The House resumed from October 9 consideration of the motion that Bill , be read the second time and referred to a committee.
Mr. Speaker, allow me the opportunity to reflect on what has brought us to this point.
Shortly after the 2015 election, a number of pieces of legislation were brought before the House. One of those pieces was Bill , a direct response to courts and the many concerns Canadians had with regard to the issue of dying with medical assistance. The issue was thoroughly discussed and debated. A lot of dialogue took place inside and outside the chamber, and, in fact, across the country. The number of Canadians who were engaged in the legislation was extraordinarily high. That was reinforced earlier this year, but I will get to that particular point later.
Back in January or February 2016, there was a great deal of dialogue taking place. Bill ultimately passed just prior to the summer break, in June 2016. At the time, parliamentarians recognized that there would be a need to make some modifications. In fact, within the legislation we passed, we created the opportunity for us to review it.
It should come as no surprise to anyone that the issue continues today. Even without legislation, dialogue has been taking place among members of Parliament and constituents. I have had ongoing feedback on the issue, in particular through emails, since 2016. People have expressed concerns and issues with the legislation.
The Superior Court of Quebec made a determination on the legislation, which ultimately dictated that we had to bring in Bill . We had initially introduced the bill earlier this year, I think in February. Prior to its being introduced, Canadians were once again formally called upon to provide their thoughts on the issue. It was amazing that in a relatively short time span, we heard from in excess of 300,000 Canadians. People from all across the nation responded to provide their thoughts and ideas on what they would like to see the government and members of Parliament deal with on this very important issue.
We were very hopeful that a committee would have the opportunity to meet and review the legislation, with the idea of looking at ways it might be changed. Then came the pandemic. As we all know, the focus and attention of Canadians changed, just as the House's priorities had to change, in order to respond to the COVID-19 pandemic. As a direct result, we lost the opportunity for that parliamentary group or committee to get together to review the past legislation, and in fact even the legislation that was being proposed in January or February.
Fast-forward to where we are today. Bill C-7 responds to a decision of the Superior Court of Quebec. It is a reasonable and acceptable piece of legislation that, in this form, makes some changes. It deals with some very difficult issues. For example, it drops the number of days of waiting from 10, after a person is approved and in a near-death situation. I believe this will generally receive good support from all sides of the House. There is the reduction of witnesses from two to one. From what little debate there has been thus far, I believe this has the potential to receive good support. The criteria that a person's death must be reasonably foreseeable is an issue that no doubt will be talked about at great length, both in the chamber and at committee. There are other aspects of this legislation that I find very compelling, and I am very interested to hear what people have to say about them.
A big concern I have is the idea that someone is able to provide consent today but, as an illness or a disease continues, might be prevented from being able to give consent knowingly later, thereby disallowing them from having medical assistance in passing. I know many Canadians share that concern. I am expecting to see a good, healthy discussion on that, whether inside the chamber, in committees or in our constituencies, where we receive feedback.
There is the issue of mental illness and the severity of it. This area is worth ongoing exploration, in different ways. As a former member of the Manitoba legislative assembly, I remember that often when we talked about spending money in health care, mental illness was nowhere near being part of the discussion. In fact, it was a very dear friend of mine, Dr. Gulzar Cheema, who raised this issue at a time when very few people raised it. In general, it is something we need to debate more.
I suspect that as we continue the debate, whether in the chamber or at committee, we will see that it is very emotional for a number of people. I know first-hand how important palliative care is, through the experience of the passing of family, in particular my grandmother and my father. I am very grateful for the Riverview Health Centre in Winnipeg for the service in palliative care they provided. To be there at the passing of my father meant a great deal for me personally, as I knew that when he was there he had the love and care of professionals who deal with people who are passing on. A person has to have a very special heart to deal with that. I had a similar experience with my grandmother, at St. Boniface Hospital. They are two totally different institutions, but the thing they have in common is the supports that are there.
I believe we need to do more in the area of palliative care, and I would love to see more discussion, more debate and more action on the issue. I believe the federal government has a role to play in that area too.
To conclude, I will emphasize for members that here is an opportunity for us not only to look at the core of the issue and have discussions, but to look at some of the issues surrounding end of life and the circumstances that, either directly or indirectly, we are all somewhat familiar with.
Madam Speaker, this is such an important debate that we are having here today, and I thank members for sharing their stories.
This is a very personal debate. I recall speaking on Bill when I first joined Parliament. I talked about my own experiences with death. I have watched other families go through these issues as well. We talked about how we could be part of making those last few days, months, and sometimes years work well and make sure of the necessary resources.
I am coming to this debate speaking from two sides, and am almost sitting on the fence on this. I am bringing forward a letter from Richard Sitzes, who is the chair of Our Choice Matters, part of Community Living Elgin. I would like to read this letter into Hansard, because I think it is very important to hear the voices and concerns of those who are disabled. I am also going to read some Twitter posts from the late Mike Sloan. Other people have covered this, and those in London would know that Mike Sloan passed away on January 20, 2020, with medical assistance in dying. He had a very difficult time, but he shared his experiences through his Twitter feed. Because of my work here in Parliament with those with disabilities, I had started a relationship with him and discussed what life looked like and how we were to move forward.
I will begin with the letter from Richard Sitzes, chair of Our Choice Matters, which is a self-advocate group. He writes:
I'm a constituent in your riding and live in St. Thomas, and am very concerned about Bill C-7 and the changes to Canada's law on medical assistance in dying (MAID). I'm worried about the negative impacts this bill will have for people who have a disability in our riding.
As chair of the Our Choice Matters self advocate group, supported by Community Living Elgin, I am speaking on behalf of our group. In Canada, many people think that their having a disability causes suffering, but people who have a disability say that it is the lack of supports, not disability, that causes them to suffer. We fear that Bill C-7 will make this situation even worse.
Right now, Canadians can only access MAID if they are suffering and close to death. Bill C-7 will make it possible for a person who has a disability to choose medical assistance to die, even if they are not close to death. We strongly believe that removing the end-of-life requirement will increase negative ideas and discrimination against people who have a disability. It will grow the idea that life with a disability is not worth living. We are afraid that people who have a disability will feel pressured to end their lives even if they are not close to death. This has already happened in Canada, and it will get worse because of Bill C-7.
We believe that the federal government should make it easier for people with disabilities to live good lives, not end them. For the safety of people who have a disability, MAID must be available only to people who are close to death. We strongly oppose Bill C-7 and ask that you oppose this legislation.
I was fortunate to follow up on this letter with Richard last week. He has been a volunteer, not only in my office but in our community, for decades. He is a person we see at every volunteer opportunity. He is there at community events to lend a hand. He looks at his life and recognizes that he has so much to give to our community. I have never met a kinder soul in my life. He just wants to help and at the same time wants to be heard. Having had the opportunity to sit down and talk to Richard, I know his concern is that he will not be the person making that choice, but that it will be made for him. He told me that he did not know who would have the final choice. This is something that Richard, who just celebrated his 60th birthday on August 15, is very concerned with. When I look at Richard, I do not see his life as being worth any less than mine. He has so much to offer to all Canadians. I hope we recognize it is imperative that we have appropriate safeguards for people like Richard who have so much to offer.
On the other side, there are some positives as well. This is where I want to talk about Mike Sloan. He was able to share with Canadians, especially in my region, his everyday struggles of living with cancer. As I indicated, I had created a bond with Mike over the last number of years. When he called to tell me he had cancer, the two of us talked about what he would be going through.
Mike had decided that he was going to die with medical assistance. Watching his death, I can understand why. I understand the struggles that he went through, and want to read some of the things that were put on his Twitter feed.
Madam Speaker, how much time do I have, given that I talk so much?
The Assistant Deputy Speaker (Mrs. Alexandra Mendès): Five minutes.
Mrs. Karen Vecchio: Fantastic. Okay, that is great.
