Mr. Speaker, it my pleasure to rise on behalf of the Conservative Party on probably the most important bill before this Parliament. I say that, without knowing how long this Parliament will run, because this is a decision with respect to the state interacting with one of its citizens at end of life.
This is probably one of the most important debates this Parliament will have, and if there is commentary coming from the government or from some pundits on why we are late and why we are approaching a time limit, that was entirely in the hands of the government for three reasons.
First, the government decided, with no reason and no grounds, to prorogue Parliament. We lost several months that could have been spent having substantive and compassionate debate on Bill and a range of other things.
Second, the bill results from a Superior Court judgment in Quebec, and normally something so fundamental would have been appealed to two higher courts: the Court of Appeal in Quebec and the Supreme Court of Canada. That was not done, and it should have been. Most legal observers believe this should have been the case.
Finally, as we may hear from the government and the today, they could have asked for more time, given the prorogation, their own delays and the pandemic. I think they will end up doing that today, and that is appropriate.
We are getting close to the deadline for this bill because of the government's inaction. The government was slow to appeal a Quebec court decision. The government also prorogued Parliament. That is why we are so close to a deadline set by a Quebec court decision.
As I said when I spoke to the previous bill, now Bill , four and a half to five years ago, when we debate the role of the state at the end of life of one of its citizens, there is compassion on both sides. There are people who do not want to see the suffering of someone near the end of life.
I will speak to the Sue Rodriguez case, when the Supreme Court was first charged with this. Someone with ALS, or Lou Gehrig's disease, loses their physical abilities and is confined in a horrible way. Approaching end of life, are they able to consent in the same way that someone would otherwise and make their own decisions about end of life?
There is compassion from people who want the well-being of their loved ones to be provided for. There is also compassion from people who are concerned about the state making determinations about quality of life. In fact, the justice in Quebec quoted many speeches from the last Parliament on the previous bill, following the Carter decision, including my speech. I talked about the concerns of a slippery slope and that we would be back in a few years. I said more vulnerable people might be swept into a law, and I am sad to say that is exactly where we are.
As a Parliamentarian, a lawyer, a father and the son of a brave woman who fought cancer, with profound memories of her from the palliative stage of that disease when I was nine, I am here to make sure the bill is debated properly and that safeguards are provided. Anyone who suggests we should be rushing this debate does not understand how profound it is.
Today's debate should be approached with respect and compassion. It is not a normal debate on normal policies. We are talking about the power of the government to take away a person's life at that person's request. It is a very serious action, and the debate that seeks to establish an appropriate legal framework is a necessary one. We are talking here about the value of human life, about human dignity.
I know that people on both sides of this debate have good intentions, but I am concerned that the bill is a first dent in the value we place on life. It is a slippery slope that we should not be taking with such a vague law and no safeguards.
In the Rodriguez decision, Justice Sopinka, who represented the Supreme Court at the time in the 1990s, talked about the distinction of a passive role of the state and an active role of the state at the end of life. “Passive” refers to palliative care, assistance with pain and, potentially, non-intervention, do not resuscitate, but the active role, when the state takes that role, attaches to section 7 of the charter, which is based on human dignity. The clerked under Peter Cory of the same court, and in fact, the McLachlin and Cory dissents both focused on human dignity with respect to section 7 of the charter.
All of them talked about the role of the state in protecting the decisionally vulnerable, as they were called, people who could be pushed into end-of-life treatment because they felt they were a burden. This has been talked about since the 1990s, and this is removing the safeguards from our regime. Every ounce of case law on the issue of assisted dying, euthanasia or assisted suicide talks about protecting those vulnerable.
That went on in the Carter decision, which reinterpreted and changed the stare decisis, the precedent of the Rodriguez decision, because of societal norms, but the one thing that did not change was the need for safeguards. In fact, the Carter court said that a “carefully designed...system of safeguards” was required and that they would be scrupulously monitored.
That is the only way the Carter decision changed the Rodriguez decision and allowed there to be assisted dying in Canada. However, Bill does not provide for assisted dying. It provides for assisted suicide, where the end of life, the reasonably foreseeable death, is removed entirely, and it removes the safeguards that every decision of the court on this subject has said are fundamental to the state having a role at end of life.
The seems to be out of touch with the entire body of case law with respect to assisted death. I think it is shameful that he is not allowing reasonable amendments to reinsert a scrupulous approach to the vulnerable. He is removing the 10-day waiting period. There is no coming back from this decision, and when the state plays an active role in the death of its citizens, the two-witness requirement is also removed.
The , who is entirely out of touch with the case law in Canada, out of touch with the decision of Mr. Cory whom he clerked for, is rushing something, suggesting we are being unreasonable, when all Conservatives want to do is safeguard the decisionally vulnerable, something both Supreme Court decisions in Rodriguez and Carter said was critical to human dignity, section 7 of the charter. All disability groups are opposed to this bill the way the government is presenting it because of the removal of safeguards and because of the redefinition.
Inclusion Canada's Krista Carr said:
Equating assisted suicide with an equality right is a moral affront. Having a disability should not become an acceptable reason for state-provided suicide. MAiD should remain restricted to the end of life.
One of the leading scholars, which I would invite the to review, Professor Grant from the University of British Columbia, said:
Disability organizations hear almost daily from individuals who are considering MAiD because the appalling lack of state supports makes life intolerable. It may be because they are institutionalized, because they cannot afford treatment, or because they are socially isolated. We have seen the social inequality of illness with COVID-19.
The government is a little upset the Conservative caucus is demanding what two decisions of the Supreme Court have demanded and is asking for, reasonably, what section 7 of the charter is built upon, which is dignity of life, to make sure we do not change the regime in a manner I spoke about five years ago: a slippery slope for the decisionally vulnerable such as the elderly isolated in a home.
We heard testimony of some people feeling like they were pushed or pressured because of the cost or lack of institutional care. Some of the professors and some of the indigenous witnesses who have raised concerns also raise concerns about generational trauma, residential schools and people who are facing that trauma and pain in their lives. Is the state then going to provide assisted suicide as a tool or should we help these people?
This is about compassion. This is about an appropriate role for the state. This is not about fundamentally changing a regime that has only been in place for a few years.
I said at the outset there is compassion on both sides, but there is an entirely out-of-step approach from the . In fact, the former attorney general, the member for , has also criticized the reckless approach of this Attorney General with respect to the post-Carter decision regime, because he would be removing the safeguards both courts have said need to be scrupulously monitored: 10 days, a few witnesses.
All major disability groups in Canada agree with the compassionate and reasonable position being presented by my Conservative colleagues. I am very proud of the advocacy we have shown. We have also been joined by legal scholars, indigenous leaders and people working with people with mental health issues. I have worked on mental health and suicide prevention for many years since my time in the military.
We are also not providing enough palliative care support. Going back to the original Rodriguez framework, where Justice Sopinka talked about the passive role of the state, allowing someone's life to end without pain and to be present, allowing family gathering at palliative, we are not doing that well enough.
The government has actually violated the spirit of the Carter decision by removing the safeguards. Remember, the safeguards, the carefully designed safeguards, were fundamental to the Supreme Court Carter decision change from Rodriguez. Why after a few years would the government remove those, particularly when some of the vulnerable Canadians, seniors and disability rights advocates, have said they feel under attack? In fact, another comment Ms. Carr made is that Bill is their “worst nightmare”.
What is the job of Parliament? We are not just delegates here to be polled. We are here to bring our perspective in the Burkean tradition of being passionate representatives for our communities, our families, our values and our points of view. I cannot think of a more important debate for us to bring those values.
As the Supreme Court said back in Rodriguez and throughout, this is about human dignity with respect to access to section 7. The early debate, both in Carter and Rodriguez, was always that we cannot have an unfairness for someone who cannot physically make a decision about end-of-life suicide, so we have to have an approach. That was McLachlin's approach in the dissent in Rodriguez. She thought that choice was cruel with respect to Sue Rodriguez.
It was never about just having a widespread approach to assisted suicide with no irremediable or reasonably foreseeable death being a part of it. Now this is opening up a state-run regime with respect to suicide, with vague terms about grievous conditions or just disability writ large. The same concerns I raised reasonably a few years ago around people with mental health issues, who could get help if we are there for them, or people who are decisionally vulnerable, as the court said for now a generation, are why the safeguards are there.
The government should not lecture us about timelines when it prorogued Parliament and when it did not appeal a superior court decision on a fundamental issue just a few years after the Supreme Court ruled in Carter. It is now ignoring disability advocates. It is ignoring indigenous leaders. It is ignoring physicians, legal scholars and the opposition. What are we demanding? We are not saying eliminate the system that was established in the last Parliament. We are saying to maintain the safeguards. There would be no Supreme Court right under section 7 of the charter were it not for the safeguards.
I am proud that the Conservative opposition is not going to step away and allow our vulnerable to be forgotten. We are going to scrupulously maintain the safeguards that the state should have when we are making profound decisions about the end of life of our citizens. We are here for the people without a voice. We are here for the people who might feel coerced, in isolation during a pandemic, into an end-of-life regime without full capacity and consent.
If we step outside the bubble, I do not care what political party one belongs to or associates with, all Canadians want to make sure the vulnerable are provided for. That is all we are asking. If we have to stay here for 24 hours a day, seven days a week to stand up for those Canadians, we will do that.
Who is being unreasonable? Is it the , who does not understand the entire body of jurisprudence with respect to assisted death? I am actually very disappointed. He was a law professor at McGill and seems to have not read the Rodriguez and Carter decisions. He is removing safeguards that are fundamental to protecting the decisionally vulnerable as per Sopinka, McLachlin and Cory in Rodriguez, and the McLachlin court in Carter.
Every single indication from the Supreme Court of Canada says that we cannot have end-of-life assisted dying, assisted suicide, euthanasia or whatever words someone uses, that section 7 charter right cannot be accessed without a very carefully crafted and scrupulously governed system of safeguards. This includes a 10-day review period to make sure somebody was not at their lowest point and then the state moves in, and two witnesses to make sure that there is not someone vulnerable being forced or coerced into it. These are very reasonable amendments that not just Conservative MPs are asking for, but Canadians are asking for.
We are adopting a reasonable approach by proposing amendments to the bill on medical assistance in dying. It is a critical issue for our society and that is why we, the official opposition, are here to defend the most vulnerable members of our society. That is why we already proposed reasonable amendments for seniors, people with disabilities and Canadians with mental health problems.
This is a very important debate for the well-being of Canadians across the country. That is why I am proud of my caucus, whose approach to Bill is very compassionate and defends the most vulnerable members of our society.
It is up to the government. Today, it might be asking for a delay from the court, which is something it should have done months ago. It should have appealed the decision or not prorogued Parliament. Even with the fact that we feel there is a deadline, we should not lose sight of who we are safeguarding.
When we come to the bar and bow to you, Madam Speaker, that is because Parliament is a court. It is the highest court and we have a dialogue with the Supreme Court on decisions related to the charter. Parliament is supreme. When the government suggests we are being unreasonable because we want to keep with the spirit of the Carter decision, this court should be respected that as well. I have not seen this from the government yet.
If the government just reviewed the Carter and Rodriguez decisions and provided those safeguards, held up the dignity required under section 7 of the charter, we could ensure that the right guaranteed in Carter would be respected with a rigorous and scrupulous approach to protecting the decisionally vulnerable and most vulnerable in our society. The Conservatives are here to provide those reasonable amendments for the well-being of our country.
I appreciate the opportunity today to allow Canadians to realize that it is not the Conservative Party holding up legislation or not respecting a court. This is the Conservative Party asking for the will of the Supreme Court, through these two decisions, for our most vulnerable in society to be protected.
Madam Speaker, I am very grateful for the opportunity to put a few words on the record concerning Bill , an act to amend the Criminal Code, medical assistance in dying, which I will refer to as MAID throughout my remarks.
The bill from the Liberal government would amend the original MAID legislation that achieved royal assent only four and a half years ago. The new bill was initiated in response to the Truchon case, where a federal court in Quebec struck down the clause in the original legislation that said MAID could only be applied if natural death was reasonably foreseeable. The Quebec Superior Court judge ruled on September 11, 2019, just over a year ago, that this clause violated section 7 of the Charter of Rights and Freedoms, which guarantees the right to life, liberty and security of the person, making this clause of the original legislation unconstitutional.
