iran's belligerence, but the suppression of the Iranian people and efforts to crush the Baha'i community in particular are also part of the record of this vile government, which requires our attention.
    After killing the Office of Religious Freedom more than a month ago, what is the government going to do for religious and ethnic minorities in Iran?
    Mr. Speaker, I share the concern of my colleague about the atrocities he spoke about. However, the question I would ask is this. In which way would it help if Canada is not there? In which way would it help if Canada does not have an embassy?
    Was it not fortunate, at the end of the 1970s, that we had a Canadian embassy in Tehran when it was time to help the U.S. hostages? Can we learn from our history?


International Development

    Mr. Speaker, last week, we learned that a Canadian-funded Syrian hospital was bombed. Such acts are clearly unacceptable and an assault on the rights of every woman and man in the world.
    Can the Minister of International Development tell the House what our government has done in response to this despicable act?
    Mr. Speaker, I completely agree with my colleague. The attack was utterly unacceptable, as is any such act targeting doctors, humanitarian workers, and the women and children who are there because they need care.
    Our government strongly condemns such violations of international humanitarian law. That is why, yesterday, the Minister of Foreign Affairs and I announced that Canada was co-sponsoring the United Nations Security Council resolution on protection of medical personnel and hospitals. The resolution was unanimously approved by the United Nations Security Council this morning.


Agriculture and Agri-Food

    Mr. Speaker, Canadian ranchers produce the safest and best-quality beef in the world. Some people with vested interests have attacked the Canadian industry over the last number of weeks and months, and some restaurants have even stopped serving Canadian beef.
     This Canadian farm boy is not going to eat at those restaurants anymore. I am wondering if the Minister of Agriculture and Agri-Food across the way will stand and commit to supporting Canadian agriculture, and do the same.
    Mr. Speaker, I can assure my hon. colleague that we support agriculture in this government. All Canadian beef is certified as safe under science research. We have the safest high-quality beef in the world. It is the safest food we can eat, and Canadians are safe and should eat this food.


Foreign Affairs

    Mr. Speaker, while we celebrate World Press Freedom Day, Raif Badawi is still being detained by Saudi authorities for criticizing their regime.
    One would like to think that our government is doing everything in its power to have him released. In an interview, however, the Prime Minister said that it is important to be discreet and not to push too hard or too fast. He does not want to become personally involved.
    When it comes to doing business with the Saudis, the Liberals are quick off the mark, but when it comes to ensuring that human rights are respected, there is no hurry.
    How does the government explain this to Mr. Badawi's wife, who is here in Ottawa today?
    Mr. Speaker, my colleague is asking if we are using every means available and doing everything we possibly can to help Mr. Badawi and have him released, since he has done nothing wrong.
    Yes, that is what we are doing. To increase our chances of success, my colleague will understand if I refrain from commenting any further.


Canadian Heritage

    Mr. Speaker, many Canadian films have received international acclaim in the past year. One fine example is the Telefilm Canada-funded movie, Room, a Canadian Screen Awards- and Oscar-winning picture.
    Room is a Canada–Ireland audiovisual treaty co-production. It stars Canada's own Jacob Tremblay and is written by the Irish Canadian author Emma Donoghue who now lives in London, Ontario, part of which I represent.



    Can the Minister of Canadian Heritage explain what the Government of Canada is doing to encourage our artistic talent on the international stage?
    Mr. Speaker, I thank my colleague for his important question.


    We believe in the importance of showcasing Canadian talent to the world, and that is why we support the film industry. One example of it is our new Canada–Ireland co-production treaty, which will help to ensure that similar successes are possible in the future.


    Our 2016 budget includes historic investments to support culture, which is why we will continue our efforts to promote our culture here and abroad.