I want to talk about Mike. There was a CTV interview done with Mike back in early January. Mike had already pinned to his desk area his plans for his own funeral, with the date to be determined. He knew what he wanted in life. He was also a very strong advocate for those with disabilities, but when he got cancer he knew that there were going to be struggles. It was not just his mental capacity he was concerned with, but the physical pain he was going through.
I want to start off with the day of Mike's death: January 20. Bob Smith, a Rogers TV host in the London area, wrote:
Mike Sloan passed peacefully at 1:25 pm EST via MAID. He asked me...to let you know. I was with him at the end, holding his hand. He thanks you all for your support on this journey. His last words were, “Tell Chub I love him.”
Chub was Mike's cat. If anyone knew Mike, Chub got him through each and every day. Chub could always be relied on because some days were a little harder than others.
Going back to January 18, Mike wrote, “When it's getting too frightening to drink liquids because they may simply spit back up or choke me, you know, let's be honest about choices here.” To me that statement by him is extremely impactful. Another day he talked about being afraid to get in the shower. He was afraid of falling in the shower. He would get in and fall and started thinking that even though he was a young guy he might need a bench. He was going through all of those different issues each and every day.
Mike was diagnosed with stage four thyroid cancer in February of 2019. He tweeted about his experiences with palliative care and the care he received. It was interesting for anyone to watch this as he would show his belly, which had different things attached for his pain medication. The thing that was so incredible about this man, for any of the other members from the London area, is that he had an incredible sense of humour. He would post a picture of his belly tied to a medical bag that he called his “little purse,” which contained his pain medication. He would also show the different tubes that he would inject the medication in to make the pain go away. He was in absolute pain.
He wrote on January 7, “I've never died before, so I don't know what it feels like, but if agonizing pain, difficulty breathing, a fever and inability to sleep are symptoms, I'm getting there.” This was a man who did not fear death, but recognized that it was going to happen. He was also a man who would go into the hospital and just be released. What was actually really comical was when he went in with shortness of breath and walked out saying he was being released with pneumonia, but was walking and doing well.
Thinking of Mike, we have to find the right balance. We have to find the balance so that the Mike Sloans and the Richard Sitzes of this world have their wishes honoured. I recognize that this is a very difficult decision for many members of Parliament.
I can tell my colleagues that my vote on Bill was the most difficult vote I ever made. One of the most important things was that there were safeguards to make sure that the family, individual and entire team involved in medical assistance in dying all knew what they were getting into. It is really important that we make sure that those safeguards are in place and use strong caution with Bill as to whether this may open a new can of worms.
I am very proud to talk about this because it needs to be debated. There is no wrong or right answer. It is about finding a balance for all Canadians.
Madam Speaker, I am pleased to rise today, but I find it difficult to be speaking to another attempt by the Liberal government to endanger the most vulnerable in our society.
After just four years, when the original euthanasia and assisted suicide legislation came in through Bill , we find ourselves considering legislation that would further loosen restrictions, eliminate safeguards and confuse our country's understanding of the sanctity of life and the government's role in end-of-life decisions. Once again, we have been told that in order to uphold the charter rights of some we must endanger the rights and freedoms of others.
I did not support Bill for many reasons. The first is the fact that the Supreme Court of Canada invoked such controversial and flawed legislation, which has been proven to be poorly applied around the world. The Liberals also chose to broaden the scope of the legislation, going far beyond the Carter decision. Another reason is that it has been placed ahead of and continues to overshadow any significant palliative care initiative.
In 2019, the promised to expand eligibility criteria, and on September 11 of last year, the Superior Court of Quebec ruled that it is unconstitutional to limit assisted suicide or euthanasia only to those whose death is reasonably foreseeable. Without even appealing the ruling and seeking the advice of the Supreme Court, which has been long occupied with this matter, the Liberals accepted the ruling. They are now rushing to change the law for our entire country.
They gave Canadians a mere two weeks to have their views heard on this deeply personal and complicated issue through a flawed online consultation questionnaire. The use of convoluted and biased language left little to the imagination in terms of how the government planned to legislate assisted death. I too tried to fill it out, and I would argue that many opposed would have been discouraged in participating due solely to the language used.
With such a flawed method, and with no idea if the feedback even remotely reflects the actual views of Canadians, how can the government proceed with this legislation in good faith? This is a rhetorical question because it does not seem to matter to these Liberals. It is clear they used this brief window for feedback to satiate the need for a consultative process.
We also know the government ignored its own timeline for a review of the original assisted suicide legislation, Bill . It was planned for this summer, and instead, we have been presented with this reckless legislation. In the midst of COVID, this was still something very important. Without a proper review and without input from the Supreme Court, this House has been asked to greatly broaden the scope of assisted suicide and euthanasia without a clear enough understanding of whether the current regime is being consistently interpreted or properly enforced.
Bill is being rushed through. This is concerning. When reading through this bill, I see elements that go beyond the scope of the Superior Court of Quebec's decision, namely, Bill C-7 would eliminate the 10-day waiting period between the date the request is signed and the day on which the procedure is carried out.
The application of the law pertaining to those whose death is reasonably foreseeable has been problematic from the very start of this debate. We know a person's reasonably foreseeable death is a flexible estimation, taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time they have remaining. The elimination of the 10-day waiting period for persons whose death is reasonably foreseeable would create the conditions for someone with an indeterminate length of time remaining in their life, possibly years, to be rushed to the decision to receive assisted suicide and euthanasia.
Aside from simply eliminating what most Canadians would consider to be a reasonable period of reflection, this element of the bill also ignores the possibility of medical advances and improved treatment methods in an incredibly innovative medical science environment. As Cardinal Collins has said, Bill creates the conditions where an individual can seek a medically assisted death faster than the wait time for a gym membership or a condominium purchase.
I also see no logical reason why the government would reduce the number of independent witnesses required for when the request is signed. It is down from two to one. The government has even relaxed the definition of someone who may serve as a witness, including medical professionals or personal care workers, even those who are paid to provide euthanasia and assisted suicide on a daily basis. This is in clause 1(8).
Surely we can agree that, for the vast majority of those requesting euthanasia and assisted suicide, the requirement for two independent individuals to witness a request to end a life is a reasonable safeguard. How do the Liberals plan to properly protect patients from potential malpractice? How does the government plan on ensuring requesters are presented with a myriad of treatment options rather than just one opinion?
The legislation continues as a series of safeguards the medical practitioner must adhere to before providing assisted suicide to those whose death is not reasonably foreseeable. One of these safeguards would require a medical practitioner to discuss with the person the means available to relieve their suffering, including palliative care.
The safeguard is even weaker for those whose death is reasonably foreseeable, requiring the medical practitioner to merely inform the person of these vital options. The government failed to follow through on its promise to invest $3 billion in long-term care, which includes palliative care. There does not appear to be any political will whatsoever to improve palliative care.
Canadians have also been calling on the government for a long-awaited national strategy for palliative care. There is a thirst among Canadians for real solutions to end-of-life care. The government seems all too willing to ignore the 70% of Canadians without access to palliative care and, instead, attempts to impose on them a flawed, one-size-fits-all regime. We can already see the consequences of pushing forward an assisted dying agenda when there is little regard for palliative care.
In British Columbia, the Delta Hospice Society was stripped of 94% of its operating budget for refusing to provide euthanasia in a facility intended for the provision of palliative care. Despite repeated attempts to defend its Charter-protected, faith-based objection to being required to provide euthanasia and reach a compromise in good faith, 10 hospice care beds are now at risk and will be surely defunded.
Why do the Liberals continue to ignore the voices of those who have a different perspective on the issue of end-of-life care? People who seek hospice care are seeking it for a reason. They do not desire a medically assisted death. In effect, what has happened in B.C. is an attempt to redefine what constitutes palliative care.
In fact, the Fraser Health Authority's decision flies in the face of the Canadian Society of Palliative Care Physicians, which has clarified that euthanasia and assisted suicide are distinct from palliative care. I caution Canadians not to regard the Delta Hospice Society's situation as an isolated one. The government has shown little interest in supporting hospice care, and I would not be surprised by further attacks on the ability of Canadians to chose to end their lives naturally.
