HESA Committee Meeting

    Welcome to meeting number 23 of the House of Commons Standing Committee on Health.

    We acknowledge that we are meeting on the unceded territory of the Algonquin Anishinabe peoples.

     Today's meeting is taking place in a hybrid format according to the Standing Orders.

    I want to remind everyone about the usual housekeeping things, one of which is to wait until I recognize you by name before speaking. For those participating by video conference, click on the microphone icon to activate your mic, and please press mute when you are not speaking. At the bottom of the screen, you will select the appropriate channel for interpretation: floor, English or French. I will remind you that all comments should be addressed through the chair. For members in the room, obviously, if you wish to speak, raise your hand. It's first come, first served if both the clerk and I recognize you first.

    We are ready to move into the orders of the day, which are that pursuant to the order of reference by the House on Thursday, December 11, 2025, the committee shall commence the clause-by-clause consideration of Bill C-234, an act respecting the establishment and award of a living donor recognition medal.

     I would like to welcome our witnesses. I'd love to welcome the sponsor of the bill, Mr. Ziad Aboultaif.

    It's a great bill, Ziad.

    We also have, as an individual and online, Mr. Christopher McCreery, author and historian.

    Mr. Aboultaif, you have five minutes to explain your bill and then, of course, we'll be subject to a question and answer period after that.

     Mr. McCreery, you also have five minutes to present. I will give you a literal shout-out when there is one minute left, so you can wrap up and finish and I don't have to cut you off in mid-sentence.

    Welcome, and please begin, Mr. Aboultaif.

     Thank you, Chair and colleagues. Thank you for the opportunity to appear today to discuss my private member's bill, Bill C-234.

    I would first like to thank the members of this committee for their incredible support for this initiative and previous efforts to improve Canada's organ and tissue donation systems.

    I would like to thank the five members of this committee, including the chair, who have taken the extra step and signed up as official seconders of Bill C-234. Your seconding of this bill has sent a strong message to our colleagues in the House and undoubtedly helped get unanimous approval from this committee. I will also note that this bill is seconded by members from all provinces across Canada.

    Before continuing, I just want to make a few comments that I had intended to make at second reading but was not able to because the bill passed unanimously before I could rise. It was a situation I did not anticipate, but I'm thankful for it.

    As you all know, I donated part of my liver to save the life of my son Tyler, but he also had another life-saving transplant. During debate in the House, a member of the Bloc Québécois expressed great pride in the organ donation system in Quebec. Not many people know that Tyler needed more than my transplant to survive to today, but he did. That life-saving donation came from Quebec. My family will be forever grateful to the anonymous Quebecker who selflessly gave my son Tyler another chance at life.

    I look forward to the day when Canada will have a living donor recognition medal. As so many have pointed out, the medal would be an opportunity to increase education and awareness of the power of living donation. It would save lives.

     This is why we think it is absolutely critical that the medal come with its own post-nominals. The post-nominals would be a lasting, visible reminder to all Canadians, long after the medal award ceremonies were over. Post-nominals offer the opportunity to reopen the discussion about living donation over and over and will help achieve our goal of education and awareness.

    Again, I thank members from all parties for their incredible support and encouragement. Their ability to put partisan politics aside and do the right thing for Canadians helped restore my faith in this place.

    I also want to especially thank Minister Dominic LeBlanc. It is well known that he is with us today because of another type of living donation. He received a stem cell transplant from a young German, Jonathan Kehl. This selfless donation saved the minister from certain death. The minister, also the President of the King’s Privy Council for Canada, has made it very clear that he strongly supports this initiative, and I'm truly thankful for his personal support.

     Since second reading, we have worked closely together on amendments to my bill in a full, open and transparent way. The amendments take input from those who would be responsible for its implementation and have been brought forward to ensure that the bill achieves its goal as smoothly as possible. In particular, I would like to thank Joel Girouard, senior Privy Council officer, and all the officials of the Privy Council Office, the Office of the Governor General and the Department of Justice for their work on the amendments proposed today.

    In addition, through this process, it's become abundantly clear that this was a unique opportunity to recognize the blood donors who give the gift of life. Throughout the discussions over these amendments, there was a clear understanding that we want a threshold that is attainable but at the same time available only to those with a very significant and sustained donation history. We're talking about those who made a huge, generational commitment to saving others. Let's understand that the number of blood donors at this level is extremely worthy of recognition.