Intergovernmental Relations

    Mr. Speaker, Mr. Gerard Comeau, with the help of the Canadian Constitution Foundation, won his court case, which would allow Canadians to bring beer across provincial lines into New Brunswick.
    Many constitutional scholars say this will inevitably end up at the Supreme Court. Authorities say that the liquor laws are still in force despite this ruling. Consumers deserve certainty, and the sooner the better. Does the government intend to refer this case to the Supreme Court?
    Mr. Speaker, that was a very positive development that we saw with regard to alcohol and the transferring of alcohol from one jurisdiction to another. That is why I am working very closely with my provincial and territorial counterparts on an agreement on internal trade, a comprehensive agreement that would reduce barriers and eliminate barriers altogether and that would work on issues around regulatory compliance.
    The idea here is to ensure we grow and create opportunities for businesses and people to succeed in Canada. That is why we are going to continue to pursue an agreement on internal trade that would address that issue.


Dairy Industry

    Mr. Speaker, half of Canada's dairy farms are in Quebec. Imported diafiltered milk is hurting my home province. We are talking about thousands of dollars lost every week. Our regional economies are in jeopardy. In a show of solidarity, the hon. member for Chicoutimi—Le Fjord poured a bag of powered milk on his head. Imagine that. However, in the House, there has been no show of support for our farmers, and nothing is being done to resolve their problem. What will it take for government members from Quebec to start representing their constituents, a nod from Toronto?


    Mr. Speaker, I can assure my hon. colleague that this government supports supply management and we are fully aware of the industry's concerns about the use of diafiltered milk in the making of cheese.
    We are working to reach a sustainable solution that works for all of the Canadian dairy sector. I am also very pleased that the member for Fundy Royal gave notice of a motion today to the agriculture committee to work toward solutions on this issue.
    We are working on this issue.


Aerospace Industry

    Mr. Speaker, the Air Canada Public Participation Act, which the government wants to water down, was a promise made to Quebec in 1989. The legislator's intention was clear: to protect the jobs in Montreal.
    I know that because I was sitting in the government when that legislation was passed. At the time, it was the Quebec caucus of the government that fought to protect our aerospace industry.
    When will the 40 Liberal members from Quebec in this government stand up and defend Quebec's aerospace industry?
    Mr. Speaker, of course we are defending the aerospace industry in Quebec and across Canada. As hon. members know, when the Government of Quebec and the Government of Manitoba decided to drop their lawsuits against Air Canada, this allowed us to modernize the legislation. It is an important step in the right direction. This will prevent future lawsuits. What is more, this will put Air Canada in a position where it can be more competitive with its rivals.
    I would remind my hon. colleague that in Quebec, Manitoba, and Ontario there are still requirements to hire Air Canada employees to perform maintenance.


    Mr. Speaker, during question period, the Prime Minister implied that it was Quebec's fault that the federal Liberals did not live up to their Kyoto commitments. I would like to ask for unanimous consent to table a document that shows Quebec decreased GHG emissions every year while I was environment minister and prove that they went up—
    Does the member have unanimous consent to table the document?
    Some hon. members: No.
    The Speaker: There is no unanimous consent.

Government Orders

[Business of Supply]



Business of Supply

Opposition Motion—Canadian Dairy Industry  

    The House resumed from April 21 consideration of the motion.
    It being 3:05 p.m., pursuant to order made Thursday, April 21, 2016, the House will now proceed to the taking of the deferred recorded division on the motion of the member for Berthier—Maskinongé regarding the business of supply.


    (The House divided on the motion, which was negatived on the following division:)

(Division No. 45)



Blaney (North Island—Powell River)
Blaney (Bellechasse—Les Etchemins—Lévis)
Duncan (Edmonton Strathcona)
Lauzon (Stormont—Dundas—South Glengarry)
Masse (Windsor West)
May (Saanich—Gulf Islands)
McCauley (Edmonton West)
McLeod (Kamloops—Thompson—Cariboo)
Miller (Bruce—Grey—Owen Sound)
Van Kesteren
Van Loan

Total: -- 142



Casey (Cumberland—Colchester)
Casey (Charlottetown)
Di Iorio
Duncan (Etobicoke North)
Fraser (West Nova)
Fraser (Central Nova)
Lauzon (Argenteuil—La Petite-Nation)
MacAulay (Cardigan)
MacKinnon (Gatineau)
Massé (Avignon—La Mitis—Matane—Matapédia)
May (Cambridge)
McKinnon (Coquitlam—Port Coquitlam)
McLeod (Northwest Territories)
Miller (Ville-Marie—Le Sud-Ouest—Île-des-Soeurs)
Petitpas Taylor
Sidhu (Mission—Matsqui—Fraser Canyon)
Sidhu (Brampton South)

Total: -- 171



    I declare the motion lost.