In The Globe and Mail, Sarah Gray put it well, stating, “The hospice isn’t a place where people come to die. It is where they come to live — to live well for the little time they have left. It is a place of celebration, connection, comfort and support. It is a place of safety for the dying and the grieving.” In Cardinal Collins' words, let us work to create a “culture of care”, rather than rush toward a culture of “death on demand”.
The government would also be wise to recall that much of the debate on Bill revolved around calls for a solid framework of conscience protection for medical practitioners involved throughout the end-of-life process. At committee, witnesses stated that the protection of conscience should be included in the government's legislative response to Carter v. Canada.
The Canadian Medical Association confirmed conscience protection for physicians would not affect access to physician-assisted suicide or euthanasia. Its statistics indicated that 30% of physicians across Canada, or 24,000, are willing to provide it. I live in a rural area of Canada, and I can assure members there are many provisions that are not available to me directly where I live.
Unfortunately, the Liberals failed to defend the conscience rights of Canadians in Bill . I also found it disappointing that they failed to support, in the last Parliament, critical legislation put forward by David Anderson in Bill , the protection of freedom of conscience act. It would have made it a criminal offence to intimidate or force a medical professional to be involved in the procedure. It would also have made it a criminal offence to fire or refuse to employ a medical professional who refuses to take part directly or indirectly in MAID.
Here we are four years later, and Bill is also void of any provisions that would protect the section 2 rights of Canadians. In Canada, everyone has freedom of conscience and religion under section 2 of the Canadian Charter of Rights and Freedoms. No one has the right to demand all services from all providers in all circumstances. As David stated, protections are needed for doctors and health care providers who are not willing to leave their core ethics behind when they are at a patient's bedside. Access to euthanasia and conscientious objection are not mutually exclusive.
We, as legislators, must ask ourselves where the Liberals will draw the line. There will always be the voices of those in our society who feel that the limitations and safeguards are too stringent. When will it be enough for the Liberal government? How far are they willing to go? What message are we sending to the most vulnerable and fragile in our society?
Over the last five years I have advocated for our veterans. I know there are countless veterans who appear able to cope with debilitating physical injuries, but they are extremely vulnerable in their mental health. We are all concerned about the number of them choosing to end their lives by suicide because of complications after serving our country. It is antithetical to try to prevent them from taking their own lives, yet tell them that there are government-designed opportunities to do so.
Bill fails to provide conscience protection, fails to protect the vulnerable and fails to fulfill the need—
Madam Speaker, I will be sharing my time with the hon. member for .
This is a very difficult bill and subject for us to deal with. In this case, the sanctity of life, something that all of us cherish, conflicts with the liberty interests protected under section 7 of the charter. This is one of those difficult times where we have to recognize that our own religious views, our own moral views are not the ones we can simply impose on Canadians. We have to recognize that charter rights are sacrosanct. Sometimes, as a member, those are difficult moments.
I personally have said before that I would not choose medically assisted dying for myself. Nor would I encourage family members to avail themselves of the opportunity for medically assisted dying. However, I also fully respect the right of every Canadian to choose for his or herself whether this right should be exercised personally.
In the Carter decision, the Supreme Court of Canada upheld that under section 7 of the charter, there was a certain subgroup of Canadians whose liberty interests were violated by the existing provisions in the Criminal Code on not assisting someone to commit suicide. The Supreme Court in Carter told us that there was a subsection of Canadians, those who were in constant enduring pain and suffering that could not be alleviated by medical treatment reasonably acceptable to them, who had the right to have their death hastened by having medical professionals assist them in doing so.
In the last Parliament, our government brought in Bill . I had the privilege of being the chairman of the Standing Committee on Justice and Human Rights. We heard from a great cross-section of Canadians. We heard from those who represented the disabled community and those who believed in the right to die with dignity. We heard from members of the clergy from all faiths. We heard from university professors, lawyers and doctors. We heard from a great cross-section of Canadians who had very diverse and different opinions.
What we tried to do was craft a law that brought Canadian society together, that protected the vulnerable but yet still afforded everyone the right that the Supreme Court had recognized in Carter, which was the right to decide for one's self whether to terminate one's life in the event he or she was in enduring pain and suffering that could not be alleviated by medical treatment reasonably acceptable to that person.
As well, we had to recognize that when we dealt with the Carter decision in Bill , Canada was at the beginning of a list of countries dealing with medically assisted dying. There were very few countries in the world that had gone where Canada was going. Belgium, Holland, Uruguay and a few American states were, but that was it. Canadian society needed to come to terms with medically assisted dying and learn more about the process before we went too far.
That is why, at the time, I supported a clause in the bill that said that medically assisted dying was limited to those whose end of their natural life was reasonably foreseeable. However, we knew that would change over time and that as Canadian society looked at the experience of medically assisted dying, the bill would come back for review before Parliament and would need to change.
At the justice committee, we proposed a number of important amendments to that bill. We inserted, by unanimous agreement at the committee, conscience rights to ensure that the doctors, nurses and pharmacists whose own beliefs would be offended by medically assisted dying were not compelled to participate in the process. We said that Parliament would need to review some subjects that we were not dealing with, such as the issue of mental illness on its own; the issue of mature minors; and, probably most important, the issue of advance directives for those suffering with dementia.
We also adopted a motion that palliative care had to be part of that review. People should have their death hastened because palliative care treatment is not available to them in Canada.
This bill takes the medically assisted dying regime, Bill , a step further based on the Truchon decision. It held that the provisions we had put in the law about reasonably foreseeable death were not constitutional and that a subgroup of Canadians who may have many more years to live but were in constant pain, enduring interminable suffering, and could not have that alleviated by medical treatment reasonable acceptable to them also had the right to medically assisted dying.
This bill establishes that this group of people also have the right to medically assisted death in Canada, but also imposes additional safeguards on them, namely a 90-day waiting period. We understand that certain people, for example, may suffer a traumatic injury and need time to consider all their options and come to terms with their situation before finally going through with a medically assisted death.
Also, based on the Canadian experience, we are amending the bill to allow certain Canadians who are about to lose their ability to offer agreement to medically assisted dying, because they have lost their capacity to consent, to do an advance consent.
Some Canadians want to access medical assistance in dying knowing that they may still have a few more weeks to live. The only reason they want to access it sooner is that they do not want to lose their capacity to consent to medical assistance in dying.
Personally, I want these people to be able to continue to live and spend those last few weeks with their families. I do not want them to end their lives prematurely because they are worried about losing their capacity to consent to the procedure.
The amendment to the law, this bill that is before us, gives hope to this group. These people will have permission to sign a contract with their doctor indicating that they want to put an end to their life on a specific date, even if they lose the capacity to consent to medical assistance in dying in the meantime.
However, there is still a safeguard in the sense that if people who have lost their capacity to consent show through any action or words that they no longer wish to end their life, the doctor must then stop the procedure.
I strongly support the bill. I think Canadian society has evolved with respect to how we see medically assisted dying. As Canadians, we now have seen where the procedure works and where it does not work. We have seen which groups have been positively impacted and which groups have been left out and where we can improve on the procedure.
Following a great deal of consultation and national interest and seeing a change in how Canadian opinion sees medically assisted dying, this bill is the right one at the right time.
Madam Speaker, it is a pleasure to follow the wise words of my colleague, the member for .
I am pleased to speak in favour of Bill , an act to amend the Criminal Code, medical assistance in dying. As hon. members know, this bill responds to the Superior Court of Québec decision that struck down the eligibility criteria that naturally occurring death be reasonably foreseeable.
In the last Parliament, I spoke during debate on the original MAID legislation. At that time, I talked about the need for us to have conversations with loved ones about death and dying. “Death” is a word that elicits strong emotions. We celebrate life, we embrace life and we talk about living. However, we avoid talking about death. We shy away from those conversations because they make us uncomfortable. I know there are those who feel this legislation goes too far. However, regardless of where people fall on this legislation, I think we can all agree that the way we deal with and talk about death needs improvement.