The court's ruling will come into effect on December 18 of this year. The Conservatives have held firm to the position that this ruling by the Quebec Superior Court should have been appealed by the federal government to the Supreme Court of Canada. Given that it is a ruling that affects life and death, I sincerely agree with our position.
Had the Liberal government appealed, it would have given Canadians significantly more time to discuss this very critical issue, and had the Liberal government not prorogued Parliament for six weeks in August and September, Parliament would have had more time to study and debate the bill. However, this position was resoundingly ignored by the Liberal government. Now we are voting on a radical expansion of MAID, and I have many concerns and will not be supporting the bill.
I do understand the desire for legalizing MAID in Canada. I witnessed my grandmother suffer terribly at the end of her life. MAID was not made available to her and, frankly, I do not know if she would have chosen it. She was a very strong and resilient woman, with a gift of the gab and an incredible ability to write, which I have inherited those gifts. That is why I am able to be here today as a member of Parliament, which she would have been so proud to see. She had these abilities despite not even having a grade eight education. She would have achieved amazing things had she not been born into a very poor family in rural Manitoba.
She tragically suffered a stroke and after that she could not speak or write, her favourite things. Then her diabetes wreaked havoc on her body and her leg had to be amputated as a result. A short while later, the doctors told us that they would have to amputate her other leg. It was really horrible and the worst thing in my life to see her go through this. I wonder if MAID would have been a kinder option for her. For that reason I understand and deeply appreciate why MAID was legalized in Canada.
However, the Conservatives have flagged a number of critical issues with this new expansion of MAID and we worked hard to bring forward amendments to ensure safeguards remained in place for Canada's most vulnerable people. Unfortunately, the Liberals voted against every one of our proposed amendments, and I really do not understand why. We presented many strong, sound arguments from stakeholders across the country, most of whom had no partisan connection whatsoever to the Conservative Party. In fact, this is not a partisan issue and yet it is being treated like one by the Liberal government, which I find deeply upsetting.
When I was researching the bill to determine my position, I was startled to discover that over 1,000 physicians had written to the in opposition to the bill. I would like to read into the record some of what their letter said because I found it extremely compelling. They said:
This bill, expanding “medical assistance in dying” (MAiD) to virtually everyone who is sick and suffering in Canada, will, if passed in its current form, make our country the world leader in administering death.
As medical doctors, we feel compelled to voice our dismay...The shock of a sudden illness, or an accident resulting in disability, can lead patients into feelings of anger, depression, and guilt for requiring care - emotions that, with proper support and attention, can resolve over time.
They went on to say:
The care and encouragement shown by physicians may be the most powerful force in overcoming despair and providing hope. Unfortunately, patients can no longer unconditionally trust their medical professional to advocate for their life when they are at their weakest and most vulnerable. Suddenly, a lethal injection becomes part of a repertoire of interventions offered to end their pain and suffering.
Finally, they went on to say:
Bill C-7 would allow those who are not dying to end their lives by a lethal injection at the hands of a doctor or nurse practitioner. Shockingly, most of the safeguards that Parliament deemed necessary in 2016 to protect the lives of vulnerable individuals from a wrongful death are being removed. Under the new bill, an individual whose natural death is considered to be “reasonably foreseeable” could be diagnosed, assessed and euthanized all in one day. We are very concerned that removing the 10-day reflection period and other safeguards will lead to an increase in coerced or tragically unconsidered deaths.
The reckless removal of safeguards previously deemed essential will place desperately vulnerable patients directly in harm’s way and may cost them their very lives.
The comments tie in very well with what we have heard from the disability community at the justice committee and the like when we were studying this legislation. In fact, 72 national disability advocacy groups have opposed this legislation. I personally fielded many calls from my constituents, who were the first to tell me that they usually vote NDP, yet they felt very compelled to reach out to me to express their fear of what this bill meant to them.
There is a genuine terror in the disability community of this bill, which I have heard first hand, yet those fears are being completely discounted by the Liberal government. I really do not understand why.
More than that, the Liberals are even ignoring the United Nations with this legislation. A UN special rapporteur on the rights of persons with disabilities responded to the expansion of MAID with clear dismay. She said:
I am extremely concerned about the implementation of the legislation on medical assistance in dying from a disability perspective. I have been informed that there is no protocol in place to demonstrate that persons with disabilities have been provided with viable alternatives when eligible for assistive dying. I have further received worrisome claims about persons with disabilities in institutions being pressured to seek medical assistance in dying, and practitioners not formally reporting cases involving persons with disabilities. I urge the federal government to investigate these complaints and put into place adequate safeguards to ensure that persons with disabilities do not request assistive dying simply because of the absence of community-based alternatives and palliative care.
That is a pretty powerful quote, in my opinion.
We know that there are considerable issues with palliative care. We know that 70% of Canadians, seven out of 10, do not have access to palliative end-of-life care in Canada. I find that to be a shocking number, and I had no idea until I did research for this bill.
I do believe that without access to good quality palliative care, we have failed to offer Canadians a real choice. If they cannot peacefully live out their final moments with safe, reliable care that is supportive and catered to their needs, then I can understand why MAID would be so appealing.
More than that, the COVID-19 pandemic has really lifted the veil on the terrible state of elderly care in Canada. In Winnipeg, our residents in elderly care homes have suffered tremendously. While we have many care homes that are doing phenomenal, outstanding work, others, not so much. A few weeks ago, Manitobans were horrified at revelations of an elderly care home just outside of my riding that was understaffed, and overwhelmed by COVID-19 cases.
When paramedics arrived, they found that some residents had been dead for hours and no one knew. Others were severely dehydrated and starving to death. If we are to provide dignity in dying, we must also ensure dignity in living. This is paramount to the discussion and has been completely ignored by the Liberal government. In fact, in the Liberals' 2015 election platform, they promised billions of dollars for palliative care. This was never delivered.
Further to that, I found it alarming that the 10-day reflection period in the original MAID legislation would be eliminated with the passage of this bill. It is important to note that the existing MAID legislation allows the 10-day reflection period to be waived under special circumstances, so flexibility on this 10-day reflection period is already in the existing MAID framework.
I am really not married to the 10 days specifically. It could be a bit shorter, or it could be a bit longer. I would need to hear from professionals in psychology to truly understand how many days are best to ensure end-of-life decisions are not made emotionally, or made in the heat of the moment, so to speak. However, I do firmly believe, at the very least, someone who requests MAID should have to sleep on it, given that there is no going back from it.
Given there are tough days, whether someone had a poor interaction with a health care worker or does not like their new room or facility, or their family has not visited in a while, or it has just been a physically or emotionally tough and painful day, there are so many reasons why someone within their most vulnerable state should have safeguards in place when making life-ending, “game over” decisions. With this legislation, if it is passed, MAID could be administered only hours later.
What really solidified my thoughts on the removal of this safeguard was the former Liberal minister of justice, the member for , who was responsible for the original MAID legislation only four and a half years ago. She questioned the current on removing the reflection period, given removing this safeguard was not called for in the Truchon decision. The person who brought forward this legislation four and a half years ago is asking why the Liberals are removing this reflection period, yet we received no firm answer from the Liberal government as to why that is. I find that to be pretty compelling. The Liberals, for reasons unknown, went far beyond what was required in the Truchon case when they created Bill , and I believe these concerns are valid.
In fact, we learned in the “First Annual Report on Medical Assistance in Dying in Canada, 2019”, that 3.6% of patients who made written requests for MAID subsequently withdrew those requests. Now, 3.6% may not sound like a lot, but of the 7,336 people who applied for MAID, 263 of them changed their minds.
We should keep in mind that MAID is new in Canada and not easily accessible everywhere. Members can imagine how many people will be applying for this after Bill passes. As MAID becomes increasingly normalized, we know that 263 lives were allowed to continue to live on because of that reflection period, which is, in my opinion, so important to maintain. However, it will not exist moving forward because of the Liberal government's refusal to listen.
Conservatives also proposed an amendment that would extend the new 90-day reflection period for those seeking MAID whose deaths are not reasonably foreseeable. We proposed to extend it to 120 days, and the arguments for this are solid. The over 1,000 doctors who I quoted earlier have said, “We live in a country where the wait time to see a psychiatrist in certain areas is 4-8 times longer than the 90-day waiting period proposed in the bill for those whose natural death is not considered 'reasonably foreseeable'”.
Further, we know that after a catastrophic accident causing, for example, a life-altering injury, suicidal ideation is very common, but with the proper support it goes away and a happy and purposeful life can resume. Moreover, it takes much longer in many cases to get a wheelchair or quality specialized rehabilitation care than the 90 days, so I ask this: What good is 90 days if someone is not able to access alternatives in that time period? I do not know.
Additionally, Conservatives believe we can better protect vulnerable patients by requiring the patients to be the ones who first request information on medical assistance in dying, and not have it openly or flippantly offered to a patient as a standard every-day option like pain medication or various therapies. Conservatives believe MAID is an extremely serious matter and should not be something pushed on patients in their most vulnerable state.
Whenever members on this side of the House state the potential for pressure to be put on patients concerning MAID, I do find, during these debates, that Liberal members essentially roll their eyes. They scoff and say that never happens, while the justice committee heard something different. It heard first-hand from witness accounts that pressure does, in fact, happen and has been happening over the past four and a half years.
Roger Foley is an infamous example of this pressure. He was offered MAID on four separate occasions to date and never once indicated that he was interested. In fact, he indicated quite the opposite. When he was having a bad day it was offered to him. It was almost as if they were tempting him by saying there is an easier way and suggesting he should just end it all. I just find that terrifying.
I find Roger's case very alarming. Safeguards must be put in place to ensure that when people are at their weakest and most vulnerable moments, they are not offered something that would end their lives forever, but rather are provided various options for better care and support, if they want it.
Another issue I have with this bill is that it moves to expand MAID so quickly. Really, this MAID legislation's original framework was just legalized four and a half years ago, which is really a blink of an eye in relative terms. The original legislation was thoroughly researched and vetted, and numerous safeguards were put in place to ensure our most vulnerable were protected. Those safeguards were considered critical at the time.
Now, less than five years later, the Liberal government is massively expanding MAID and doing away with many of those safeguards it itself deemed critical in the first legislation not even five years ago. At this pace, I very much believe and fear that we may be debating expanding MAID for children or those with mental health issues within my lifetime, and I find that absolutely terrifying.
More than that, this legislation comes before the mandatory five-year review. I feel that without that we are flying blind without the proper data that could have been revealed in a comprehensive review. There are simple questions I would have hoped would have been assessed in that review, such as these: “Who is taking MAID?”; “Is it mostly the elderly or the poor?”; “Is it racialized communities or wealthier white people?”; “Is MAID affecting certain demographics?”; “Why those demographics?”; “Are there reoccurring themes for choosing MAID that could be addressed by providing better care during suffering at end of life, rather than death?”.
We should be doing everything we can as legislators to provide alternatives to MAID that are reliable and easily accessible to everyone, yet the current government is not doing that at all.
What I find interesting on this is that the current Liberal is responsible for this aggressive expansion of MAID. He, in fact, voted against his own government's Liberal legislation on MAID, the original one four and a half years ago, because he believed it did not go far enough. We have known for a long time what his position is, and that leads me to question whether the Liberal consultations on this bill were really impartial. It may explain why this legislation goes far beyond the what Quebec superior court judge called for in the Truchon ruling.
There are so many questions with this new freedoms Canadians have with MAID. I firmly believe we have the responsibility as legislators to proceed on ending the lives of Canadians with extreme caution. There is a profound shift happening in our society concerning MAID, and we must proceed thoughtfully and with thorough, exhaustive research, which has not happened with this expansion of MAID. For me, this expansion, to put it plainly, is too much, too fast, too soon.
Bill would remove other critical safeguards as well, such as the requirement to have two independent witnesses sign off on MAID for a patient. This safeguard helps to prevent abuse and coercion of MAID and provided much-needed oversight on those discussions with patients. To think a person needs two independent witnesses to sign off on a will, but not to end their actual life, makes me feel as though we are living in the twilight zone.