    As we know, a donor is someone who donates without compensation for that donation. They give of their own free will. Anyone who receives compensation for donation should not be eligible for recognition.

    Without going into each amendment, I can assure you that I have carefully reviewed them and welcomed them all as friendly amendments. While I understand the responsibility of this committee and the purpose of this review process, as a fellow member of Parliament, I'm also satisfied that certain scrutiny is not warranted and would welcome any effort to expedite the clause-by-clause process to accept these amendments as proposed.

    I can honestly say that the minister, ably assisted by his director of parliamentary affairs and issues management, Émilie Simard, has provided answers to any questions I have had, has made thoughtful and constructive suggestions and has demonstrated a passion and excitement for this legislation at every step of the way.

    It has been a wonderful experience, and I look forward to working with them as the bill progresses. Again, I'm truly thankful for the support of my colleagues. I can't wait for this bill to return to the House for third reading as quickly as possible.

    Thank you.

     Thank you, Mr. Aboultaif.

    Now I want to go to Mr. McCreery for five minutes, please.

     Thank you, Madam Chair.

     I appreciate this opportunity to speak today.

    I'm here as an individual, not in my role as private secretary to the Honourable Mike Savage, Lieutenant-Governor of Nova Scotia, or as a Nova Scotian public servant.

     My doctorate focused on the development of the Canadian honours system, and I've spent the last 30 years researching and writing about the origins, history and development of our honours policy and the system overall.

    I've published 10 books related to Canadian honours and served as adviser to the Privy Council Office, the Office of the Secretary to the Governor General, Britain's Cabinet Office and numerous provinces.

     Understandably, I have followed the progress of your bill with great interest, not just as it relates to the honours system but because a very dear friend of mine, Laurie Anderson, was the recipient of a heart transplant a number of years ago. Through her experience, I've gained at least a peripheral understanding of the importance of organ and tissue donation to the well-being of our fellow Canadians. I've seen it first-hand.

     The goal of encouraging greater public knowledge of the importance of donation and the desire to increase such gifts is laudable. No one can argue with the encouragement of exemplary citizenship through blood and tissue donation. That said, the concept of creating a national honour to recognize blood and tissue donation does not fit into any part of the existing Canadian honours system.

    At present, there are only a handful of countries with a specific honour that recognizes blood or tissue donations, notably the Russian Federation, the People's Republic of China, Saudi Arabia, Monaco and Luxembourg. Héma-Québec and Canadian Blood Services each have extensive donor reward programs, while St. John Ambulance in Canada has a national organ donor recognition award that is given to both living and deceased donors. None of our Commonwealth cousins, with whom we share so much of our honours traditions, nor France, another country from which we inherit significant elements of our honours system, has blood or tissue donor medals.

    Nevertheless, reading your deliberations and sensing the unanimity among honourable members, it seems inevitable that this bill will pass and will be sent off to the Senate in short order, so I will limit my remaining comments to how you can improve the bill.

     I will start with what I think is the most difficult and objectionable aspect of the bill. The inclusion of post-nominals with the proposed medal is highly problematic. Post-nominals have hitherto been reserved for orders and decorations, such honours as the Order of Canada, the Star of Courage and the Order of Military Merit, to name but a few. They have never been associated with a medal for service or volunteerism.

    The inclusion of post-nominals for this medal will be highly offensive to some veterans and current members of the Canadian Armed Forces, notably those members of the CAF who were awarded the Sacrifice Medal. The Sacrifice Medal is awarded to CAF members who have served in war or combat-like situations, such as Afghanistan, where Canadians were killed or physically maimed, lost limbs or were mentally affected with PTSD. In recognition of their service, sacrifice and suffering, they were awarded the Sacrifice Medal, which is a medal with no post-nominals. These are people who answered what I would say is the highest call the country can ask of its citizens. You cannot compare voluntary blood donation or tissue donation with the loss of life or limb or permanent mental health issues caused by military service, so the provision to include post-nominals should be stripped.

     There are also other elements of the bill that are incongruous with our existing honours system. With reference to clause 3, Canadian honours are normally established by letters patent under the Great Seal of Canada and approved by the Sovereign, as the Crown has been the font of all honours since the time of New France and Acadia.