Whether a grievously ill patient chooses to die at home or in a palliative care facility or chooses medical assistance in dying, we should be having these conversations sooner and lovingly assisting those who are ill in the end of their life. These decisions are often made during a health crisis. Ideally, each of us should be engaged in advanced care planning.
I would like to share the story of Bob Lush, an incredible man, respected lawyer and my friend. Bob and his wife Maureen shared a love and bond that was obvious to all who met them. Bob died on March 17. This summer I had lunch with Maureen and she shared with me the decision they took to use MAID. With Maureen's permission, I would like to share Bob's story.
Bob had been diagnosed with multiple system atrophy and pulmonary fibrosis. He also exhibited symptoms of Parkinson’s. While his body was failing him, his mind was as sharp as ever. Over time, these serious health issues would worsen, which led his doctors to tell him that he was palliative and that there was nothing more they could do. A palliative care nurse asked if they had thought about MAID and provided them with a brochure. It was not an option they had considered before, but Bob and Maureen together decided that this option would be the most loving way for Bob to leave this earth. I cannot possibly put into words the tremendous love these two shared.
Maureen described for me Bob's last days. They chose March 17. All medical equipment was removed from Bob's room and it was filled with flowers and candles. They loved listening to James Taylor's “American Standard” album, and it was playing. Maureen and Bob's son John were by his side. As Moon River played, the doctor administered the MAID drugs. Bob closed his eyes and peacefully, painlessly and humanely passed away. To hear Maureen describe it, I could hear both the love in her voice and the sadness of losing Bob, but she had no regrets and, in fact, wanted Bob's story to be shared so that other families could consider this option for their loved one, if it was the right decision for them.
The legislation before us here today would update our MAID laws in several ways. The bill would maintain existing safeguards and ease certain safeguards for eligible persons whose death is reasonably foreseeable. New and modified safeguards would be introduced for eligible persons whose death is not reasonably foreseeable. Persons whose natural death is reasonably foreseeable, who have been assessed as being eligible for MAID and who are at risk of losing capacity, can make an arrangement with their practitioners in which they provide their consent in advance, which allows the practitioner to administer MAID on a specified day, even if the person has lost their decision-making capacity.
For persons who choose MAID by self-administration, a person could waive in advance the requirement for final consent in case complications arise following self-administration, leading to loss of capacity but not death. These new safeguards would exclude eligibility for individuals suffering solely from mental illness. It would also allow the waiver of final consent for eligible persons whose natural death is reasonably foreseeable and who may lose capacity to consent before MAID can be provided.
This legislation would also expand data collection through the federal monitoring regime to provide a more complete picture of medical assistance in dying in Canada. These are important changes and ones that have been called for since 2016, when the government responded to the Carter decision with its original legislation.
Since MAID became legal in June 2016, there have been more than 13,000 reported medically assisted deaths in Canada. This figure is based on voluntarily reported data from the provinces and territories prior to November 1, 2018; and the data collected under the new monitoring regime after that date. MAID deaths as a percentage of all deaths in Canada remains consistent with other international assisted-dying regimes.
The government undertook extensive consultation in order to update the MAID legislation. In January and February 2020, the Government of Canada engaged with provinces, territories, Canadians, indigenous groups, key stakeholders, experts and practitioners to receive their feedback on expanding Canada's MAID framework. Over 300,000 Canadians participated in online public consultations between January 13 and January 27 of this year.
It is important to recognize that MAID is not the right option for everyone. We still have work to do to educate Canadians about end-of-life options. When the former Bill was debated in the House, I spoke about palliative care and the need to educate Canadians about it as an end-of-life option. I was pleased the Senate amended our original bill to include palliative care in the legislation. Our government has worked collaboratively with partners, including the provinces and territories, to develop a framework on palliative care. We are implementing a targeted action plan of providing $6 billion directly to provinces and territories to better support home and community care, including palliative care.
I would like to share once again Bonnie Tompkins' story, a story I shared in 2016 during debate on the original MAID legislation. She is currently compassionate communities national lead for Pallium Canada, a national non-profit organization focused on building professional and community capacity to help improve the quality and accessibility of palliative care in Canada.
When her fiancé, Ian, was diagnosed with terminal cancer, he was adamant that he wanted medical assistance in dying. As is common, his biggest concern was the burden he would place on loved ones as his illness progressed. After he saw Carpenter Hospice in Burlington and was educated on the options available—
Madam Speaker, I am very pleased to speak to the important Bill . We need to know its origins to understand why we are at this point today.
In 2016, working on Bill was a rather difficult exercise given that the Liberal government was intent on bulldozing it through. I believe that is the right expression, because the government refused all amendments proposed by the different opposition parties, including the Conservative Party, the NDP and the Bloc Québécois.
The government put pressure on the Senate by giving it a deadline. The Senate wanted to improve the bill before the House voted on it. What was the end result? In September 2019, the Superior Court pointed out that the bill passed by the House was not adequate, especially with respect to the issue of the foreseeability of the date of the person's death.
That is where we find ourselves today. We are in the House debating an extremely sensitive subject, but we have not had much time to consult the experts.
Everyone has a different perspective on the issue, whether they are members of the House or members of the public in Quebec or elsewhere in Canada.
I wrote a speech, but I have decided not to read it. Instead, I would like to share my own experience with my colleagues.
The vote on Bill C-14 was the hardest vote I cast in my first four years in Ottawa.
On the one hand, I had some constituents asking me to vote in favour of the bill, while others wanted me to make sure that the legislation would protect the most vulnerable and honour the conscientious objection rights of medical practitioners. On the other hand, I had constituents going through a very difficult time with a loved one who was suffering and could not access MAID.
I did not sleep well the night before the vote. I knew that no matter which position I took, whatever I said in the House could be interpreted by the media and by Canadians. Allow me to explain. Some members voted against Bill C-14, and I would imagine that others will vote against Bill C-7. Members voting against the bill are doing so not because they are against it, but because they do not think it goes far enough.
The opposite is also true. Some members voted in favour of Bill C-14 in 2016 because they wanted to make sure people got the bare minimum. No matter which side we took, we had to explain something extremely sensitive, and I do not think a simple yes or no could accomplish that.
I often ask myself, who am I to decide for someone else? As lawmakers, it is our duty to protect the most vulnerable, especially if we remove the criterion of reasonably foreseeable natural death for access to MAID. This is reflected in the questions that some members have been asking in the House. I am sure it reflects the opinion of many Canadians who wonder what would happen if a person wanted to give advance written consent in case their situation changed over time. There is much more to this debate, and I do not think we are done talking about it.
Madam Speaker, I forgot to tell you that I will be sharing my time with the member for .
I am very concerned about ensuring that this bill enables all Canadians, wherever they may live in this country, to have access to the appropriate resources to make the right decision for their situation. The current pandemic has exposed the weaknesses in our health care systems. I doubt all Canadians in rural areas have access to specialists who can guide them and give them the right information so that they can make a decision based on their circumstances.
I am also very concerned about minors and vulnerable people. During the study of Bill in 2016, I had the opportunity to hear the testimony of two witnesses who had suffered accidents and endured the most traumatic ordeals a human being can experience. They told me that, had they had access to MAID back then, they probably would not have been talking to me that day because they had been in such a dark place at the time.
I know people who were there for the final moments when someone who was suffering asked for MAID. I am certainly concerned about all that, and it makes me wonder what the best solution is. Is it because we do not have the necessary palliative care resources? Is it because both the federal and provincial governments and health care facilities are making poor decisions? I am wondering about that.
I must say, I feel like we are rushing the process today, because has been quite a while since the courts asked Parliament to modernize this legislation after what happened in Quebec. This is a government that shut down Parliament under the pretext of being in a pandemic, as though we could not do more than one thing at a time. There are 338 MPs. Committees could have continued to sit. We could have heard from experts who could have explained this issue to us properly so we could make the right decision, the best decision.