Criminal Code

[Government Orders]
    The House resumed consideration of the motion that Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), be read the second time and referred to a committee, and of the motion that this question be now put.
    Order, please. I would encourage members who wish to have discussions to take them behind the curtains or out into the lobby.
    I wish to inform the House that because of the deferred recorded division, government orders will be extended by nine minutes.
    Resuming debate, the hon. member for Scarborough—Agincourt.
    Mr. Speaker, I am pleased to rise to speak to Bill C-14, the government's response to the Carter decision that we have recently dealt with by tabling this particular piece of legislation.
    I wish to state at the outset that I will be supporting the bill, but with some reservations. I will explain why I believe the bill deserves support, but by the same token, I believe that somehow in a future Parliament the bill could go further.
    I intend to engage in this discussion by going through three thematic components in the brief 10 minutes I have to make my contribution to this important debate. I know this has been at times an emotional issue for parliamentarians, but in the three thematic components, I wish to give my rationale for my support at this time.
    The first of the three themes looks at the moral considerations that many members and much of the broader public have expressed. Second, I want to discuss perhaps more fulsomely our duty as parliamentarians to respond to issues of constitutionality, particularly when they are challenged in the courts. Third, in the short remaining time I will have, I wish to express some personal thoughts on this as it impacts me directly.
    First, I want to thank many constituents in my riding of Scarborough—Agincourt for their interventions on this subject. This has been an emotional matter, and I would have to state on the record that the overwhelming majority of constituents who reached out to me are opposed to the government introducing Bill C-14. That has been primarily on moral grounds. They feel that allowing physician-assisted death is essentially tantamount to murder.
    In the opportunities I have had to discuss this matter with my constituents, I made it clear that Parliament is under a positive obligation to respond to the decision in the Carter case. If Parliament does not present some form of legislation, the consequence of its failure to do so would mean that the provisions of section 14 and subsection 241(b) of the Criminal Code would no longer be operative as of June 6. We would essentially be left in the situation of a legislative vacuum. It is important to put a regulatory framework around physician-assisted death.
    As I pivot from the issue of morality to the issue of our responsibility as parliamentarians, I want to raise the point that while morality is important, and this has been a theme discussed in the House, ultimately we as parliamentarians must first make sure that we put in laws that pass the constitutional test. Where the Supreme Court of Canada has rendered a decision indicating that something is not constitutional, that it is a breach of some form of the constitution, whether on jurisdictional grounds or on grounds under the charter, Parliament needs to respond. In my view, that is what the government is doing in Bill C-14, under a very difficult timeline. That is perhaps why there has been a decision to introduce Bill C-14 in a relatively controlled and restrictive manner. It is reflective of the fact that we are under a very tight time obligation.
    Therefore, I understand why the Minister of Justice, the Minister of Health and others, who have done yeoman's work in this regard, have taken initial steps to make sure it meets the constitutional test set out by the Supreme Court of Canada. However, in my view, it does not necessarily go far enough.
    I want to pay tribute to the ministers and to all the other many parties and Canadians who have contributed to the debate. I note that there was incredible work done by the Special Joint Committee on Physician-Assisted Dying, led by Senator Ogilvie and the member for Don Valley West. I want to pay tribute to all the members who participated in that committee.