Further, Conservatives have advocated for amendments that would ensure physicians who sign off on MAID applications have expertise in a patient's condition. One would think that for a life-ending decision such as MAID, the safeguard would be a given, but no, the Liberals disagree, and again for reasons largely unknown.
Additionally, a number of constituents have reached out to me with significant concerns that health care professionals who do not agree with the morality of MAID would be forced to help administer it. The Liberals have insisted that this will not be the case and that the conscience rights of health care professionals will be protected. However, communication on that has been dismal, to say the least, otherwise I would not be receiving so many calls about it. I urge the Liberal government to invest more time and energy into communicating on this specific issue.
I will end with a quote from the over 1,000 doctors who I have mentioned throughout my remarks. They said:
Our profession has been coerced into facilitating suicide rather than preventing it, for ever-increasing numbers of citizens. We watch in utter dismay and horror at how the nature of our medical profession has been so quickly destroyed by the creation of misguided laws. We, the undersigned, declare that the passage of Bill C-7, if left unchecked, will contribute to the destruction of much more than our medical profession, but fundamentally, of a Canadian society that genuinely values and cares for its most vulnerable members. Canadians deserve better.
Madam Speaker, we are now at the third reading stage of . This means all the amendments that will be considered by the House have now been considered, and we must now pronounce on the final version of the bill and its effects.
Before I speak about this bill in final form, I want to respond directly to what I see as the government's principal argument for this legislation and other similar legislation. It tells us this is all about choice: the choice of individuals to live as they choose and die as they choose. The idea is that moral judgments about good living and good dying ought to be made by the person doing the living and dying, as opposed to by someone else, because the individual is uniquely qualified to make judgments about their own happiness and someone outside their skin simply cannot make those judgments as well.
This is the one serious argument people use to advance this bill and others like it. We should of course appreciate the existence of other unserious arguments, such as the assertion that, “The courts told us to,” or, “This is what people we have consulted told us to do.”
A small part of this bill responds to a lower court decision, but most of it has been invented, out of thin air, by the government and whoever it consulted or did not consult. Over a thousand physicians have signed a letter opposing this bill, and every single disability rights organization that has spoken out about this bill has spoken in opposition to it. These are unserious arguments stemming from unserious readings of court decisions and unserious consultation.
The serious argument made in support of this bill, as I have stated, is that people ought to have the choice to make decisions about their living and dying because they know what will lead to their happiness better than anyone else. This is the argument, but we should also notice how those who use this argument ultimately choose to apply it selectively. Even while suggesting it is all about choice, they insist on changing the words we use to describe the choice in order to make us feel better about it.
The phrase “medical assistance in dying” was invented at the time Bill was proposed, and is not a phrase used in other countries to describe the phenomenon of doctors killing their patients. If this is really about choice, why do we have to invent new pseudo-terms to make ourselves feel better about that choice?
If I asked members point blank whether they think a person should be able to commit suicide, I am sure many would respond that this is not suicide. It is completely different, as it is medical assistance in dying. Formally, what is meant by medical assistance in dying is facilitated suicide, or killing in a medical context. We claim to be focused on choice, but we still are uncomfortable enough with the choice that we have to invent new words to describe it.
Some members do not like the use of the word “euthanasia” to describe the phenomenon of doctors and nurses killing their patients after being asked to do so. The told the Standing Committee on Justice and Human Rights that phrases “referring to this bill as 'euthanasia' legislation, which I have heard in the House of Commons, are incredibly demeaning to the dignity of people”.
The may be interested to know the word euthanasia actually comes from two Greek words: “eu”, meaning well, and “thanatos”, meaning death. The term euthanasia means “good death”, and is itself a sanitization of the concept of killing. If the term is misleading, it is not because it is too harsh but because it is too gentle. As we have heard, not all cases of assisted suicide can reasonably be called good deaths by any definition.
Notice that the word euthanasia is never used to describe the administration of the death penalty. The term was invented in order to sanitize the idea of the medicalized killing of a consenting person. It is instructive that a sanitized term for this practice, once people had a full social awareness of its meaning and reality, had to be replaced by a new sanitized term to further obscure the true nature of what is taking place.
No doubt, in 20 or 30 years, the term MAID will be thought gauche and replaced with another, more up-to-date sanitization of a term that no longer makes us feel better about something we naturally feel uncomfortable about. The point is that if this all about choice, and if we are comfortable with this choice, why are we not comfortable speaking plainly about sick people committing suicide and about doctors killing their patients when asked to do so? Would that not be a more plain and accurate description of the choice that many wish to defend?
If there is a practice or activity that people are uncomfortable seeing depicted or hearing described accurately, perhaps we should ask ourselves why we feel uncomfortable instead of demanding that the images and descriptions be put aside.
Members should observe as well that the idea of a choice to die, or a right to die, is being advocated for selectively. Some people have a right to die and some people do not, apparently, so we have to ask why this principle is being selectively applied.
Suppose that I, an able-bodied healthy white man, experienced some great personal tragedy such as the death of a child or the breakup of my marriage. It is possible that following such an event I might start to experience extreme existential pain and suicidal ideation. If I then went to a doctor to share the feelings I was experiencing, I would not be presented with MAID as a way out of the challenges I was facing. The way I look, my health status and other characteristics I have would signal to the doctor that my life was worth living. We know it to be true that when a young, able-bodied person chooses to die, those around them will say, “What a tragedy. He had so much to live for.”
The argument for a choice to die does not apply to those who society believes should not choose to die, even if such people are sincere in their expression of pain, in their sense that their pain is irremediable and in their desire not to continue living, but what of a person who is older, who is disabled, who does not fit the stereotypical social mould of someone who has a lot to live for, presents themself to the health care system experiencing existential pain and suicidal ideation?
We know from testimony from the justice committee that people in this situation are offered and even pressured to opt for MAID. People who are elderly or living with disabilities are often offered and pushed to take MAID without asking for it. This is the testimony given over and over again at the justice committee and confirmed by the , who acknowledged how concerned she is about people with disabilities being regularly and proactively offered MAID that they do not want.
We see here an important and revealing contradiction in the application of the principle of choice. For some in society, death is seen as an unreasonable choice and is actively discouraged. For others, death is seen as a desirable choice and is actively encouraged. This is not just a debate about choice, therefore. Rather, it is a debate about how the architecture of choice is set up differently for different people, based on whether others assess their lives as being worth living.
This is what leaders in the disability community are deeply concerned about: how this legislation includes them and only them in the additional category of those for whom we think death is a reasonable course of action.
Suppose that of my four children one had a disability and suppose that I taught three of my children to always press on because life is beautiful, but I told the fourth child that they should consider death if they ever faced circumstance that they could not handle. Do colleagues think that situation would make my fourth child feel privileged by the special offer of choice or do colleagues think she would feel devalued by the fact that I thought death was uniquely an option for her, based on the presumption that her life was not worth living?
Choices do not exist in a social vacuum. When we speak about choice, we recognize that people are making choices between available options and the nature of those available options is constructed by the society in which they live.
I used to think that people were always better off with more options, that just like a menu at a restaurant, we are always better off with more options available to us: the longer the menu, the better. If I do not like any of the new options available, then no problem. I do not have to choose them, but I should not begrudge other people the opportunity to have more choices available to them, even if I do not like those choices. Nobody is made worse off by the lengthening of the menu. Then I realized that it was not that simple. If I am in a restaurant and the only options available are chicken or beef then, arguably, yes, I am better off with the addition of more items on the menu; a fish option, a vegetarian dish, etc., but there is also a case in which the existence of certain options on the menu fundamentally changes the nature of the experience.
Suppose that while travelling, I encounter a restaurant that offers a human flesh sandwich in addition to the usual fare. It is fairly safe that I would not stay and order in that restaurant even if I had no intention of ordering the human flesh sandwich. It is unlikely that any members of this House would feel comfortable eating in such a restaurant, even if all they planned to eat was the filet mignon. That example illustrates the way that the offer of an additional option can actually change one's entire experience of a place or environment. A person with a disability who is offered death has a very different experience of health care from a person who is consistently offered life-affirming care.
The fact that people are offered or encouraged toward certain choices, and that some people are offered those choices and others are not, changes the entire experience of health care for many people. Part of the response to this brave new world of so-called medical assistance in dying is that people are seeking safe spaces where they can receive care that is life-affirming. There are still many people in this country who have about as much interest in receiving care in an environment where death is being offered as they do in eating at a restaurant where cannibalism is offered. Such people should be free to receive care in a hospice where life is the only choice and where they feel safe from the possibility of pressure of a momentary weakness or from the sense that they are an unnecessary burden. Some are still looking for care that is animated by the conviction that all lives are always worth living, but perversely, those who claim to champion choice are actually attacking these safe spaces. With the absence of conscience protection in this or any other legislation like it, doctors are being forced out of their profession and life-affirming hospice care is being shut down.
We wonder why we have a crisis in long-term care in this country. Maybe it has something to do with the fact that so many of the people in organizations that have historically operated in this space are being pushed out because of a lack of conscience protection. Protecting the conscience rights of physicians and institutions is not just about the rights of providers. It is about the right, indeed the choice, of patients to receive care in a certain kind of environment if that is their desire.
I know from the many conversations that I have had with constituents, including those who are very supportive of the expansion of MAID, that the present realities of the social architecture of choice are top of mind for them during their advocacy. In other words, they want more euthanasia because they find the alternative intolerable. An absence of good care, an absence of effective pain management, an absence of support to live in a way that accords with their sense of dignity and a sense of resignation about these realities leaves them to want to be able to end it all, rather than endure under undesirable conditions, but those conditions could themselves be changed. The expansion of euthanasia, along with continuing pressure on all health care institutions to offer it, will further erode the life-affirming nature of care that people receive.
I remember once having a long conversation with a constituent who explained to me her reasons for advocating for expanded euthanasia. She emphasized the classic arguments about choice and control, and then shared with me a story of being in a care situation and struggling to have a bowel movement unaided. She went to the nursing station for help, and unfortunately was met with a gruff and unempathetic response. Her memory of the sense of indignity she felt, struggling for a long time on her own, and then seeking the help of a person who seemed uncaring and disgusted, was clearly a part of her thought process about the circumstances under which she would want to die.
While I can identify with her feelings in the moment, I think the solution is to give people the choice of compassionate care. It is a tragedy that people are considering death because of moments of perceived indignity that can be quite directly resolved.
Many older people who are considering death say that they do not want to be a burden on others. This is expressed as a matter of choice, but it is also revealing about the architecture of choice. It is generally unheard of for children to insist on paying rent to their parents or living independently because they do not want to be a burden. Certainly, I have never heard such sentiments from my children.
Why are elderly people made to feel like they might be a burden, while children are not? Again, this is an issue of social context. If children were constantly told from a young age that they were a great burden to their parents, that they were costing them money that could be spent on other things, and that they were interrupting their social lives, then children would likely start to worry about being a burden.
Conversely, if seniors and people with disabilities were constantly affirmed for their value and their ability to contribute to society, constantly told that they hold the key to our future rather than constantly being told about the burden they impose, then of course they would be more likely to choose life instead of death.
This is not just a question of choice. It is a question of the social architecture of choice that leads people to make different choices in different kinds of situations based on the limited options in front of them and based on the way that different options impact each other.
To underline this with one further point, it should not escape the notice of members that the government's Bill , the proposed ban on conversion therapy, is built on the premise that people cannot consent to something that is contrary to their human dignity. Although I have concerns about the text of Bill as written, I agree with the principle that conversion therapy is wrong and should not be allowed.
In light of both Bill and Bill , it remains unclear to me what the government's view is on the ability of a person to consent to harm. Is it the view of the government that people should be able to voluntarily consent to things that harm them? Looking at these bills together, we might conclude the government finds it okay for people to consent to death but not okay for people to consent to certain things that are deemed worse than death. However, this subjective categorization of certain harms as being worse than others clearly may contradict an individual's own subjective sense of what things are more harmful than others.
It is time for us, as parliamentarians, to talk about the choices that elderly people and people living with disabilities have in front of them, and to give them options besides death, to move from a narrow focus on questions of choice to a discussion of the architecture of choice that puts people in impossible and painful situations. A good society is not just one that gives people the formal right to make choices between different alternatives. It is one that ensures that those alternatives are sufficiently robust so that individuals are able to make choices that truly lead to happiness. Of course not all choices lead to happiness.