Again, this is something that will not be easy for many of us. We have differing opinions within our party and elsewhere. However, I would like to note that I am proud of my party for letting me vote freely. I want to thank my leader for allowing this, without any pressure from my organization. I hope that all political parties will offer this choice, because this is a vote of conscience, and it is challenging for us to represent our constituents, who do not all share the same opinion. We also have our own conscience. For some, this is a matter of religion or beliefs, which means we may not all see eye to eye on this file.
Personally, the thing I wrestle with the most is wondering who I am to decide what is best for someone who is suffering. I believe that is what will guide my decision on the day of the vote. I hope that I will be able to make the right decision and that all of us can then work with the government to put all the necessary resources in place to properly inform and educate the public, and provide everything we can to vulnerable people who are going through tough times with loved ones, so that they are adequately supported in making the best decision.
In closing, I hope that next time, we will have more time to talk about people who are not vulnerable, sick or about to die, but still want to express advance consent.
Madam Speaker, it is an honour to participate in the debate on Bill , which will amend the Criminal Code.
As someone who travels four or five hours to get to Ottawa on a regular basis, often I sit in Parliament and ask, “Do my constituents really care about what we are talking about?” I am pleased today to participate because I believe that this is a subject matter that every Canadian feels strongly about, one way or another, and that potentially could impact every Canadian. I feel very honoured to participate in this debate today.
We are doing so because the Supreme Court deemed certain provisions of the original medical assistance in dying legislation, MAID, to be unconstitutional. That provision, deeming death must be reasonably foreseeable, is being withdrawn in Bill . The second important piece of this bill is the removal of the 10-day waiting period. In my remarks today, I want to address both of those changes.
First, I would like to state at the outset that I support the bill. In contrast to some others who have spoken, I do not believe the government should have appealed the Supreme Court decision. While I commend the government for finally bringing forward this legislation, it is unfortunate that the Liberals are only acting when being made to do so by the courts. This is somewhat of a repeat of four years ago when the government was forced by the courts to introduce the original MAID legislation.
Those suffering near the end of life should not have to resort to the courts before government acts. I guess one could say, however, that late is better than never, and it is certainly better than endless appeals of the decisions.
Four years ago when the original bill was introduced in the House, I made a special effort to obtain the collective views of my constituents. While I personally supported the original legislation, I also wanted my vote to reflect the feelings of my constituents. I reached out extensively to survey my constituents through phone calls, emails, Facebook and direct mail.
The responses at that time were from all age brackets and all demographics. The end result was 77% of several thousand respondents supported the legislation. Ironically, that number is awfully close to the percentage of support I received in the general election just one year ago. I am confident that a similar survey today would yield the same results, and the majority of my constituents would be supportive of the changes being proposed in the bill.
What I heard from constituents reflected my own personal views. While I respect some deeply held views from constituents who do not support MAID, I am of the belief that I, and only I, should determine how much pain and suffering is reasonable for me when end of life is near. I do not believe any institution or government should deny me my constitutional right.
Some medical professionals do not support MAID, and that is their constitutional prerogative. Those advocating against these changes feel those rights are not adequately protected in the legislation. That may be legally correct, but medical professionals not wanting to administer MAID clearly have a professional responsibility to refer patients. In Alberta, the website for Alberta Health Services has a listing of doctors who are willing to perform MAID. If it is the view of a medical professional that he or she is not prepared to perform MAID, they can make a referral.
The second important piece of this bill is removing the 10-day waiting period. I also support this. The contention that someone who is suffering to the extent that they ask for MAID one day will simply wake up a few days later and change their mind, I do not agree with. In my view all the 10-day period provided for was additional suffering and an opportunity, for those who oppose MAID on fundamental principles, to try to change the patient's mind. In my view, both are wrong.
I am sure most MPs are receiving the same emails I am getting, many from constituents asking that I support the legislation and others who are opposed. I have no issue with those opposed to MAID. Where I do take issue is with some of the rationales that are being used. Medical professionals' conscience rights is one, and I have spoken to that.
Others claim the legislation would take us down the slippery slope of other countries, where euthanasia is available to children and those with mental illness. Clearly those are red herrings because this legislation would do none of that. Others are asking for more study, another delay tactic, similar to appealing the court decisions. It is more work for lawyers, less satisfaction for those suffering.
Increased funding for palliative care has also been raised as an option by those opposing this legislation. Enhancing palliative care is always welcome, but in my view is not directly related to this issue. We are talking here about people wanting to end excruciating pain and suffering. These people are not asking for their pain and suffering to be made more comfortable.
Our health care system must do both things well. It must allow for people to live with dignity and receive excellent care as they reach the end of their lives. In addition, the provision of health care is a provincial responsibility, and I do not believe it should be part of this discussion.
Since the original MAID legislation was passed four years ago, I have taken a special interest in this issue. Unlike some other members who spoke earlier, I have not attended a death where someone has chosen MAID. However, I have had dozens of constituents make a real effort to tell me they experienced MAID with a loved one and that it was very special and appropriate. They personally thanked me, as someone charged with making laws in this country, for making this provision available at end of life for their loved one.
I have not had one constituent call me to say how bad this experience was. In almost all cases, these same constituents have said that society needs to go further. In fact, many constituents seem to believe advance consent already exists. They cannot believe they are not allowed to prepare a legal document, while of sound mind, that would provide their loved ones with guidance in the event they are nearing their end of life but are no longer of sound mind. For that reason, it is critical the get on with his public consultation on a broader review of MAID, which was promised some time ago.
The needs to find out what Canadians want and not make those suffering take years to go through the court system to get change. Like most things, the Liberals blame COVID. However, there are many ways of seeking input from the public regarding other changes to MAID, and the minister needs to get this discussion moving now.
In summary, I look forward to the bill being studied in committee. I know there will be those opposed to the bill and those in favour making presentations, and all need to be heard. For me personally, I have consulted and listened to my constituents and feel very comfortable voting in favour of the legislation.
Madam Speaker, I will be sharing my time with my esteemed colleague from .
It is with great emotion that I rise in the House to speak to the bill on medical assistance in dying.
First, this bill is the result of a decision handed down by the Superior Court of Quebec. I am very familiar with that court. I had the great honour and responsibility of arguing cases before it in my previous life. Barreau du Québec lawyers have the privilege of working with one of the best courts in the world.
This court rendered a decision and rather than appealing it, the Liberal government said yes. Quebec will once again be leading the way for the rest of the country. Our progressive and forward-looking Quebec will guide Canada. That makes me proud both as a lawyer and a federal government MP from Quebec.
The purpose of Bill is to ensure that people like Ms. Gladu and Mr. Truchon have the same rights, opportunities and freedoms as those who are facing an imminent or reasonably foreseeable death.
The ruling in Truchon found the eligibility criteria of reasonably foreseeable natural death to be unconstitutional. Our government also agrees that MAID should be available to relieve suffering and pain from serious medical conditions and is now proposing through this legislation to amend the Criminal Code so that Canadians can end their lives with medical assistance if that is the right choice for them. To accomplish this, Bill proposes to repeal the requirement that natural death be reasonably foreseeable, opening up access to those who are suffering in a wider set of circumstances.
The changes to the legislation propose to create two pathways in terms of the procedures that must be followed to assess a request for medical assistance in dying. While I do not have time to get into the details of the two regimes in full, there are a number of points that I wish to highlight today.
For those people who are suffering intolerably from a serious medical condition, but whose death is not reasonably foreseeable, the safeguards put in place emphasize the importance of ensuring that sufficient time is taken to evaluate the request. A minimum of 90 days will be needed so that the person can be assessed by a doctor who has some experience with this condition, which will help to ensure that the person gets all of the information, services and tools that might help them improve their quality of life.
Bill also creates new safeguards with respect to consent. Individuals requesting an assessment for medical assistance in dying give their consent, of course. Clearly, they also give their consent to receive MAID when they officially sign their request. However, what matters most is consent when MAID is about to be administered. There must be no doubt as to the person's desire to receive MAID at the moment they receive it. Doctors will be more comfortable proceeding under those circumstances.