     I want to note the contributions of the federal external panel, the provincial-territorial expert panel, and the many stakeholders and Canadians who have contributed to this very difficult debate.
    I would note, though, that not only have many of my constituents expressed concerns with respect to this particular bill, but in some specific instances they have asked us to consider invoking the section 33 notwithstanding clause found in the charter, which of course is the legislative override provision. I would view that as a more sophisticated way of saying they oppose it and that ultimately parliamentarians should please consider overriding the charter rights of certain individuals by invoking or using the notwithstanding clause.
     I would say to those individuals who have expressed that particular feeling that this is something we have to do and tread upon very carefully, particularly where we are potentially treading on rights that have been protected under the Canadian Charter of Rights and Freedoms. I would submit respectfully that it is important we do so in a manner that follows the tests that are similarly found in section 1 that were ultimately articulated in the Oakes decision that deals with the judicial override clause that is found in the charter.
    Under Oakes, there are essentially three tests that need to be met, and if any one of those tests fails, namely in dealing with the judicial override, then one would not be able to invoke section 1, and I would argue that one would have to use the same principles under section 33 in exercising the legislative override. Those three tests basically deal with rational connection, that the impairment is done in as minimal a way as possible, and that we look at the deleterious effects and salutary benefits of any limitation that is imposed under section 1.
    Typically, in application of section 1 of the charter in most instances, the failure falls under the second test, that the impairment is not as minimal as possible. Certainly, that was the basis in which the section 1 test was applied in Carter and which the court found that the proposed absolute ban on physician-assisted death did not meet the minimal impairment test. The court had carefully gone through the trial judge's analysis and concurred with the trial judge's position with respect to the application of section 1.
    In terms of whether we would consider invoking section 33, as I mentioned already, this Parliament, this House of Commons, has never exercised section 33 as a legislative override, and I would argue that we too should be extremely careful. That is the test that we need to apply as parliamentarians in terms of determining whether we feel it is appropriate to use the legislative override.
    As I mentioned before, the bill seeks to meet in a very expedited fashion a court-imposed time challenge and to deal with the suspension of the declaration of invalidity under sections 14 and 241 of the Criminal Code of Canada. We must do so by June 6.
    As I have indicated before, I will be providing my support for the bill, but I would argue that there are a couple of additional things that we as a Parliament need to consider in the future. These were articulated quite clearly in the report from the special joint committee of the Senate and the House of Commons.
    My first issue is that the bill currently does not deal with the issue of advance directives. I am sympathetic to those Canadians, particularly those who are suffering from diseases like ALS and others, who may still be in quite good shape at the present time, but at some future point, when they are getting close to their end-of-life situation, will not be able to express their particular consent. In my view, the issue of a clearly articulated regulatory framework that allows for advance consent should be considered.


    I am also—
    I am sorry, but the time is up. The member will be able to finish through questions and comments.
    Madam Speaker, part of what I am doing in raising my intervention at this point is to actually give my colleague the opportunity to finish off the point he was making, which I think was quite close to his conclusion.
    As he does, I wonder if he could also address something that came up in his discussion of advance directives, which was the very last thing he was addressing. He mentioned individuals who suffer from ALS. I would submit to him, and I would be interested in his response to this, that the Supreme Court's jurisprudence in this matter is based entirely on cases of individuals with ALS who approach death in a very atypical manner, in that their minds typically are completely intact while their bodies are completely frozen.
    Advance directives, I would submit, are primarily something that deals with the opposite situation, where the person's body may be fine, but the mind is gone, most obviously someone who is affected by Alzheimer's or some other form of dementia.
    If the member could work that into his comments, I would appreciate it. If not, I would very much like to hear the rest of what he has to say.