People can make choices that they think will lead to happiness, but do not. This is especially serious when a decision is final and irreversible. The wider community has a reasonable interest in ensuring that a person making that choice has at least all of the information in front of them, taking into consideration the fact that people can and often do adapt to new circumstances over time. A belief in the pursuit of happiness entails a belief in freedom but also a belief in the value of encouraging the considered use of freedom through due reflection.
Having reflected on the application of the concept of choice in this context, I would now like to make a few additional comments about the provisions of this bill and the timing of it. This bill proposes to eliminate the requirement that death be reasonably foreseeable for those seeking euthanasia and puts those for whom death is not reasonably foreseeable on a second track with some distinct requirements. The reconsideration of the question of reasonable foreseeability was provoked by a court decision in Quebec, the Truchon decision, which the government could have chosen to appeal but did not.
This bill deals with more than this question. It also arbitrarily eliminates a number of safeguards that have nothing to do with the Truchon decision. It eliminates the 10-day reflection period. It reduces the required number of witnesses. It eliminates the requirement for contemporaneous consent. The removal of the 10-day reflection period in particular has led experts to point out that this opens the door to same-day death, to a situation where a patient could request and receive euthanasia on the same day.
Some members of this House have strenuously objected to the use of this term. Same-day death is a jarring idea that someone's worst day could be their last, and that temporary suicidal ideation could lead to immediate death. However, those who find this term uncomfortable must face up to the fact that the legislation as written contains no parameters for those for whom death is deemed reasonably foreseeable.
If members believe that time parameters exist, then they should point to where they exist in law. If members believe that time parameters should exist, then they should have supported their reintroduction into the bill. As the law stands before us now, there are no legislated requirements around timelines for those for whom death is reasonably foreseeable.
At third reading, members must choose whether or not they will vote for same-day death in Canada. As Wilberforce said:
You may choose to look the other way but you can never say again that you did not know.
The Conservatives have proposed reasonable amendments to reintroduce the reflection period, introduce a shorter reflection period and reintroduce requirements around contemporaneous consent and independent witnesses, in particular, recognizing the different experiences people with disabilities have reported with respect to the health care system. We also introduced a requirement that health care practitioners only discuss euthanasia if it is brought up by the patient first. These safeguards matter and would protect vulnerable people by reducing their risk of being rushed and pressured into vulnerable situations.
In response to our call for safeguards, the government said it trusts health care practitioners and these rules are not required. The purpose of a safeguard is not to respond to what may be the average case, but to establish a minimum standard. We are talking about 100,000 people in this country whose professional qualifications would allow them to administer euthanasia. Are those 100,000 so uniquely virtuous or trustworthy they do not need laws to regulate their behaviour while the rest of us do? I believe most people in medicine are doing their best to selflessly serve others, but one needs only listen to the testimony at the justice committee to realize some of those who are providing health care have fallen short of that call. All of us need laws to regulate our behaviour to some extent. If we need regulations, then how can we expect those 100,000 people to be different? Are there no bad apples? I am not arguing they should be subject to unique suspicion, but that they simply need rules and laws to guide their actions like the rest of us do. People charged with taking another person's life should do so within strictly defined parameters for their own good and that of everyone else. I trust doctors just as I trust police officers, but they still need regulations and oversight. We recognize there are some bad apples on our police forces and if we need safeguards for police officers in light of their power to take life, then we also need safeguards for those in power to take life in a medical context.
The government has been working very hard to push the narrative about timing, claiming the Conservatives are responsible for delaying this bill. It should stand to reason that if the government wants us to invest in rapidly passing its bill, it must proceed to persuade us that it is a good bill, which it has not done. The Truchon decision requires a response, but matters would be much simpler if the bill only focused on a response to Truchon instead of a variety of other changes. As it is, we are forced to consider all of the elements together, not just the narrow part that responds to Truchon. This is the government's choice, not ours.
Let us also take stock of how we have come so close to the court deadline. This legislation was presented in February. In May and June, the Conservatives wanted the House to sit in a modified form, but the government refused to allow it. Then it killed its own bill by proroguing in August. All of these moves pushed us into the mid-fall before the bill was considered. It then received a mere four meetings of witness testimony at the justice committee. The government's approach to this legislation has been to delay until the last minute and then demand urgency instead of a considered review. Let us be clear that this is a political tactic designed to subject these radical changes to as little debate as possible.
As a high school student, I had the honour of participating in a special MLA for a Day program at the Alberta legislature. At one of our meetings, a seasoned Progressive Conservative minister explained to us how legislation was passed. Students were surprised by the length and complexity of the process. They asked why it took so long and could the process not be shortened a bit. The minister told us he was glad it took so long because one of the fastest pieces of legislation to ever pass in the Alberta legislature was the Sexual Sterilization Act of 1928, which allowed the government to sterilize people with disabilities against their will based on the analysis that they imposed an undue burden on society. Legislators at that time should have taken more time to listen to people with disabilities and considered the implications of what they were doing. The point that when we are in too much of a hurry to make decisions we risk undermining the fundamental rights of our fellow human beings, in particular, those living with disabilities, has stuck with me to this day.
Those of us on this side of the House who are raising concerns and demanding that time be taken to consider this bill and appropriate safeguards be put in place are on the right side of history. As was the case with the Sexual Sterilization Act of 1928, when this bill is repealed in five or 50 years, I will proudly tell my grandchildren that I took a stand for the universal immutable dignity of every human being.
Madam Speaker, I am thankful for the opportunity to address the House on this very important issue and to continue to act as a voice for those who continue to be ignored.
The government is acting as if rushing the legislation through in order to meet the Truchon deadline is its number one priority. Canadians are suffering because of the pandemic, and while people and businesses continue to fall through the cracks, the government is prioritizing expanding access to euthanasia over providing Canadians with the support they need. Shockingly, it is rushing the bill through before the mandated five-year review of the euthanasia regime in Canada has even taken place. This is reckless and this recklessness will cost people their lives.
The Truchon decision is not a binding legal decision for the House of Commons, but the government is choosing to act as though it is, despite calls from this side of the House to appeal it. When we are dealing with something this serious, with stakes as high as life and death, it is imperative that the process is not rushed by a lower provincial court decision. Our vulnerable citizens deserve better. In all honesty, this deadline is nothing more than smoke and mirrors.
Amazingly, Bill would not only expand access to euthanasia to those for whom death is not reasonably foreseeable, but goes beyond Truchon by eliminating necessary safeguards that are in place to protect the vulnerable. By removing the 10-day reflection period, people nearing the end of their lives can receive medical assistance in dying on the very same day they request it. That means, in essence, for many Canadians, their worst day will be their last day.
I would like to point out an important statistic from the “First Annual Report on Medical Assistance in Dying in Canada” presented in 2019. In this report, it states that as of the date of its release, 263 Canadians who had requested MAID ended up withdrawing their requests. Because of the current 10-day waiting period, 263 Canadian lives were saved. It is clear these people felt they wanted to die on the day the request was made, but decided days later that they wanted to keep on living.
Had the 10-day reflection period not been in place, 263 Canadians would have had their lives ended prematurely. Maybe it was a phone call from an old friend, meeting with a family member or good news from their physician that caused them to change their minds. It does not matter. The point is that they did. Why does the government want to rob Canadians of the opportunity to make that decision? It justifies the need for Bill with the Truchon decision, but where in Truchon does it say that?
Another important safeguard that Bill seeks to eliminate is the requirement for final consent. This is one that truly frightens me. The reasoning behind the removal of this safeguard is the fact that a person may lose the capacity to consent to euthanasia before it is carried out if a person's illness advances causing significant cognitive decline. Therefore, people can give advance consent to have their lives ended should they lose the capacity to make such a difficult decision.
It fascinates me that we all agree that if a person is unable to provide advance consent to sexual activity, and that person is taken advantage of when not having capacity to say no, a crime has been committed. However, the government believes people can provide advance consent to have their lives ended, even if they lose the capacity to say no when the procedure takes place. The problem with the principle of advance consent is that it is impossible to know what people's desires are if they are unable to communicate them. We cannot know if a person in that state truly wants to die. Maybe the individual has had a change of heart and wishes to keep on living at the time MAID is administered, but just can't say that. That is horrifying.
The risks associated with the removal of the 10-day reflection period and the requirement for final consent are too serious for me to accept. We should remember that the stakes are as high as life and death. The government needs to protect vulnerable Canadians. It needs to ensure safeguards are in place. The removal of these safeguards puts their lives in danger.
I would like to remind the government of the voices it ignored in its rush to meet this unnecessary deadline, the voices of disabled Canadians, their doctors and advocates. I remind members of the words of Krista Carr, the executive director of Inclusion Canada, who said that this bill is disabled Canadians' “worst nightmare”. There are also the words of Catherine Frazee, who said that the bill tells people like her that their lives are not worth living.
How about Dr. Heidi Janz? She told the justice committee that the bill “will result in people with disabilities seeking MAID as an ultimate capitulation to a lifetime of ableist oppression.” Roger Foley bravely told the committee from his hospital bed that, if the bill passes, he will not survive and the Parliament of Canada will have his blood on its hands.
I am here in the House to remind the government of the words they refused to listen to. The stream of euthanasia access for those who are not dying is ableist and dangerous. These are not my words. These are their words.
Doctors who work with disabled Canadians made it very clear at committee that a 90-day waiting period is simply not enough time. They explained that suicidal ideations are very common when someone experiences a catastrophic medical episode, but with good care and support they are almost always overcome.
In my last speech on the bill, I introduced the House to Kristine Crowley's story. Since her spinal cord injury 33 years ago, Kristine has lived the kind of life that most able-bodied people dream of, but it took her years after her injury to feel great again. She worries that people like her will decide to end their lives when they are at their lowest point.
Now I will share the story of David Shannon. David suffered a spinal cord injury in a rugby scrum when he was 18 years old. He shared that after his accident he lay in bed close to death more times than he wishes to contemplate. David has gone on to have a career in non-governmental organization leadership and a law practice focused on human rights and health law.
I will share a comment from David:
I have accomplished a lot in my life. I've crossed our great country by the power of my wheelchair—coast to coast. I've jumped out of an airplane at over 25,000 feet. I've made it to the North Pole and planted an accessible parking sign. I’ve written a book, performed in plays and on TV. I’ve received my law degree and been a Human Rights Commissioner. And I am an Order of Ontario and Order of Canada recipient. I’ve loved and been loved. My proudest accomplishment is that I lived.
Several times during this debate, members on this side of the House have asked how many stories like this will never be told if Bill passes. I urge my hon. colleagues to truly understand what is being asked here. Much like the removal of safeguards, knowing that lives like those of David Shannon and Kristine Crowley will be cut short if this legislation passes is far too great a risk for me to accept.
Those who support the bill continue to fall back on the idea of autonomy to justify their willingness to ignore these risks, so I will read a comment from David Shannon addressing this:
What offends me most about Bill C-7 is that there is an implicit licence to promote death. And I ask, why is there not the promotion to pursue one’s autonomy? When someone is first injured, they are compromised. They need to know there are supports available, that life can be fantastic, not coerced to leave their life and loved ones behind.
When someone is first injured, they are compromised. When someone is compromised, their autonomy is impaired. It is in this compromised state that the government wishes to offer death to Canadians. I will also remind the House of the government's absolute failure to provide disabled Canadians with the care they need. I remind the House that it often takes much longer than 90 days to even see a specialist. I remind the House what the told the justice committee: It is easier to receive MAID in this country than it is to receive a wheelchair.
Not only are we offering death when a patient's autonomy is most compromised, but we are coercing patients to die by failing to offer them care. I have asked this before, and I must ask it again: Do we really want our legacy as members of Parliament to be the Parliament that offered patients death before we offered them care? That is where we are headed with this legislation.
Once again, on behalf of disabled Canadians, their doctors and their advocates, I am begging members of the House to stop this attack on Canada's disabled community. They have been crystal clear about the ultimate abuse that their community would be subject to if the bill passes. I am begging members to hear their pleas. We know the abuse we can expect in the future, so the government will not be able to say it did not know, just that it did not listen.