Depending on their illness, some individuals risk losing their capacity to give consent between the time they are approved for MAID and the day they would like to receive it. Although we expect that most people are ready for MAID rather quickly once their request is approved, some people may wish to wait for a specific event such as a child's wedding or the birth of a grandchild. Those who wish to wait before going ahead with MAID are caught in an impossible situation if there is the risk of losing capacity. Either they wait for their special family event and risk losing their ability to die as they wish, or they move up the date of the intervention and miss a very important moment with their family and friends.
Therefore, this bill will enable individuals in real danger of losing their capacity to consent prior to the day specified for administration of MAID to make special arrangements with their practitioner. Such arrangements must be made in writing. The doctor and the individual must work together to come to an agreement that works for both of them. This safeguard is important for individuals as well as for doctors because they are the ones who bear the tremendous burden of ending someone's life.
The bill addresses another difficult situation.
Let us suppose that, when the day comes, the person has lost their capacity to consent to MAID, but remains conscious and alert, although not competent. Let us also suppose that they act in such a way or make gestures clearly indicating that they do not want to receive MAID. The bill addresses this situation—which we obviously hope will be rare—by clearly stating that the physician must not proceed because, in this case, it is no longer what the person wants.
The concept of freedom of choice, for me, remains central to all of this. I watched my grandmother suffer from Alzheimer's. Not long after I was born she was diagnosed, and when I was very young she used to repeat the same stories over and over again to me, about her own life and the life lessons that she wanted to pass on. She would tell me about how she used to work two and then three jobs, taking shifts overnight in order to buy her family's first home and provide a better life for her children. What that repetition instilled in me was certainly an understanding that my grandmother was probably the strongest woman I knew, that she was a force of nature.
When I was about seven or eight she forgot who I was, she forgot who everybody was, and I had to very painfully remind her every time I saw her. By the time I was 10 she no longer remembered language at all, and it was just humming, which I still somehow found very soothing, comforting and somehow okay. The degradation from there continued; her eyes no longer opened at all, she was in a wheelchair, the humming had completely stopped and when I was 15 the only muscles that worked were reflexive ones. Even if nothing else in her body moved, she would chew food if it was put into her mouth. It took two people to move her from her wheelchair to her bed or to change her, and this situation went on like this for 10 years.
As a teenager I used to wonder constantly what it would feel like to be trapped in a body like that, wondering if that was really the same strong woman in there or not. It was 10 years of listening to hushed voices in the kitchen saying, “...but there's nothing we can do.”
I do not know for sure, of course, what my grandmother would have decided for herself, but I do know for sure what I would want. For those who would decide something different for themselves, or for whom their beliefs are contrary to assisted dying, this framework provides everyone with the freedom to decide for themselves.
It is not a crime under the Criminal Code to take one's own life. It is a crime to take someone else's. The changes proposed would ensure that those people who need and who would like doctors to help them in order to end their life with dignity, at the time that they choose, can do so.
MAID is certainly one of the most challenging social issues in our society, which is made up of people with very diverse viewpoints and needs. I believe that this bill would achieve the right balance between the freedoms and rights of those who are dying and who are seeking a peaceful medically assisted death and our medical practitioners who need a clear framework for timing and consent.
I call on all members of this House to support Bill .
Madam Speaker, I am so pleased to be able to speak to Bill , which seeks to amend Canada's medical assistance in dying legislation.
This is officially one of the hardest decisions I have had to make since entering politics, first at the municipal level in 2009 and then at the federal level. I never used to get my family involved in my decision-making. However, on this issue, I decided to get my wife and adult daughters to sit down with me at the kitchen table for a frank and serious family discussion.
Our government has been working on this bill since 2019. We have had discussions about the future and the choices that we need to make as parents. These discussions were extremely difficult. I know that this is an issue that hits very close to home for Canadians, but we do not talk about it in public very much. However, medical assistance in dying is a very complex and very serious issue for me.
Yesterday, when I came back from my run, a neighbour was waiting on my doorstep. We had an intense discussion, a very good discussion, on medical assistance in dying. He had just been diagnosed with ALS and was very emotional, which made me very emotional. He asked me if I had voted for or against the bill the last time. Because I understood that an individual's right to choose is very important, I voted in favour of the bill. This time too, I agree with the amendments proposed by the Quebec courts.
I have deviated somewhat from my speech, but events like these give us an opportunity to reflect on the reasons we are here. This subject has not been talked about very much in the House, and some opposition members have asked why it is up to all of us here to make these decisions. It just so happens that we chose to be decision-makers and that sometimes we have to make tough choices like this one.
We immediately embarked on an inclusive process with the provinces and territories in response to recent court rulings about MAID rules. We held extensive consultations. We talked to doctors, organizations, vulnerable people and eligible individuals. The consultations were part of our government's progressive approach to ensuring that the federal framework reflects evolving views and Canadians' needs. That is how we always make decisions here in the House. Our goal is always to improve Canadians' lives and be as fair as possible.
We were particularly focused on making sure that people with disabilities could express their views on the subject. People with disabilities are extremely important to me, given my past experience as parliamentary secretary to the minister responsible for persons with disabilities. That was an incredible experience, and we drafted the first accessibility act, which is near and dear to my heart.
Bill would amend the Criminal Code provisions respecting medical assistance in dying to provide greater autonomy and freedom of choice to eligible individuals seeking medical assistance in dying.
Protecting vulnerable individuals and respecting the right of people with disabilities to equality and dignity are essential considerations. More specifically, this bill would broaden medical assistance in dying to people with irremediable medical conditions who are in an irreversible decline but are not at the end of life.
The bill also proposes excluding persons whose sole underlying condition is a mental illness, introducing a host of safeguards for persons whose death is not reasonably foreseeable while maintaining and relaxing existing safeguards for persons whose death is reasonably foreseeable.
The bill also proposes permitting persons whose death is reasonably foreseeable and who were deemed eligible for medical assistance in dying to provide consent in advance of the time of the procedure even if they lose the capacity to consent prior to the day specified in the arrangement with the medical practitioner.
Supporting and advancing disability inclusion is not new for our government. From day one, we have been committed to achieving these objectives and have improved our programs to better respond to the needs of persons with disabilities. It should be noted that the Government of Canada fully respects the equality rights of Canadians with disabilities. That is why we have been working hard since 2015 to advance the accessibility and inclusion of persons with disabilities.
For example, in 2018, we acceded to the optional protocol to the Convention on the Rights of Persons with Disabilities. This means that Canadians have additional recourse for filing a complaint with the UN Committee on the Rights of Persons with Disabilities if they believe their rights under the convention have been violated.
In July 2019, we passed the Accessible Canada Act, which we are in the process of bringing into force. This legislation is considered one of the most important advances in federal legislation on human rights for persons with disabilities in more than 30 years.
In 2019, we also launched the accessibility strategy for the public service of Canada, in order to make the public service more accessible and inclusive. In addition, we improved data collection, in particular regarding indigenous people with disabilities. We recognize that integrating people with disabilities is about more than simply passing a law, and we are working with these people and other stakeholders to combat stigmas and prejudices. The culture needs to change so that the significant contributions made by Canadians with disabilities are recognized and valued as much as those of other Canadians.
Bill C-7 gives vulnerable people new, concrete safeguards against pressure and coercion, to ensure that MAID remains an informed, voluntary decision.
Today, as Parliamentary Secretary to the Minister of Seniors, I see that this has once again become a hot topic in my riding and in our discussions. I see how important it is to give people the right to make their own end-of-life choices. Fundamentally, we hope to strike a fair balance between respecting the individual autonomy of people who request MAID and protecting vulnerable people. We want this measure to be as compassionate as possible.
Madam Speaker, I would first like to mention that I will be sharing my time with the hon. member for .
I am speaking here in the House of Commons today about Bill , an act to amend the Criminal Code with respect to medical assistance in dying.
Many people here have had unique experiences involving the end of a loved one’s life. Personally, my most recent experience was last year, when I held my father-in-law’s hand until we were sure that he could die without suffering. I realized then that not everyone is that lucky. I thought about my grandmother, who fought a long and painful battle with cancer for many years.