    Madam Speaker, I thank my colleague for his generosity.
    I was simply getting to the issue of mature minors, to say that I do have some additional trouble and am concerned about appropriate safeguards. That was my other particular area of concern.
    Let us get back to the question that my friend posed with respect to ALS or other conditions where the body is sound but the mind is not and the person may not be able to express the issue of consent. Again, I think the key is the particular regulatory framework that is put around the issue of advance consent.
    Clearly, a person, knowing that at some point in the future he or she will be losing his or her mental capacity, would have to have expressed it extremely clearly in an unreserved fashion that would ultimately meet the regulatory framework set out, with two physicians concurring that in fact consent was given in an express manner, and setting out the clear guidelines, the clear situation in which he or she would be prepared to be administered with medically assisted death.
    If we could create that kind of a framework, I think that would address the concern the hon. member may have.
    Madam Speaker, my hon. colleague from Scarborough—Agincourt has a very thoughtful approach to this issue.
    I am in the enviable position of knowing that while not all of my constituents support this bill, most of my constituents support this bill, because they have been waiting a long time to see compassion in medically assisted death. I particularly want to commend my colleague for voting on this bill, knowing that the comments he has heard from his constituents go the other way.
    I want to give him a little more time to share with us what he plans to say in further convincing his constituents that what he has done is required under the Charter of Rights and Freedoms.
    Madam Speaker, I want to get to my final point which is personal.
    Not only am I a member who has to decide as a parliamentarian, but I am also a member who was recently diagnosed with recurrent cancer. I may in fact be someone who may have to, potentially, depending on how treatment goes, avail myself of this option. It is not one I would like to contemplate, not one that I think is a choice I would like to make, but it is a practical reality of something I might have to face.
    We simply have to have an honest conversation with our constituents. In fact, I commend my colleague from Victoria, who has offered to come and do a joint presentation in my riding to explain the practical realities of this bill. At the same time, we need to hear from Canadians and understand why they have objections.
    At the end of the day, the point I want to make is when there is not societal consensus on a particular issue, we ultimately have to make sure that any bill that is put before us is constitutional and does not trample on the rights of individual Canadians.


     Madam Speaker, before I participate in the debate at second reading on Bill C-14, concerning medical assistance in dying, I want to tell the people faced with making difficult end-of-life decisions and their loved ones that I am thinking of them.
    Everyone knows that medical assistance in dying is a complex, delicate, and extremely personal issue. Since the Supreme Court ruled in the Carter case last year, Canadians have been taking part in this national debate. This issue continues to be debated and seriously considered around the world.
    I would like to share with my colleagues what is happening elsewhere in the world. Almost everywhere, the deliberate taking of a life or aiding someone to end their life are serious crimes punished by lengthy sentences. As many people know, Canada is not alone in legislating to authorize medical assistance in dying.
    Oregon, Washington, Vermont, and California are examples nearby. A little further away, Colombia, Belgium, the Netherlands, and Luxembourg have legislation authorizing one type or another of medical assistance in dying. The provisions on safeguards, controls, and reports, which are all found in Bill C-14, are similar.
    Usually, requests for medical assistance in dying must be voluntarily submitted by the patient in writing. In many cases, this must also be done in the presence of independent witnesses. The patient must obtain a second opinion from an independent doctor and must wait a certain amount of time between the day the written request is submitted and the day that the medical assistance in dying is provided.
    Colombia has a unique approval process for requests for medical assistance in dying. Every hospital has interdisciplinary committees to assess such requests and support the patients and their families throughout the process.
    Nearly all of the regimes we have looked at include a mandatory monitoring system in which independent committees collect information to monitor the situation. That information is then used to publish periodic public reports on medical assistance in dying.
    The safeguards and controls set out in various statutes are relatively consistent. However, there are differences in the types of medical assistance in dying that are authorized and the circumstances in which medical assistance in dying is authorized. The differences in terms of who is eligible for medical assistance in dying and the way that assistance can be provided fall along a continuum.
    On the one hand, we have the four U.S. states, which I mentioned earlier and which have enacted laws: Oregon in 1997, Washington in 2008, Vermont in 2013, and, more recently, California in 2015. In these states, a mentally competent adult 18 years of age or older can receive the assistance of a physician to die, provided that their request is voluntary and this person is suffering from a terminal disease, defined as an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.
    In these U.S. states, just one doctor may prescribe a substance that the patient administers to put an end to their life at the time of their choosing. This is what we commonly refer to as physician-assisted suicide. Voluntary euthanasia, in which the physician administers a substance that causes the death of the patient, is expressly prohibited. Patients are also not able to submit an advance directive.
    In Colombia, a ministerial resolution was drafted in response to two rulings by the country's constitutional court. The resolution contains eligibility criteria similar to those of the U.S. states.