We have been warned in no uncertain terms about what will come, but now I would like to speak about the abuse that is already happening.
Gabrielle Peters, a journalist who lives with a spinal cord injury, wrote the following in a recent open letter to Canadian senators. “I know that Bill C7 must be stopped because I know passage of this bill will result in preventable deaths of disabled people. I know this because I know those already happen. I know they already happen because I was almost one of them.”
The government is rushing to eliminate safeguards for euthanasia when the current safeguards are not even being adhered to. According to bioethicist Dr. Jaro Kotalik, it is evident provincial and territorial authorities are not fully engaged in their role of monitoring, enforcing and reporting on the performance of the MAID program, which they are expected to do according to federal laws and regulations.
This is clear from Roger Foley's testimony to the Standing Committee on Justice and Human Rights. His caregivers, who he depends on for every comfort and necessity of life, have suggested four times that he opt for MAID. Roger's death is not reasonably foreseeable, so this is completely illegal.
It is incredible that on the International Day of Persons with Disabilities, every Liberal MP voted against protections for persons with disabilities being added to Bill . Even the , who expressed in the Senate pre-study that she shares some of the concerns of disabled Canadians, voted against our amendment.
Let me remind the House what the UN Special Rapporteur on the rights of persons with disabilities said on her visit to Canada: “I am extremely concerned about the implementation of the legislation on medical assistance in dying from a disability perspective. I have been informed that there is no protocol in place to demonstrate that persons with disabilities have been provided with viable alternatives when eligible for assistive dying.”
The opposition tried to address that concern by moving an amendment in committee requiring that patients have meaningful access to care before MAID can be administered. I remind the House that the Liberal members voted it down.
Let me share another concern raised by the rapporteur. She said, “I have further received worrisome claims about persons with disabilities in institutions being pressured to seek medical assistance in dying, and practitioners not formally reporting cases involving persons with disabilities.”
Earlier I referenced the 2019 Health Canada report on MAID. While some of the statistics therein were helpful, there were clearly some issues with the report, namely the lack of any mention of abuse. The information collected was self-reported by MAID providers, so uncovering abuses was unlikely. We know there has been abuse; that much is clear. Cases like Roger Foley's, as well as those of many others, make this undeniable.
Archie Rolland, 18 months before his death by MAID, was transferred against his will from a residence that provided highly specialized care to a geriatric long-term care facility that could not meet his needs. He said that it was not the illness that was killing him. He was tired of fighting for compassionate care.
Sean Tagert, a father with ALS, exhausted from battling for the care he needed to live at home, was told he would have to be placed in a long-term care centre hours away from his home community and family. He was unable to live the remainder of his days at home with his young son and felt the only option was MAID.
There are also the stories of Alan Nichols,Yvon Tremblay, Gabriel Bouchard, Tommy Sec, Jonathan Marchand, Raymond Bourbonnais, Candice Lewis and far too many more. Some of these people are still fighting for their lives and some of them already gave in to the pressure to die.
Why are there so many horror stories? Why is there such a lack of compliance? It is simple: There is a lack of oversight. Many doctors and family members of patients have told me their complaints lie dead in the water. There also exists a culture of severe bullying in medicine, so doctors are scared to speak up out of fear of losing their jobs.
A press release from back in March written by the Physicians' Alliance against Euthanasia said, “The pressure has been intense for many physicians, especially amongst palliative specialists, some leaving even before this latest development. Descriptions were made of toxic practice environments and fear of discipline by medical regulators.”
When I last spoke to the bill, the asked me if I knew of any cases of pressure the led to prosecution. There are plenty of cases of pressure, just no prosecution. When complaints are made about abuse, there is virtually no avenue for recourse. If someone complains to the police, they are blocked from investigating by doctor-patient confidentiality. When complaints are made to the College of Physicians and Surgeons, they are not followed up on. Many doctors feel cowed into submission before complaints are ever made in the first place.
I attempted to find out from the Legislative Library of British Columbia how many complaints were lodged against doctors with B.C.'s College of Physicians and Surgeons regarding MAID. The response I got is as follows. “The College of Physicians and Surgeons of B.C. cannot disclose the existence of a patient complaint against a physician, unless the complaint leads to formal discipline. Therefore, the exact number of complaints to the college, whether related to MAID or not, is not possible to ascertain using public sources.”
The response went on to offer me a media scan of newspaper stories related to MAID complaints in the hopes this would be helpful. Imagine that: The only place where any information is publicly available on MAID complaints is in the media. Shame on us. Imagine the cases of elder abuse that are happening under this easy-to-cheat scheme. We have millions of elderly Canadians with no protection from this regime because there is absolutely no way of monitoring it.
Imagine the cases like that of my constituents, who attended a town hall I held when the MAID survey was open for submissions. Together with almost 100 people, we went through each question attempting to understand and respond in a thoughtful way. The more questions we answered, the more we all realized the issue was far too complicated and nuanced for a survey to be of any good.
Then a young father stood up and told his own story of being diagnosed with terminal brain cancer. In the town hall, he explained how he had become depressed following his diagnosis and sought counselling to help him cope with his new reality. Instead, his counsellor offered him MAID. He was shocked that in his darkest hour a professional counsellor would suggest the very thing that was extremely tempting for him, but not in alignment with his ultimate goal to live his best life to its natural conclusion.
The medical professional on our panel was shocked. This was completely illegal under current law and should have been reported, to which the young man said this: How does one even report it? Imagine that: This man, whose life was put in jeopardy, was completely unaware of even how to report the incident. The doctor said he could go online and write a complaint to the College of Physicians and Surgeons, and told him to do it right away. The young man replied that he did not have the energy. He was going through chemotherapy and was absolutely exhausted. He could not wrap his mind around anything extra at that time.
How many people are out there right now who either do not know who to file a complaint with or just do not have the energy or strength in them to fight? They are already fighting a battle with death and now we want them to go online and file a complaint they may not live to see to its conclusion.
Let me close with a comment from a constitutional lawyer, Derek Ross. He said:
In the face of ongoing evidence that the current procedural safeguards are not being followed, it is alarming that the government is seeking to remove many of those safeguards, rather than strengthen and uphold them. Who is investigating these findings of non-compliance? And who is collecting and consolidating this data? The Carter decision was premised on the assumption that procedural safeguards would be “scrupulously monitored and enforced”. The federal government bears responsibility for reviewing reported cases of non-compliance and ensuring that data regarding non-compliance is gathered and used to inform future policy decisions.
There are horrible abuses of the current MAID regime taking place, which anyone who is engaged with it will know. The bill is a nightmare to disabled Canadians and to physicians across Canada. The risks associated with it are too serious to accept, and the stakes are as high as life and death. We cannot get this wrong.
Madam Speaker, I will be splitting my time today with the hon. member for .
I rise today to participate in this important debate on Bill , which seeks to expand medical assistance in dying, or MAID. While the Liberal government has summarily dismissed the role of Parliament with respect to the all-party committee study, an evaluation of this law, I believe it is still important to ensure my remarks appear on the record because Bill C-7 is literally a matter of life and death.
Let me begin by quoting my hon. colleague, the member for , who posed this question to the government during the earlier days of our hybrid sittings. In the context of advocating for defibrillators to be placed in community halls, hockey rinks and other places Canadians gather, he asked:
It will cost approximately a billion dollars to renovate Centre Block. I believe that's accurate. It will cost $5 million to put these AEDs, defibrillators, into all police cruisers. This would save 300 lives per annum. Is the cost of saving 300 lives per annum—one half of 1% of a billion dollars—more or less important than renovating Centre Block?
My colleagues on both sides of the House know I am a strong supporter of our institutions and our history, and of protecting them for future generations to appreciate, learn from and, in some cases, even revere. This is true of Parliament, historic sites across Canada and even statues of our founders for their vision and even, at times, for their faults, and sometimes many faults. My hon. colleague for was posing a simple but profound question to Parliament, which was what is the value of life, and how can it be measured? It is a question that all members of Parliament have been consumed with since the start of the coronavirus pandemic: How can we protect and save lives? It is a question that will form the basis of debate in the House of Commons for the remainder of our natural lives and well beyond.
In just over eight months, all levels of government have spent a combined half a trillion dollars in their struggle against the pandemic. Rich or poor, old or young, married or single, with kids or grandparents: it does not matter what families or households look like. Everyone is impacted by COVID-19, and governments have acted. The measures brought forward were, in one way or another, based on one simple, profound truth: that elected officials at every level of government across the country support life, and want our nation to fight for it and protect it.
I stand today as someone who will be voting against this piece of legislation, Bill . Medically assisted death is a practice that, if left unchecked, could in some dark corners of society turn the right to die into an obligation to die.
How is it that a government that advocated overwhelmingly to accept closures and economic lockdowns in response to the coronavirus can be the same government that has unmoored us from protecting Canadians, by vastly expanding the legal parameters of medically assisted death? It is grisly.
I would like to quote the member for , the former minister of justice, who stated the following about this legislation, Bill :
[Why] is Bill C-7, medical assistance in dying, abolishing the safeguard of a 10-day reflection period and reconfiguration of consent, thereby introducing advance requests for MAID?
Nothing in the Truchon decision of the Quebec Court of Appeal, which the government chose not to appeal, requires this, and the Supreme Court of Canada, in Carter, insisted on the requirement of clear consent. Palliative care physicians, disability advocates and other experts insist that this is an important safeguard and, like other legislated MAID reports on mature minors and mental disorder, advance requests also raise significant challenges.
It is very troubling that this is the direction the Liberals have chosen. A single decision in a single province by a single lower court has upended the law as it stands today, passed by a previous Parliament.
A culture of life is abandoned. Even the most basic safeguards are deemed by the current , the cabinet and caucus to be overly restrictive. We have a fragile consensus established in the last Parliament and with Bill , we will undo that important consensus. I hope we can rediscover that consensus again in a future Parliament when its leaders are more reflective on matters of life and death and perhaps will express some humility when we face these questions.
We must, as parliamentarians, even those who sit across the aisle, reject the unwise extension of medical assistance in dying in our society. However, I am dismayed that this will not happen.
Bill is medical assistance in dying in name only. Its sponsors cling to that description to give it a fig leaf of respectability and to make it palatable to the public. Bill C-7 would strip away both safeguards to protect vulnerable Canadians and even the belief that one's death should be near, imminent or even reasonably foreseeable. Whereas medical assistance in dying has built in safeguards, today's bill does not and we are simply left with medical assisted death.
Madam Speaker, it is an honour to enter into debate on such an important subject.
The first thing I would like to address are the comments that the and other members of the government have been making that somehow the Conservatives are holding this bill up, that we are somehow responsible for this delay. I will expand on this, but there is really one word that completely rejects that argument, “prorogation”.
The government came forward with the legislation before. It certainly will not surprise any of my constituents, but when the government used its excuse for the need for a legislative reset, it just happened to coincide with the day that very revealing documents were to be released relating to an unprecedented scandal the and various members of the government were facing, it prorogued Parliament, resetting the legislative agenda, because of COVID, they claimed. Now many of the bills they introduced in the previous Parliament have been reintroduced in this Parliament. Then they make it about the Conservatives somehow holding up the process.
We are 24 days behind in the legislative process during which we could have dealt with this legislation and many of the other important things, COVID-related and otherwise, yet here we are. The words that come to mind about it are not necessarily parliamentary, but it is a shame that we find ourselves in this position and that members on the government side would suggest we are somehow not doing our jobs by debating legislation that is literally about life and death.
Constituents will hold government members to account on this subject. I have heard often from those concerned on all sides of this issue. I will get to some of the comments that the has made more recently. There is the need for dialogue, discussion and careful consideration so we can strike the right balance. That is why Parliament exists, the hallowed chamber that we all have the honour and privilege of sitting in,so we can have discussions.
I would love to see the composition of the House changed a little with respect to the numbers of seats that particular parties have. I am certainly doing my best to ensure that happens, and there is some encouraging news on that front. However, it is interesting that the people who Canadians send to this place, regardless of the composition, is due to the importance of the dialogue associated with every aspect of our jobs here, whether it be COVID-related, or related to medical assistance in dying, as we are debating today, or the many other issues that come before this chamber and its committees.