Naturally, as the Bloc Québécois critic for the status of women and seniors, I was contacted by a number of groups about this bill. I will therefore recap all of the work my party did on this important issue, while emphasizing the great sensitivity of Quebeckers when it comes to medical assistance in dying. I will conclude with the position of some seniors’ and women’s groups who have made extremely useful recommendations.
First, let us talk about the reason for this debate. In September 2019, the Superior Court of Quebec ruled in favour of Nicole Gladu and Jean Truchon, both suffering from incurable degenerative diseases, stating that one of the eligibility criteria for medical assistance in dying was too restrictive, both in the federal legislation covering MAID and in Quebec’s act respecting end-of-life care.
Two brave individuals, and I know people who knew them personally, simply asked to be able to die with dignity, without uselessly prolonging their pain. Suffering from cerebral palsy, Mr. Truchon lost the use of all four limbs and had difficulty speaking. Pain killers are no longer working for Ms. Gladu, who suffers from post polio syndrome, and she cannot remain in one position very long because of the constant pain. She said that she loves life too much to settle for mere existence.
What we are talking about here is the “reasonable foreseeability of natural death” requirement. Justice Christine Baudouin said it well in her ruling when she wrote that “The court has no hesitation in concluding that the reasonably foreseeable natural death requirement infringes Mr. Truchon and Mrs. Gladu's rights to liberty and security, protected by section 7 of the Charter.” That is the crux of this debate.
The defendants were challenging the fact that they had been denied access to medical assistance in dying because their death was not reasonably foreseeable, even though they had legitimately demonstrated their desire to stop suffering. Jean Truchon had chosen to die in June 2020, but he moved up the date of his death as a result the pandemic. Nicole Gladu is still living, and I commend her courage and determination.
The Bloc Québécois' position on this ethical question is clear. I thank the member for for his excellent work and co-operation on this matter. I remind members that, as many have already pointed out, legislators did not do their job properly with Bill C-14. As a result, issues of a social and political nature are being brought before the courts.
We need to make sure that people who have serious, irreversible illnesses are not forced to go to court to access MAID. Do we really want to inflict more suffering on people who are already suffering greatly by forcing them to go to court for the right to make the very personal decision about their end of life? This will inevitably happen if we cannot figure out a way to cover cognitive degenerative diseases.
Obviously, we agree that we need to proceed with caution before including mental health issues, but that is not the issue today. The exclusion from the bill of eligibility for medical assistance in dying for individuals suffering solely from a mental illness requires further reflection, study and consultation, which will be completed at the Standing Committee on Health as soon as the motion that has already been moved by my colleague from Montcalm is adopted.
I would like to remind members of the important role Quebec played on this issue. Quebec was the first jurisdiction in Canada to pass legislation on this issue.
Wanda Morris, a representative of a B.C. group that advocates for the right to die with dignity, pointed out that the committee studying the issue had the unanimous support of all the parties in the National Assembly. This should be a model for the rest of Canada. Ms. Morris said she felt confident after seeing how it would work in Quebec and seeing that people were pleased to have the option of dying with dignity. The Quebec legislation, which was spearheaded by Véronique Hivon, was the result of years of research and consultation with physicians, ethicists, patients and the public. It has been reported that 79% of Quebeckers support medical assistance in dying, compared to 68% in the rest of Canada. That is important to point out.
In 2015, when the political parties in the National Assembly unanimously applauded the Supreme Court ruling on MAID, Véronique Hivon stated:
Today is truly a great day for people who are ill, for people who are at the end of their lives, for Quebec and for all Quebeckers who participated in...this profoundly democratic debate that the National Assembly had the courage to initiate in 2009. I believe that, collectively, Quebec has really paved the way, and we have done so in the best possible way, in a non-partisan, totally democratic way.
In this time of crisis, we must work together constructively to put people's well-being first. This is not about which has greater merit: palliative care or medical assistance in dying. This is about being able to offer both, to offer a choice. That is why I would like to remind the House that health transfers must be increased to 35% because Quebec and the provinces are the ones who know their regions' needs best and are in the best position to minimize disparity among the regions.
I would now like to tell the House about a meeting I had with the Association féminine d'éducation et d'action sociale, or AFEAS, in my role as critic for seniors and status of women. During the meeting, the AFEAS shared its concerns about this issue with me. I will quote the AFEAS 2018-19 issue guide:
Is medical assistance in dying a quality of life issue? For those individuals who can no longer endure life and who meet the many criteria for obtaining this assistance, the opportunity to express their last wishes is undoubtedly welcome. This glimmer of autonomy can be reassuring and make it possible to face death more calmly....
As the process for obtaining medical assistance in dying is very restrictive, those who use it probably do so for a very simple reason: they have lost all hope....
This procedure cannot be accessed by individuals who are not at the end of life....People with degenerative diseases, who are suffering physically and mentally, do not have access to medical assistance in dying.
That meeting took place last January. Last week I received a call from the president, reminding me how important this bill is, not only to her members but to all Quebeckers and Canadians. Work on this bill must continue in committee so the necessary improvements can be made.
Before being elected, I was a project manager responsible for raising awareness about elder abuse and bullying. I used to teach that violating people's rights is a form of abuse, that any attack on rights and freedoms, including the failure to recognize an individual's capacity to consent and to accept or refuse medical treatment, is a form of abuse. In 2020, a focus on proper treatment is long overdue.
Let me conclude by saying that I hope all of these comments and all of Quebec's lived experiences, in terms of respecting people who request and choose to die with dignity, will encourage all members of the House of Commons to give their unanimous support to Bill C-7 and to medical assistance in dying. Let's show some empathy for everyone who is suffering. Let's give them the choice. It is said that we do not choose to be born, but once we are, the cycle of life begins. Let's ensure that we ourselves have the choice to die with dignity in accordance with our own final wishes. This bill is long overdue. We need to act.
Madam Speaker, no one likes to talk about death. It reminds us that we are mortal, as are the people we love and the people we are emotionally attached to. We do not like to feel negative emotions. Our brain reacts negatively to these emotions by releasing hormones that make us panic.
Death is such a difficult subject that most people worry when a loved one starts talking about wills, last wishes or funeral plans. They worry about the person’s health, when that person is only trying to plan for the future. This may sound ghoulish, but life always ends in death. Our entire lives are planned, starting with our parents planning our education and then us planning our careers, moves, children, and so on. We can plan for death and funeral arrangements the same way, even if we do not have suicidal tendencies.
For there to be death, there has to have been life. We have a short time on this planet, so we need to act responsibly, not only for ourselves, but also for the generations to come. We are only borrowing this planet. The place where we live is temporary.
I listened to my colleagues’ arguments last week, and I also read a lot about medical assistance in dying. I even discussed it with my father. I love my father. I hope that he will be with us for a very long time. I am a daddy’s girl. Unfortunately, my father’s wishes are currently impossible. He told me that, if he were to be diagnosed with a degenerative disease and told what was going to happen, he would like to be able to tell his doctor, at a certain point in the progression of the disease, that he wanted medical assistance in dying and that he did not want to linger.
For now, that is impossible. It is something to think about.
Even if these discussions about our loved ones’ final moments are difficult, we need to have them. They are important. They ensure that we can respect the person’s wishes to the very end. It does not mean that the person will necessarily opt for medical assistance in dying. It means that we will know what the person really wants at the end. It can also prevent families from being torn apart.
One of the points raised by my colleagues was the fear expressed by several disability advocacy organizations that people with disabilities will be urged to get medical assistance in dying. I must admit that I, too, was concerned before I read the bill.
Once I read the bill, I saw that the request for medical assistance in dying must be made in writing by the person in question, and that it can be withdrawn at any time. When the substance is being administered, if the person gestures or speaks in a way that appears to be expressing a change of heart, everything stops there. That is the case not only for people with disabilities, but also for people whose death is foreseeable.