     It limits eligibility to adults who have an incurable disease, which is defined as a serious, progressive, and irreversible disease, or a pathology that will lead to death within a relatively short time frame. It requires a specific prognosis of six months, in other words, the assurance that death is expected relatively soon. Unlike the U.S. states, Colombia authorizes only euthanasia. A doctor must administer the substance that will cause the patient's death.
    At the other end of the spectrum are Belgium, the Netherlands, and Luxembourg. In those three countries, patients can access medical assistance in dying if they are experiencing intolerable or unbearable physical or mental suffering caused by a serious incurable illness and if there is no possibility of improvement. Patients do not have to be dying or suffering from an illness that puts their life in danger in order to be eligible. In other words, physician-assisted suicide and voluntary euthanasia are authorized in those countries.
    Although medical assistance in dying is provided only to adults in Luxembourg, minors as young as 12 can seek medical assistance in dying, with their parents' consent, in the Netherlands. In Belgium, adults and emancipated minors can seek medical assistance in dying in similar circumstances. In 2014, Belgium expanded its eligibility to include children of all ages, but only if their death is likely to occur in the short term and their suffering is physical.
    The experiences and lessons learned by the Benelux countries were closely examined. For example, the law in the Netherlands authorizes requests for patients who no longer have the ability to express their wishes. However, research suggests that doctors are generally not prepared to euthanize such patients.
    Consideration was also given to the Benelux countries' experience regarding patients who are suffering intolerably solely because of a mental illness. This is a very controversial issue. Evidence shows an upward trend in the percentage of people who seek euthanasia solely because of mental illness, and experts are starting to express their concerns about the fact that medical assistance in dying under such circumstances is becoming increasingly common. For example, in Belgium, people have been euthanized because of intolerable suffering resulting from depression, anorexia, blindness, fear of a disability or further suffering, and the pain caused by the lost of a loved one.
    Many people fear that such broad access to medical assistance in dying can present real risks for people who are lonely or isolated and those who do not have any social, economic, or community support. It could also reinforce prejudice regarding the quality of life of seniors, people who are sick, and people with disabilities.
    Our government sought to learn from the experience of other jurisdictions. The government is committed to continuing to examine the more general issues, and it will continue to observe what is being done elsewhere in the world in terms of medical assistance in dying.
    I support Bill C-14, which was introduced by our government. Once this bill is passed, it will alleviate the suffering of those covered by its scope and will allow people to die with dignity.



    Madam Speaker, one thing my colleague intimated early in his speech was the number of countries that allow physician-assisted suicide. There is sometimes a misconception that most countries do allow physician-assisted suicide. The reality is that less than 3% of the world's population live in areas where physician-assisted suicide is accessible.
    I have a question, though, regarding the terminology being used in this bill, “medical assistance in dying”. There is no clear demarcation between physician-assisted suicide and voluntary euthanasia. Part of that, I think, is because we like the softer language of the current bill, but the more important distinction is that in a regime that has physician-assisted suicide, the results are that only 0.3% of all deaths are attributed to physician-assisted suicide. In regimes that have voluntary euthanasia, it is 3.0%, a tenfold increase in the number of deaths resulting from a system with voluntary euthanasia.
    I am wondering if my colleague would agree to include an amendment in the final bill that would say that wherever possible, where the patient is able to, it must be physician-assisted suicide, so that the patients themselves must administer the drug that the doctor prescribes.


    Madam Speaker, I would like to thank my colleague for his question.
    My colleague spoke about certain statistics and data, which I appreciate. I say that with all due respect and without any sarcasm whatsoever. However, this is not about ratings and assessing the numbers and the data. This is about human suffering. We should not lose sight of the fact that this exercise is made necessary by a Supreme Court ruling based on the charter. The current situation is no longer acceptable.
    The purpose of my explanation was to show that there are situations where countries have been much more permissive and we have major concerns. In other situations, countries have been far less permissive, and now there are questions. We tried to do something that addressed the problems raised by the Supreme Court, while dealing with the information that we have before us, which is about human suffering.