We cannot diminish the requirement for us to do our due diligence. in every aspect of the word. I am certainly doing my part in this debate and resoundingly rejecting the government saying that somehow the Conservatives are delaying this. The blame for that lies directly on the desks of the members of the Liberal government. They are manufacturing urgency when the reason there is even urgency to begin with is due to carefully crafted political games by members of the government opposite.
As listened to the talk about Bill over the course of specifically the last number of weeks, there has been an evolution in his responses. The last time I participated in debate was from my constituency office and the , the day before, had talked about how the Liberals had found broad consensus on this issue, that they had come together and done what the people had asked them to do.
He bragged about the 300,000 submissions to the consultations, when I know for a fact, and I mentioned this in my last speech, that the position the government came to was certainly different from many of the consults my constituents sent in, which did not seem to be acknowledged.
I find it very interesting that when the minister answered yesterday, there was a change in his tone. The referred to this as a sensitive subject. He was much more nuanced in his approach, acknowledging that there is wide disagreement on it, but that Conservatives should hurry it up. I am paraphrasing, but the change in the minister's tone is a clear example that the Liberals' hands have been slapped. The Liberals claim to have consensus on an issue when it is clear they do not.
We have disability rights advocates and medical professionals who certainly seem to have a wide consensus, although I will not go so far as to say it is universal, as that is an inappropriate use of a term with such a broad application. However, there seems to be a tremendous amount of consensus, not universal, that this bill is flawed and deserves due consideration.
That is exactly what this institution's role is, whether it is us or the other place debating Bill . I imagine the bill will pass. At second reading and report stage we certainly saw the bill pass, so I anticipate that we will see a similar result and that the other place will also have the opportunity to go through the dialogue.
I do want to talk about how we are facing a tragic irony. The Government of Canada, like governments around the world, like provincial governments and like municipal governments, has poured trillions of dollars into COVID response programs. It is without question that those who are most at risk and most vulnerable among us for this virus, which has gripped our world over the last number of months, or close to a year, are seniors. I find it tragically ironic that, in the legislative reset supposedly prioritizing COVID, we would be debating this bill, which puts some of our most vulnerable at risk.
While governments have poured trillions of dollars, in many cases rightfully so, into COVID relief and response programs, we are here debating a bill that would allow people to end their lives and reduce safeguards on a decision that can be no more final. That tragic irony brings us to today. The government members will talk about the need, and often they criticize Conservatives' debate on many aspects of the COVID response, yet here they are pushing for something that is the antithesis of what all parliamentarians would certainly say is trying to do what is best for constituents, which is doing what is best for Canadians.
Often the constitutionality of this place is forgotten, and the reality that the highest elected office in this land is not that of the prime minister, but that of the member of Parliament. We could have a lengthy discussion about why there is that misunderstanding, whether it is because of the prominence of American media in Canada, education or whatever the case may be, but in regard to the primacy of Parliament in Canadian law and society, the member Parliament is the pinnacle of what this institution is.
There are 338 of us. When constituents talk about things like western alienation, they ask how we can make a difference. My response is that I know I can make a difference because I occupy the same number of seats as the does, as the member for does, and as does any one of my Conservative, Bloc, NDP and Green colleagues. That is the strength of our institution and why free votes are a part of the reality of this place. I would certainly encourage my colleagues—
Madam Speaker, it is with a great deal of emotion that I rise again in the House to speak to this extremely sensitive issue, medical assistance in dying.
In this speech I will highlight the parliamentary and judicial reality. As the House leader of the official opposition, I have a thing or two to say about that. In fact, I have quite a few things to say about that. I will talk about the reasons why we are gathered today to talk about Bill at third reading stage. I will also address the substance of the issue, that is, my position and that of my colleagues.
Before I begin, I would like to make certain things clear: this is a topic that leaves no room for partisanship. On this file there are no good guys or bad guys, good positions or bad positions, good votes or bad votes. There are just positions that we are comfortable with, that we believe in and are prepared to defend personally as individuals. This topic may be terribly divisive, just as it may be a golden opportunity to have an intelligent conversation that is above all respectful of differing opinions.
As you well know, Madam Speaker, I do really enjoy political battles. I do not hate the arguments and the counter-arguments. On the contrary, it is part of politics. However, there are issues that do not lend themselves to this.
As far as I am concerned, when we talk about assisted dying situations, the issue is not a partisan one. There are no bad guys and good guys. There are no good votes or bad votes. There are only votes and positions in which we are comfortable. Where we stand firm on that is being respectful to our counterparts. This is the issue, and this is why I want to address it. While sometimes, the House knows, I like to be a little aggressive in my comments, in this case I will try to do my best to be modest, because I want to be respectful to each and every position.
Bill C-7 responds to a decision of the Quebec Superior Court. However, this is not the first time that medical assistance in dying has been addressed.
Members will recall that the province of Quebec was the first to begin working on this issue, which led to the passage of a law on medical assistance in dying. Unfortunately, or fortunately, I know what I am talking about because I was a member of the National Assembly of Quebec. In passing, I was elected for the first time 12 years ago on this day. As a provincial representative, I worked for six years on this sensitive issue under three ministers and three different governments.
I want to be clear. This issue can be dealt with in a non-partisan way, and the proof is that three premiers—Premier Charest, Premier Marois and Premier Couillard—in two different political parties led the parliamentary work that resulted in the adoption of the first provincial law on medical assistance in dying in Canada. I would like to point out that this was done under the leadership of a premier who was a physician, Dr. Philippe Couillard. I was there.
Then came the Supreme Court of Canada's decision in Carter, again, on medical assistance in dying. The federal government had to decide how to define and set the federal criteria for medical assistance in dying. Prime minister Stephen Harper, recognizing that the federal government was on the verge of an election campaign, rightly decided, with the support of the other political parties, not to address this issue. That was the right thing to do.
As I said earlier, this issue is not a partisan one. That is why former prime minister Harper did the right thing and put it aside during the campaign in 2015. Then the new government elected, which could have been Conservative, NDP or Liberal, would table a new bill. I have been part of that discussion. I have been part of that committee.
The government was well advised to create a cross-party and, more importantly, joint parliamentary committee, which had both senators and members of Parliament as members.
I had the honour of sitting on that committee, at the request of my then leader, the Hon. Rosa Ambrose. I had the privilege of having very interesting and fascinating conversations with Canadians across the country who had different points of view. We came to a consensus in the form of Bill . I want to be clear about the use of “consensus”, because the way democracy works, and this is a good thing, means that some people are in favour while others are against.
Bill C-14 was passed in the House of Commons five years ago. This bill included a clause that could be considered a sunset clause, since it required that parliamentarians review the legislation.
It was inevitable that this issue would end up before the courts, and it did. A Quebec Superior Court judge issued a decision in Truchon v. Attorney General of Canada on September 11, 2019.
Through the , the federal government immediately reviewed the decision, decided to hold an online consultation and introduced a bill in the House of Commons in February. As we see it, that was the first major mistake. I have nothing against the judge or the Quebec Superior Court. Every court has its own responsibilities and makes its own decisions. The judge was appointed to that court in 2017, which was a good thing, and she was appointed to the Court of Appeal on November 20, which was a very good thing.
Every aspect of this issue is sensitive. No matter which law we pass, there will be legal challenges. The better approach, the more responsible, respectful, reasonable approach, would have been for the government to appeal the ruling and then take it to the Supreme Court. As my colleague from Alberta quite rightly said earlier, the Constitution says that every province has a superior court and a court of appeal before cases reach the Supreme Court.
For that purpose, we need to have the highest degree of evaluation. In that specific case, the Superior Court of Quebec is good, but it is not enough. We need to be sure of our judgment on that. That is why the government should have appealed the decision and then let the Supreme Court judges decide what is good and right based on the law, based on our Constitution and based on our Canadian history that we are proud of. That is how it works.
However, that is not how it went. The government decided to call the shots right now. I heard my colleague from . He is always articulate and always passionate, but with all due respect, I do not agree with him. Just because we are appealing this decision to the appeal court and then the Supreme Court, that does not mean we pay no respect to the Superior Court of Quebec.
It is simply a matter of respecting the judicial process as it is set out in our Constitution, particularly when it comes to an issue as sensitive as medical assistance in dying. Regardless of the law that is passed here, we can expect it to be challenged.
It would have been far better to draft legislation based on a Supreme Court decision, as we did five years ago, rather than on a Superior Court decision. I say that with all due respect for Justice Baudouin, who was just recently appointed to the appeal court by the Liberal minister, and for the Quebec Superior Court, which plays an important, essential and extremely serious role in our justice system.
A debate took place in the House of Commons. This was well before COVID-19, before the words “in-person meeting” became part of our everyday vocabulary and at a time when the word “zoom” referred to a camera lens and not to a way of holding meetings. In short, we have adopted a lot of new concepts in 2020.
Getting back to what I was saying, Bill was introduced in the House of Commons on February 24 following the decision rendered on September 11, 2019, and the subsequent government consultations. On February 26 and 27, we began debate at second reading. We followed the usual regular, rigorous process. Discussions were held. Things were being done in a reasonable manner, even though it would have been preferable if this matter had been brought before the Supreme Court.
Then COVID-19 happened. The government did what it had to do, that is, it postponed the study of this bill and sought an extension from the court because of the delay. The court agreed. Parliament resumed in September, and that is when the government made a serious mistake. I will come back to that later.
Now let's get to the substance of Bill . As I said earlier, there will not be unanimity on this bill because society is not unanimous. That is the very foundation of democracy. That is why we are here in the House of Commons. Some people are for, and some are against. Some people are right-leaning, and some are left-leaning. Some people are sovereignists, and some are federalists. Society is not a monolithic block. The beauty of society lies in all its different textures. That is the democracy that we must preserve. That is why we need to have intelligent debates in the House of Commons.
That is why, during the analysis, our party proposed two amendments that are entirely respectful and reasonable and that seek to protect the most vulnerable people in our society. The amendments essentially call for the 10-day reflection period to be restored when death is reasonably foreseeable, and for the 90-day reflection period to be increased to 120 days when death is not reasonably foreseeable. The purpose of those amendments is to ensure that individuals who choose to act have enough time to look into their hearts and make the decision that feels right.
That is why prestigious organizations have spoken out against Bill C-7. The Canadian Psychiatric Association has expressed very serious reservations. The Canadian Bar Association has said that it has conditional reservations about this bill. The Council of Canadians with Disabilities opposed the bill. Groups like Living with Dignity, a Quebec-based network, and Inclusion Canada have spoken out against the bill. Indigenous spiritual leaders have expressed very serious reservations. In short, society has spoken, and that is what makes for an interesting debate.
We needed to have a proper debate, with people on both sides of the issue. That is why we would have liked the debate to run its course, without the very heavy influence of the deadline imposed by the Quebec Superior Court.
I will now talk about our work in Parliament, which is essential. I mentioned that Bill C-7 was introduced in February, before COVID-19 and the return of the House. However, the government decided to prorogue Parliament. We know that the made this decision because he was not pleased with the work being done by our MPs on the parliamentary committees studying ethics and WE Charity. The more the work progressed, the more things were heating up for the Prime Minister. He therefore decided to prorogue Parliament.
This prorogation put an end to all committee and House work, and the study of Bill C-7 had to start all over again. As a result, we lost 24 days of parliamentary time. Had we not had this prorogation, we would have resumed on September 21, not on September 23 with the throne speech. Furthermore, had we started on September 21, we would not have lost all the work that had already been done so far on the bill, which adds up to 24 additional sitting days.
The government has the power to prorogue Parliament. Even if I accept the prorogation, why did the government wait so long to introduce Bill C-7? Today we are being told that the Superior Court's December 18 deadline is fast approaching and that we need to hurry up so the Senate can pass the bill in time.
The government presented its throne speech on September 23. When was Bill C-7 introduced? It could have been introduced on September 24, like Bill C-2 was. It could have been introduced on September 25, like Bill C-3, the bill on judges, was. However, this bill was introduced on October 5, costing us seven parliamentary sitting days.