The Canadian Charter of Rights and Freedoms states that people with disabilities have the same rights as people without disabilities. This implies that they have the right to life, and that they are entitled to receive the treatments appropriate to their condition. Why would they not also have the right to medical assistance in dying if they meet the criteria clearly indicated in the bill? Do people with disabilities not have the right to decide for themselves simply because they have a disability? I find that unacceptable. I reject the idea. People with disabilities are capable of making their own decisions. They are rational beings. This has nothing to do with making decisions for other people.
It has to do with allowing people the right to make their own decisions concerning their own death.
I would add that other safeguards have been put in place, namely the three-month wait time with support services. My colleagues talked about that. It is not always easy to get in touch with a doctor or social worker, for example. I used to live in the regions. My doctor was a general practitioner. However, I do not think anyone ever had a better doctor because, when the time came to pick up the phone and call a specialist, he was the first to do so. Nothing could stop him. I wish everyone had that kind of doctor.
All of this makes me think that people with disabilities are not at risk. They will decide for themselves, they will have the same rights and responsibilities as people who do not have disabilities and for whom death is foreseeable.
I read that people are concerned that doctors will suggest medical assistance in dying based simply on a person’s disability. The very idea is repulsive, since doctors would not encourage patients to die. They would first try to relieve their pain and make suggestions for how to live with their condition. Beyond that, according to the bill, it is not up to the doctor to decide, but the patient. Doctors assess the situation and the request. Their role is not to suggest but to inform. It is the patient’s role to request and suggest.
I also read that some people believe that opening up medical assistance in dying to people with disabilities might suggest that their lives are not worth living. I have read and re-read the bill, and nowhere does it say that the life of a person with a disability is not worth living. Did anyone here tell Stephen Hawking that his life was not worth living? Did anyone tell any of our Paralympic athletes that their life was not worth living?
I am getting worked up because I have a little cousin who suffers from severe cerebral palsy. She barely speaks, but when she wants something, she knows how to make herself clear. She will never be able to request medical assistance in dying. Given her personality, I am convinced that, even if she could speak, she would not request it, because she is a ray of sunshine, because she is the person in our family who always believes that everything is good, everything is right and, at the end of the day, we can get through whatever life throws at us. I love her. She makes us see the beauty of laughter and closeness.
Although her life is complicated, it is certainly worth living. Therefore, saying that the bill is suggesting that the lives of people with disabilities are not worth living is yet another despicable point that was made.
The bill’s preamble states that life and the dignity of seniors and people with disabilities must be respected and that suicide must be prevented. I agree. To deny people with disabilities who are capable of making the choice the right to decide whether to receive medical assistance in dying is to deny them their dignity. Are we prepared to do that?
That amounts to treating these people as if they were less important, as if they were incapable of making decisions because of their disability. The very idea is repulsive to me.
Not everyone with a disability will request medical assistance in dying, just as not everyone without a disability will request it. Medical assistance in dying is an exceptional measure. It is not the rule. It is a choice that is fundamentally personal and that should not in any way be imposed by another person.
Some called in particular for the withdrawal of the 10-day wait period for people whose death is foreseeable.
Once again, I have very personal reasons for supporting that withdrawal.
I had an aunt who was quite the character. She spent five years fighting cancer and receiving treatments, some of them experimental. At some point, she could no longer stand it, and asked for medical assistance in dying. Because of the 10-day wait period, she died the day before she was to receive the drug to help her die—
Madam Speaker, before I get started, I will let you know I am splitting my time with the member for .
Today, I have the opportunity to participate in this debate on Bill from my riding in Guelph. Before I get going on the debate, I would like to recognize that Guelph is situated on the ancestral homelands of the Anishinabe people, specifically the traditional territories of the Mississaugas of the Credit First Nation.
I am proud our government has brought forward a bill that proposes changes that respond to the Superior Court of Quebec's September 2019 Truchon ruling. The proposed changes were informed by concerns and issues raised during consultations earlier this year in discussions with provincial, territorial and indigenous partners. As a result, we have had careful consideration of past experience with MAID in Canada.
I recognize medical assistance in dying is a deeply personal and complex issue. I have heard extensive feedback from my constituents on this topic as recently as this morning. During today's debate, we are hearing very personal stories from MPs that are very similar to what we heard when we first brought forward the legislation in Bill . There are arguments for and against, which we need to recognize and look at.
Some of my constituents who have shared their support for these amendments and the swift passage of this bill have noted to me the importance of dying with dignity, as well as consistent and equal accessibility for all Canadians, as part of what our legislation needs to provide.
Earlier this year, I had a constituent reach out to me and share her personal story regarding medical assistance in dying. She told me that she felt very strongly about this issue because her husband of 56 years, John, had passed last December after four years of battling an illness and how appreciative she was that we had taken some first steps toward addressing these issues. She told me about the vibrant man John was, with a big heart, a successful career and an impressive education. She told me they had conversations about getting old together and how they would deal with aging, but these discussions did not include suffering or what might happen if the pain became too great. As John's illness progressed, he was moved into a long-term care facility where he spent the rest of his life. It was there that she saw so many others who were unable to be independent. She was saddened to see there was no dignity for these people, or for her husband John, as they were no longer able to look after their own personal needs. I saw this myself with my mother as she went through care in her last 10 years of life. The story of my constituent was one that conveys the importance of providing a diverse end-of-life option for Canadians that will help them provide the right decisions to be able to end their days with dignity, comfort and peace of mind.
Of course, there are two sides to this debate. I have heard from other people and received a lot of feedback that they understand we are coming at this as a deeply personal and sensitive topic for everyone, but are concerned these new amendments may impact the disability community, something we have discussed in the debate today, and the conscience rights of medical practitioners or our work toward improving palliative care. They all really do stitch together. While I am sympathetic to these concerns, I am also pleased to see our new legislation strikes the right balance of autonomy and protection of vulnerable people. This is thanks to many disability advocates who have participated actively throughout the consultation process, including specific round tables that focused on issues faced by the disability community. As was mentioned earlier in the debate, 300,000 people had input throughout the month of January 2020 to help us get to where we are today.
Additionally, our law specifically acknowledges the conscience rights of health care providers and the role they play in providing medical assistance in dying. These new amendments do not make changes to these rights and I know we will continue to work with provinces and territories to support access to medical assistance in dying while also respecting the personal convictions of health care providers.
However, the most common concern I have heard from my constituents is the need to prioritize palliative care over medical assistance in dying.
It is really the end-of-life care that we are talking about in both cases. In palliative care, Canadians are approaching the end of their life, and they deserve to receive care in the setting of their choice and to live out their days in comfort and dignity. They also deserve the freedom to make this fundamental decision about life and death without fear of their personal choice being obstructed by politics or government.
In Guelph, we are very blessed to have a wonderful palliative care facility that has been growing over the years as people recognize this as an option towards the end-of-life care that they are looking for.
However, 70% of Canadians are left without access to adequate palliative care. We have the responsibility to act in the interests of patients and their families, which is why our government supports access to both palliative care and medical assistance in dying. End-of-life issues are as diverse as Canadians themselves, and these issues also change throughout the course of medical needs and procedures that are available.
It is our responsibility as a government to provide as many options as possible for Canadians, so that they can take these deeply personal choices and make them on their own. That is why our government has worked collaboratively with partners, such as the provinces and territories, to develop a framework on palliative care. To support this framework, our government is implementing a targeted action plan that will help to improve access to palliative care for underserved populations; support families, health care providers and communities; and look at the funding that is needed to be able to execute our plans.
I would like to take this opportunity to thank Hospice Wellington and its executive director, Pat Stuart for the amazing work they do to support our most vulnerable citizens, including through palliative care.
I would also like to thank the constituents of Guelph who have personally reached out to me over the last several months to share their feedback, suggestions and personal stories around medical assistance in dying. I look forward to continuing to engage with my colleagues on this important subject and with my constituents, so that we can work to create a system that is responsive to the needs of patients, and creates an environment that can create comfort and reassurance for patients and their families.