    Madam Speaker, today's debate is critical. It is extremely important. It affects everyone, and it gives rise to both hopes and fears in our communities.
    The NDP thinks that we need to listen to the experts, and it also wants the government's bill to measure up to the Supreme Court's decision in Carter. Right now, we have some concerns about that. For example, in paragraphs 13 and 14, the Supreme Court talks about the cruel choice that patients with degenerative diseases face. Will they put an end to their life right away, or will they wait until they are no longer able to do so?
    The all-party committee made a recommendation that patients be allowed to make an advance request regarding their end of life when they know that their situation is irreversible. Unfortunately, the recommendation from the all-party committee was not included in the government's bill. Would my colleague agree to add this recommendation to the bill in order to improve it?
    Madam Speaker, I thank my colleague for his question.
    There is one thing I must point out that is very meaningful. In life, we are all faced with choices, and we make these choices, but when the time comes to act on our choices, we have the option of changing our minds. We often exercise this right.
    In the situation my colleague mentioned, the individual could not change their mind. That is why the government chose not to accept this recommendation. Someone makes a choice, but when the time comes to act on it, no one can ask them whether they have changed their mind or are reconsidering their decision.
    People are autonomous and the choice is theirs to make. The government decided to accept that choice.
    Madam Speaker, I cannot tell you how privileged I feel to take part in this discussion, and I mean “discussion”, because in the course of our work, which went on until midnight last night and will do the same tonight, it really has been a discussion, with the goal of coming up with the best possible solution, and not a partisan debate.
    These kinds of subjects come up very rarely in history, and when the time comes for me to leave politics, I will look back on this as one of the most memorable topics of discussion in my time here.
    In studying a bill, we must of course take a rational and intellectual approach, based on facts and science; however, with this kind of subject, we cannot ignore our personal experiences and, for many of us, the dimension of faith that goes along with life and quality of life.
    Just a few decades ago, it would have been unthinkable for us to have a debate on the issue raised in Bill C-14. Today, this discussion is essential in order to address the concerns many Canadians have about quality of life.
    Our society is constantly evolving, and for obvious and sometimes valid reasons, our democratic institutions will always be partly out of step with popular sentiment. However, the wishes of the majority should not be the only factor that guides us in our decision-making, because if our democratic institutions do not protect minorities, I wonder who will.
    There are some historic issues that stand out in the life of a parliament, and as a result of the Carter ruling, we are now being called on to deal with such an issue. Although we are aware that there is little time left to deal with such a vast and also complex issue, we nevertheless have the good fortune of being able to refer to the Quebec experience, which quite surely can be a source of inspiration and can answer many of our questions.
    Today, armed with the Quebec experience, our personal experiences, and input from many organizations and people in our respective ridings, we are being called on to make the best possible decision about how to provide medical assistance in dying. This is not about whether or not this assistance should be available.
    The Supreme Court made that decision in Carter. As we all know, it was a unanimous ruling that sent a clear message on behalf of those who have spent years fighting for the right to die with dignity. It is up to us to legislate a framework for that assistance in a way that ensures respect for everyone's charter rights.
    The bill is far from perfect, but at this point, I plan to vote in favour of it so that we can have the opportunity to perfect it by suggesting useful amendments during the committee's study.
    I would like to share a very personal experience because I think that is the best entry point with this issue. Until recently, I was spared any major health problems, but not long ago, when I had a kidney stone that was relatively benign and easily treated, I had to cope with waiting six hours to get a drug that would alleviate my suffering.
    When I shared my story with a few people I know, several of whom had had similar experiences, I saw how quickly people responded to suffering with sincere compassion.
    Although this was a relatively minor health problem, for the first time, I felt, in my own body, the pain that may have been felt by my own parents, who both died of cancer. I spent as much time as possible with them when they had to move into a hospice. There is no doubt that their suffering was enduring and intolerable and that their health problems were grievous and irremediable. They met all of the criteria set out by the Supreme Court.
    The workers in that hospice understood and still understand that no one should have to suffer while they are waiting to die when there are ways to relieve their pain, even though, in many cases, one of the side effects of the drugs is to precipitate death.