Now, the government is lecturing us, claiming that the Conservatives will not stop talking for talking's sake and that we are wasting time. No. The government has full control over the agenda, and it is the one that decided to prorogue Parliament, wasting 24 days of parliamentary time. On top of the prorogation, this government wasted seven sitting days before introducing this bill, even though it knew full well that everything had to be finished by the Superior Court's December 18 deadline.
Consequently, I will never accept responsibility for the fact that we are still not done, a week and a half out from the December 18 deadline set by the Quebec Superior Court. The government is entirely responsible for this situation, and I will never allow it to accuse us of causing delays.
Not once have Conservative members acted petty, not at second reading, not in committee, not at report stage and not at third reading. Some members support this issue and others oppose it, but we have always expressed our opinions in an appropriate, respectful way.
We never used filibusters or any other rule to be sure that we would let it go, without any decision made. We were respectful, because this issue calls for being respectful. We did it correctly. I am very proud to be the House Leader of the Official Opposition, because members on this side of the House, the official opposition, did a tremendous job at each and every stage. Conservative members were very serious; they were very parliamentary; they did it correctly.
That is the opposite of what the Liberals did at the Standing Committee on Finance, where they engaged in systematic obstruction for over 16 hours to prevent the committee from studying ethics scandals, and at the Standing Committee on Access to Information, Privacy and Ethics, where the Liberals engaged in almost 40 hours of obstruction over the course of 10 meetings. That is what I call wasting time. We have done serious, diligent work here, and we are very proud of that.
As I said, the government that is being held hostage by that date, December 18. If ever this bill were not passed by Canada's Parliament, including the Senate, by December 18, what would happen? Bill will continue to apply, and the Truchon ruling will apply in Quebec.
Basically, the regime proposed in Bill would not apply, but life would go on, no pun intended. People will keep doing what needs to be done, as they have done from the start, except that the Truchon decision will apply in Quebec and Bill C-14 will apply in the rest of Canada.
I would like to talk about one final, but critical, issue.
With regard to freedom of speech and freedom of vote, I am very proud to be the House Leader of the Conservative Party. On this issue, each and every Conservative member has the right to vote on his or own belief. The best proof of that is that my , the future prime minister of Canada, the member of Parliament for Durham, voted against and I did for. This is what democracy is all about.
In our party, we have people who are against, like my , and there is me, the official opposition House leader, who voted for. That is what democracy is all about. We should fight for that. Even if I disagree with some of my colleagues and even if all my colleagues behind are not pleased to see that I will vote in favour, so what?
We are the only party to preserve that tool that is so important, that tool that can fight cynicism in politics. I am proud to be part of that team.
During the vote on the amendment, there were even Conservative members who voted against the entirely reasonable amendments that we proposed. When it came time to vote on the report, 13 Conservative members voted with the government on this bill. I was one of those members. There were six Quebeckers, seven members from outside Quebec, anglophones, francophones, people from the east and west and even neighbours. I voted in favour, but my neighbour from , who is right next to me, voted against.
Let us celebrate this democracy. Let us celebrate this parliamentary system. Let us celebrate full freedom of conscience when it comes time to vote on these issues. Most of all, let us rightly stand up for the work of parliamentarians and vigorously condemn the fact that this government has been dragging its feet, which is why we ended up here with little time to spare.
Madam Speaker, I am thankful for the opportunity to again speak to the bill. There were a lot of things that I wanted to say the first time around at report stage that I could not share because we ran out of time, but hopefully I will be able to conclude my remarks today.
I am splitting my time with the member for .
The spoke in the House earlier today and talked about how Bill is moving our country from a regime of assisted death to a regime of assisted suicide. We presently have in place former Bill , which was brought in as a response to the Carter decision. That bill recognized the fact that the Supreme Court said that medically assisted death was a right but needed to be surrounded by guardrails, by safeguards that would ensure that the most vulnerable in Canada do not end up dying when they have an opportunity to live a productive life.
The Carter decision resulted in legislation that imposed a requirement that death needed to be reasonably foreseeable. The legislation before us eliminates that and a whole bunch of other safeguards that the original legislation was intended to keep in place.
Why are we at this place in the first place? Members in the House know that a lower court from Quebec, one single judge, ruled in the Truchon case that the reasonable foreseeability aspect of Bill violated the Charter of Rights. It was unconstitutional. This is a lower court from Quebec, one single judge, making a life and death decision for Canadians across the country.
One would expect, from a Liberal government that takes veterans to court and takes first nations to the Supreme Court of Canada, that this life and death decision would be appealed. The Truchon case would be appealed through to the Supreme Court so that we could have the Supreme Court, which articulated the Carter decision, comment on whether reasonable foreseeability was in fact constitutional.
Instead the Liberal government said, no, it was not going to appeal and in fact it would simply respond to the Truchon case and do exactly as that single judge of a lower court asked it to do. The Liberals eliminated reasonable foreseeability from Canada's medical assistance in dying regime. That is why we are here.
Members may recall, when first came forward, when the Carter decision had to be responded to, that parliamentarians noted the fact that this represented the crest of a steep, slippery slope toward making assisted suicide available to a broader and broader group of vulnerable Canadians. That was the concern that we expressed at the time and, quite frankly, some people mocked us. They said we were fearmongering. They pooh-poohed our concerns. Today, here we are and our concerns have been borne out.
Last time I did not get a chance to read into the record a letter from a doctor in my community of Abbotsford, Dr. James Warkentin, who expressed his concerns about the legislation. He says, “I appreciate your invitation to write to you regarding C-7. As a family physician, the decriminalization of medical assistance in dying in 2016 struck me at my core. How could killing someone one day cost me my licence and send me to jail, and the next day be expected of me to provide? Furthermore, how could our most vulnerable be protected from the pressure to end their life one day and then have state-sanctioned avenues the next?” He went on to reference the six reasons why over 1,000 Canadian physicians have signed a letter opposing Bill .
In a moment I am going to read that letter into the record, because I believe those judges would appreciate having that letter on the record so it is very clear that many medical professionals across the country oppose Bill , which would remove many of the safeguards, the guard rails, the protections for the vulnerable which were originally intended under the Carter decision.
The letter begins like this:
This bill, expanding “medical assistance in dying” (MAiD) to virtually everyone who is sick and suffering in Canada, will, if passed in its current form, make our country the world leader in administering death.
As medical doctors, we feel compelled to voice our dismay at how individuals who have little lived experience of the realities involved in the everyday practice of medicine suddenly and fundamentally changed the nature of medicine by decriminalizing euthanasia and assisted suicide.
As a side note, when they refer to “individuals who have little lived experience of the realities involved in the everyday practice of medicine”, they are referring to us, the Parliamentarians in the House. It goes on:
Unfortunately, our patients are the ones who suffer the most from the consequences of this ill-devised scheme. The shock of a sudden illness, or an accident resulting in disability, can lead patients into feelings of anger, depression, and guilt for requiring care - emotions that, with proper support and attention, can resolve over time. The care and encouragement shown by physicians may be the most powerful force in overcoming despair and providing hope. Unfortunately, patients can no longer unconditionally trust their medical professional to advocate for their life when they are at their weakest and most vulnerable. Suddenly, a lethal injection becomes part of a repertoire of interventions offered to end their pain and suffering.
Bill C-7 would allow those who are not dying to end their lives by a lethal injection at the hands of a doctor or nurse practitioner. Shockingly, most of the safeguards that Parliament deemed necessary in 2016 to protect the lives of vulnerable individuals from a wrongful death are being removed. Under the new bill, an individual whose natural death is considered to be “reasonably foreseeable” could be diagnosed, assessed and euthanized all in one day. We are very concerned that removing the 10- day reflection period and other safeguards will lead to an increase in coerced or tragically unconsidered deaths.
The reckless removal of safeguards previously deemed essential will place desperately vulnerable patients directly in harm’s way and may cost them their very lives....
Our profession has been coerced into facilitating suicide rather than preventing it, for ever-increasing numbers of citizens. We watch in utter dismay and horror at how the nature of our medical profession has been so quickly destroyed by the creation of misguided laws.
That is an excerpt from a letter from over 1,000 physicians in Canada. It does go on, but I do not have time to complete it.
That is the perspective coming from our medical profession across the country and it is the disability groups, medical professionals, faith groups, palliative care advocates and first nations that are all calling for more caution before expanding assisted suicide, yet the government has refused to listen to those concerns.
At the committee, our Conservative opposition members brought forward numerous amendments that would have addressed some of the failings of the legislation, that would have reinstated the protections for which the vulnerable within our country have called. Seventy-two disability groups oppose this legislation. They want more protections, yet they are not there.
I encourage my colleagues across the way to please give this legislation more time. Give us an opportunity to get this right.
Madam Speaker, I have been a little disappointed at the tenor of the debate recently regarding MAID. I am hopeful we can carry this back to the passionate, but compassionate, debate we had earlier.
This is a matter of conscience and I am certainly very proud to be part of a party that has given me, as the member for Northumberland—Peterborough South, the freedom to decide how I would like to vote on this bill.
When we look at the legislation, after extensive consultation with folks inside and outside of my riding, a number of issues have occurred. The challenging part for me is that despite many advocates for persons with disabilities raising the alarm bells, much media attention on this and how they might feel, we really have not seen any amendments or changes to this legislation.
I would say this earnestly and with openness for my friends across the aisle. Are we so arrogant that we believe this language is absolutely perfect and completely beyond improvement? The member for used to say a number of times that there was always room to be better and there was always the opportunity to be better. In response to that, with all kindness and respect, this bill can be better and there are opportunities to do that.
Some legislation the government has put in during this last year alone has failed. The rent subsidy program did not go off as well as the government had hoped. All reasonable observers, and even members on the other side, would acknowledge that. That is why they had to relaunch the program. The LEEFF program is also not working up to capacity and no doubt will have to be redone. We have seen those challenges.
The difficulty with this legislation is that there is no ability to redo it. This is a life or death matter. If we lose members of our most vulnerable communities due to the legislation, we cannot come back. There is no redo of this. I am perfectly aware, as a lawyer, of the obligation the court has put in front of us from the Truchon decision to get this legislation revised. However, there are multiple devices, as our leader spoke about, to get that time extended.
In all respect and fairness, any reasonable, objective observer would say that it was the government that prorogued Parliament for an additional six weeks. We would have had the time to pass this on time.
I will get into my remarks, but let us keep the tenor of this debate how it is meant to be and how our constituents want it to be. They want a deep discussion of the important issues of passion, the very reason our Parliament exists and the very reason this reasonable debate is what makes Canada, in my opinion, such a great country.
To get into the substance of my speech, those who support Bill do not want anyone to suffer. Those who do not support it do not want anyone to suffer either. It is important to begin this controversial debate by recognizing that both sides, regardless of how different their beliefs are, are passionate for the right reasons. As with any legislation that will have a dramatic impact on people's lives, the discussion is very important.
Medical assistance in dying is a relatively new topic. Canada is one of the few countries that has legalized it so far, and as such, we much proceed in this new territory with the utmost caution. As our members have spoken about, we need the safeguards. This is not just the members of the Conservative Party mentioning this. Some of our most noted jurists in Canadian history have brought this up, jurists from all sides of the political spectrum who have called for and demanded that there be safeguards. As we say, and it is only common sense, this is a matter of life and death. While we should be guaranteeing a death with dignity, I strongly believe we should first guarantee a dignified end of life.
In order to do this, in order to make sure that people are choosing medical assistance in dying for the right reason, I believe that we need to have a conversation around the state of palliative care in our country. Unfortunately, the state of palliative care in our country is less than favourable. While medical assistance in dying is currently considered an essential service, palliative care is not. This is an issue that should be gravely concerning to everyone in this House and across our country.
Palliative care is a type of health care for patients and families facing life-limiting illnesses. It helps patients to achieve the best possible quality of life right up to the end of one's life. I know, and I am sure that many members share this, I have had some of the most important conversations of my life with loved ones and friends at or near the end of their life. These moments provide so much quality to those who carry forward and provide so much advice that I carry forward with me to this very day.
Where it is possible to retain a reasonable quality of life, we as a society have a sacrosanct obligation to make sure that people are taken care of, so that, if they do decide on medical assistance in dying, they have done so of their own free will and not because of a poor quality of life that could have been avoided.