    I have to say that when I remember the relief that I saw on my mother's and father's faces, I am inclined to support this bill and try to improve it.
    This bill should be accompanied by a real national strategy on palliative care. In my opinion, some or all of the $3 billion that the Liberals promised for home care during the election campaign should have been included in the most recent budget. However, that is not the case.
    Cancer can strike at any age and often there is no hope of recovery. Many other diseases produce similar effects of enduring and intolerable suffering without necessarily being life-threatening.
    That is why I am also concerned about the fact that in this bill, the government did not use the wording in the conditions set out in the Supreme Court's decision. The Supreme Court basically said that Canadian adults who are able to consent and who have a grievous and irremediable medical condition that causes enduring suffering that is intolerable to them have the charter-protected right to physician-assisted death. That is the crux of the Carter decision, which gave rise to the bill that is before us today, Bill C-14.
    What is the government trying to do today with this fourth criterion that it added, whereby the natural death has to be reasonably foreseeable? I have to admit to the House that in my mind at least, this is confusing. The terms are hard to define, the likely commendable goal being to seek the broadest consensus, even though that consensus already exists. If not, we would not be debating this bill. The Supreme Court likely would not have ruled the same way either if it had not sensed the evolution of this society.
    We are about to undermine the process with such a vague and mandatory criterion because the legislation tells us that to have access to medical assistance in dying, the person absolutely must meet the four criteria set out in the legislation. The first three criteria are easy to understand, but the fourth is exceptionally vague.
    I hope to see this fourth criterion disappear during our discussions in committee. With it, we are about to force those who are suffering to again demonstrate the unconstitutionality of the legislation, leading us right back to where we are today. We are here now, so let us see the work through and do it properly. Let us agree to ensure that this bill complies with the Constitution, that it will not be challenged later, and that those who wish to use it can finally do so.
    Other questions remain practically unanswered, which is why the work coming up in committee after the bill passes second reading, I hope, is so important. As we point out in our supplementary opinion attached to the report, the government must adopt an approach to legislating medical assistance in dying based on the following principles: protecting vulnerable persons; taking into account the ethical concerns of all medical professionals; guaranteeing equal access to medical assistance in dying; protecting the conscientious objection of health care professionals; and respecting jurisdictions.
    My time is running out, so I will conclude by saying that the NDP's job is to clarify the ambiguous provisions in the bill, strengthen the bill to avoid charter challenges, and demand stronger commitments with respect to palliative care and mental health care services to protect the most vulnerable Canadians. I can sense this in listening to my colleagues and all members of this House.
    I am prepared to take questions from my esteemed colleagues.



    Madam Speaker, I would like to put a different twist on this. We have heard a great deal about another component: the issue of palliative care. There is merit to getting further insight and comments on the record with regard to that.
    I know the member's background and, in particular, his political affiliation. Recognizing that the leadership in Ottawa needs to work with different levels of government to get something of equal value in every region of our country, I am wondering of the member would provide his thoughts on the importance of investing in palliative care. We might find situations where people make this decision, and one thing they take into consideration, no doubt, is what sort of palliative care there might be. Would the member like to comment on that particular issue?


    Madam Speaker, I thank my colleague for his question.
    Several aspects of Bill C-14 blur the line between federal and provincial health jurisdictions. As soon as we start talking about palliative care, we are talking about health care, which is a provincial jurisdiction.
    Nevertheless, the federal government can still take a leadership role, especially with its health transfers, so that Canadians across the country have equal access to palliative care as part of the end-of-life care continuum. Naturally, this must be done in accordance with the provincial and territorial legislatures.


    Madam Speaker, it is kind of funny to hear government members say that palliative care is a priority for them considering that there is nothing for palliative care in the budget.
    Can my esteemed colleague help us figure out what is going on?
    Madam Speaker, I thank my colleague for his question. Unfortunately, my response will sound a little partisan, which is what I hoped to avoid on this issue.
    That is the kind of response the government has been offering up since coming to power six months ago. The government members went on and on about middle-class tax cuts, but the cuts will not help anyone who earns $45,000 or less. Those people are still not part of the middle class.
    They say one thing but do another. What do people remember? Actions. During the election campaign, the Liberals promised to invest $3 billion in home care, which includes many different services. I am sure some of that money could have been allocated to palliative care and incorporated into this bill.
    Of the $3 billion that was promised, not a penny showed up in the latest budget for any kind of home care. They seem to have postponed this important element. We have an aging population in Canada and Quebec, and we need to tackle these crucial issues.