Quality palliative care focuses on the concerns of patients and families, and works to support patients through both physical and mental symptoms of serious illness. This may include everything from helping to manage a patient's pain and symptoms to keeping them comfortable in their home for as long as possible.
Unfortunately, while 75% of Canadians would prefer to have their last moments at home, only about 15% have access to palliative home care and 60% die, instead of being surrounded in the homes that some of them have grown up in, in cold, stark hospitals.
Many physicians have raised the concern, because the majority of Canadians do not have access to high-quality palliative care. It is possible that many people, or at least some people, may be choosing MAID because they do not feel there are other options. Amongst the concerns are those laid out by Dr. Stephanie Kafie, a family physician in Niagara Falls with a focus on caring for the elderly.
She has said that something that has not been considered in the rush of passing this bill is the state of palliative care. It is not considered an essential service, however, MAID is. In her experience, many requests for MAID reflected a need for palliative care. Rushing misguided laws regarding the medical profession has led to an erosion of their profession and started significant damage to doctor-patient relations. Their hands are tied. They are not consulted on the drastic changes that are being made.
As Dr. Kafie notes, the importance of consulting with doctors in the creation of legislation is so crucial. As is so often is the case with parliamentarians, not enough people working on the legislation have any any experience in the field itself.
Dr. Drijber, a palliative care physician, has spoken out on this issue, stating that this legislation seems to ignore the importance of the dignity that comes with palliative care, the importance of those final moments for both the living and those who will pass on. He has gone so far as to say that it seems the government has not fully consulted with experts or people who work in the field to help guide them through their decision-making process.
When we come to a conclusion here, in all earnesty and openness, I am reaching out to the other side. They know that there are people in their constituencies who will have differing opinions from them, as do I. We need to make sure that all voices are heard. Are we so arrogant as parliamentarians to think we should not change the legislation, that we cannot, as the member for has said, always do better?
Madam Speaker, I will be sharing my time with the member for .
Here we are on December 8, 2020, only 10 days away from a deadline imposed on Parliament by the Quebec Superior Court from the Truchon decision. The Liberal side of the House is suggesting that perhaps it is the fault of members of the Conservative Party for delaying progress on this very important topic. I take exception to that.
How did we come to this point in the first place? Our leader spoke this morning and he raised this topic, and so I am just going to repeat some of what he said. First of all, there was the failure of the current Attorney General to appeal this decision of the Quebec Superior Court. It is a lower court. In my opinion it was a wrong decision, and it should have been appealed, first of all, to the Quebec Court of Appeal. We would have had the benefit of the wisdom of that bench. Subsequently it should have been appealed, like all important constitutional issues, at the Supreme Court of Canada. I have the deepest respect for the Supreme Court of Canada and the constitutional expertise and scholarship that has come out of that court. The Attorney General has missed that opportunity to be able to engage the Supreme Court of Canada in the discussion on this very important topic.
Parliament, as our leader said, is the top court of the land. We are sovereign. We can make and unmake any laws that we want, provided that they are within the four walls of the Constitution of this country. That is the dialogue that we should have had with the Supreme Court of Canada. That, sadly, will not be happening on this topic.
The second very important point is prorogation. We had been making good progress on Bill . We were talking about this back in February and March already. Prorogation happened, and the debate had to go right back to square one. How is that our fault? Why did the Liberal government decide on prorogation? It was not for any good policy considerations. It was strictly for political considerations, so we are not going to wear that. The Liberal government is going to wear that.
Another point that I would like to raise is that if Bill reacted in the narrow way that the Truchon decision required, this debate would be much shorter and faster, but the government has decided to take the opportunity to expand the debate. The Liberals are suggesting that we are disrespecting the Truchon decision and the Quebec Superior Court by raising these issues. We are not the ones who are raising the additional issues; it is the government in its Bill C-7 that is doing so. If Bill C-7 was just about the Truchon decision, then it would not be talking about removing the 10-day reflection period. The “First Annual Report on Medical Assistance in Dying in Canada, 2019”, just recently published by Health Canada, has told us that, of the 7,336 MAID applications in 2019, 236 of the applicants changed their minds during the 10-day reflection period. Obviously, that 10-day reflection is there for a purpose. It is serving that purpose very well. Why would we be removing that?
Furthermore, Bill has introduced the concept of advance directives and, consequently, the elimination of contemporaneous consent by the person who is asking for the medical assistance in dying. That would be shifting the final decision away from the person receiving medical assistance in dying to the person who would now be going to apply it. We are no further ahead. I do not think that is an improvement.
Then, there is the other requirement, removing the second witness. What is that about? Why is that so important? There are so many legal documents that require two witnesses, wills for example, to make sure that there is not coercion on the part of people who might benefit. In the case of wills, the beneficiaries of the will might benefit. It is a long-standing legal principle that two witnesses be required. These changes are significant, and disability groups across the country have told us so loudly and clearly.
Of the many groups that appeared before the committee hearings, not one of the disability groups was in favour of Bill and the removal of these protections. That is why we are at an impasse in this eleventh hour.
Mr. Neil Belanger, executive director of the British Columbia Aboriginal Network on Disability Society, commented on a newly released document entitled “In Plain Sight”, commissioned by British Columbia's minister of health, the Hon. Adrian Dix, to review indigenous-specific racism in British Columbia's health care system. Although it is a review of B.C.'s health care system, the principles in it would apply right across Canada. Mr. Belanger and the group that he represents are concerned about the proposed removal of safeguards. He said:
There is no debating the systemic racism and discrimination within Canada’s health systems, and the experiences and deaths of Indigenous peoples when seeking care. We all would be remiss to believe that this somehow would not permeate into MAID.
He went on to say in his testimony before the Senate committee that:
...the Government of Canada has failed to engage the Indigenous peoples of Canada living with disabilities, Elders, and Indigenous Leadership in relation to MAID on any tangible level. This lack of engagement is contrary to the government’s stated commitment to reconciliation, UNDRIP, and the CRPD.
Other disability groups are saying the same, yet this government is refusing to listen. Mr. Belanger takes this a step further. He and the organization for which he speaks advocate sticking with the end-of-life criteria already in place after the Carter decision and after Bill , which was the well-considered opinion of Parliament just four and a half years ago.
Recently, when Mr. Belanger's organization presented to the Senate committee on legal and constitutional affairs on Bill , he said that:
[BCANDS]...stands with our sister disability organizations and countless others across Canada in calling for the removal of Track 2 in the proposal changes to Bill C-7, and limiting access to MAID to the end of life criteria...
Track 2 is medical assistance for those people whose death is not reasonably foreseeable.
People may state the obvious: that this is all water under the bridge and that the Truchon decision said that it is unconstitutional. To go back to my original comments, that decision should have been appealed, and it was not. I am going to have to tell Mr. Belanger that the debate has been had already. This government has sadly treated as a settled constitutional principle that it is unconstitutional for any law of this country to refuse medical assistance in dying to those who meet all the other criteria, but are not dying.
This is a fundamental shift that was not debated. This government has stated on many occasions that it had broad consultations and 300,000 people responded, but the one question it never asked was if people agreed that medical assistance in dying should be given to those whose death was not reasonably foreseeable. The fundamental question was never asked. That is not a true consultation, in my opinion. It is a pretext for advancing a legislative agenda that had been preconceived. It has been said on several occasions in the House during this debate that the current voted against Bill four years ago because it did not address that, and did not expand MAID to that point. This is the current imposing his will on Parliament and forestalling that very important debate.
The first report by Health Canada on the state of medical assistance in dying stated that roughly 2% of Canadians in 2019 used medical assistance to die. That is the average across the country, but it is much lower in some provinces. It is the average in Quebec and far above the average in British Columbia.
Why is that? Is it because there are more sick people or old people—
Madam Speaker, earlier this morning, the began today's debate with a strong speech about the problems with Bill and how the government has been handling it. He started by saying that it could be the most important bill before this Parliament, regardless of how long it actually lasts. After all, we are discussing a matter of life and death, and the decision we make here will make all the difference for countless Canadians.
These are people who will be making their own choices, which will directly impact their own lives, their legacies, their loved ones and their caregivers. It is a choice they might not have expected to ever have to make, whether because of a sudden illness, the unrequested suggestion of assisted suicide or some other reason. Anything could happen, which is why we have to maximize the protection and safeguards there will be for each person involved, especially for those who are most at risk of abuse and neglect.
At this last stage of debate in the House of Commons, I want to focus on the choice, or in some cases the lack of choice, a person might face. Some argue we are seeking their best interests by expanding access to MAID, not only for the relief of suffering but also purely for the sake of free choice.
On the idea of choice, we have to remember this is not an ordinary decision. Someone's death, premature or otherwise, is literally a point of no return. The decision is final. With all the circumstances leading someone to consider the end of their life, it gets complicated very quickly.
To explain it from someone's lived experience, I will quote journalist Ben Mattlin, who suffers from spinal muscular atrophy. He wrote the following in the New York Times:
I’ve lived so close to death for so long that I know how thin and porous the border between coercion and free choice is, how easy it is for someone to inadvertently influence you to feel devalued and hopeless—to pressure you ever so slightly but decidedly into being “reasonable,” to unburdening others, to “letting go.”
Perhaps, as advocates contend, you can’t understand why anyone would push for assisted-suicide legislation until you’ve seen a loved one suffer. But you also can’t truly conceive of the many subtle forces—invariably well meaning, kindhearted, even gentle, yet as persuasive as a tsunami—that emerge when your physical autonomy is hopelessly compromised.
Despite Mattlin's significant physical disability, he is a father, a husband, an author and a journalist. He has a successful life and he knows what he wants. He is less vulnerable than others who lack the confidence and spark he has, who could easily be persuaded that assisted suicide was their best option.
The idea of this happening voluntarily is, in many subtle ways, the start of a slippery slope that leads to it happening less voluntarily, or involuntarily. The choice is not always so free, especially if real alternatives are lacking. One of the greatest fears a lot of people face in their lifetime is their own mortality, and in a lot of breadth that is what we are discussing here today.
When I talk about Bill , when I talk about facing our own mortality, I often reflect on the experiences my wife and I have had, when grandparents and other loved ones within our family have passed away. We have spent countless hours at their sides, either in the hospital or in their care home. The time spent with one's family is so precious and valuable.
Within the last year, the health of my wife's grandma deteriorated. Her husband had passed away a few years prior, and she had been living in, I think, level 1 care for most of COVID. We were not allowed to go into the facility and had to stand outside the building. She had a nice corner unit with lots of windows, so we were able to observe her condition and speak to her through the window.
Over the course of time, we watched her state of mind and physical state deteriorate steadily and progressively. Her state degraded to the point that she could not lift her head when we came to the window to talk to her. She could not see who was there.
When the restrictions were lifted and one or two people were allowed into the unit, my wife was able to sit beside her grandma, hold her hand and tell her that she loved her. To see her state improve, and to be able to lift her spirits, was so powerful.
I think that as we are having this discussion on Bill , we especially need to ensure that we value life and that we are giving people every option to live their lives. We should also have the opportunity to have our loved ones at our sides as we go through the final moments and face the ultimate end of our mortality, the end of our life.
We need to make sure that people have full supports as well. At the risk of sounding like a broken record, I note that one of the biggest parts of Bill is the need for palliative care. I have talked at length previously about the need for it to make sure we are providing real choice and real options to people so they have all the options they need and, quite frankly, deserve.
The vast majority of people who are being considered under Bill , or who will consider MAID, are in our senior population. When we look at the contributions they have made to our society, these are the people who built our country. These are the people who have provided us with the freedoms and opportunities we have. However, here we are discussing a bill, which we will be voting on in the near future, that basically signals to them that we do not value their lives and do not value the contributions they have made to this country. That is what the bill signals.
I know people will argue that this is not what the bill is doing, but sometimes it is not about what the bill directly does, but what it is going to do indirectly. The moment we signify to our country, to our citizens, that we inherently do not value and defend life to its fullest extent, we are sending the wrong message to people.
I realize that people who advocate for Bill and medical assistance in dying are doing it from a position of compassion. I will never question somebody who says that is the reason they are advocating for it. However, we also need to realize that part of a compassionate response to people who are at that point in their life—