    The administration of honours is usually done by the Office of the Secretary to the Governor General, with no minister responsible for individual programs. The Prime Minister has responsibility for overall honours policy at the highest level but does not select recipients or become involved in the administration of honours. It should be left to the Governor in Council to set the criteria for the medal, and it should not be embedded in this act.

    It is highly unusual for ministers of the Crown to be involved in the setting of criteria for national honours. Indeed, when our entire honours system was set in place in 1967, it was set up to be placed at arm's length from such involvement.

    With reference to subclause 6(1), the medal should not be awarded by the Governor in Council—that is, it should not be awarded on the advice of ministers of the Crown. It should be conferred by an instrument signed by the Governor General, as is the case for all other honours. This was the precedent set by Lester Pearson when he was prime minister. He wanted to insulate the nomination and honours process from partisan involvement or the perception of it.

    Subclause 6(3) excludes MPs and senators from receiving the medal. Again, the only honour we have that excludes such people is the Order of Canada. You are eligible for every other honour in the system. There is no reason to exclude you from being eligible for this if you're a donor.

    Clause 7, which mandates public ceremonies, should be removed. No national honour in Canada mandates public ceremonies. Many people wish to receive their honours privately. Having the medal presented by MPs and senators could also be problematic, in the sense that it could be seen as a partisan gift. I know many of you recently presented the coronation medal, but that's a medal for which you had direct nominations.

    Clauses 10 and 11, where you're mandating reports, is again already covered off by the Office of the Secretary to the Governor General through its Treasury Board-mandated annual reports.

    To me, the simplest way forward would be to change the regulations related to the Sovereign's Medal for Volunteers, create a separate ribbon and have that awarded for voluntary blood and tissue donation.

     Thank you, Mr. McCreery. You've gone over time. You can speak up if someone asks you a question. Thank you.

    Certainly. You're welcome, and thank you for your indulgence.

     Before I go to the question and answer section, I want to provide members of the committee with a few comments on how committees proceed with clause-by-clause consideration of a bill.

    As the term indicates, this is an examination of all the clauses in a bill in the order in which they appear in the bill. We go in order; we don't jump. We go clause by clause, starting with the first clause and moving onward.

    I will call each clause successively, and each clause is subject to debate, a vote and/or an amendment. If there is an amendment to the clause in question, I will recognize the member proposing it, who may explain it. The amendment will then be open for debate. When there are no further members who wish to intervene, as in all debates, the amendment will be voted on.

    Amendments will be considered in the order in which they appear in the package each member received from the clerk. Each amendment has been given a number in the top right-hand corner, if you look at your amendments package, to indicate which party submitted it.

    During debate on an amendment, members are permitted to move subamendments. Only one subamendment may be considered at a time.

    All of you have your papers in front of you so you can follow along through this, so I'm going to begin now.

    Let's go to questions and answers before we go to clause-by-clause. I just wanted to let you prep all your papers in front of you for when we get to that point, so you're ready to go.

    We're going to do one round of questioning with six minutes for each party, and I will begin with Mr. Mazier for the Conservatives.

    You have six minutes, please.

    Thank you, Chair.

    Welcome, Ziad.

    This is a great bill. I still remember the day you sat down with me and went through your paces and told me your very personal story, as you indicated in your opening remarks. Thank you for bringing this legislation forward. I know we definitely went to bat for you, and it was fully supported throughout the whole House, so good for you.

    Your courage as a living donor is truly inspirational, so thank you for that.

    Your bill would create a living donor recognition medal to honour the Canadians who have donated an organ to save another person's life, and that is quite profound, as you've shared. Right now, there are over 4,000 Canadians on waiting lists to receive an organ transplant.

     This medal is about recognition, but I think it will also inspire more Canadians to donate an organ and, therefore, reduce waiting lists for transplants.

    Would you agree with that?

     Absolutely. Thank you for the question, and thanks for your support.

    Yes, the intent behind the bill is to encourage more Canadians to come forward and donate to save more lives, and not just to make the life of an individual better but to make the community better as well.

    There's also a sense of unity across Canada. When my son received a life-saving organ from Quebec at the last minute, it was on Christmas Eve, and there was a snowstorm. You can only imagine the feeling of that gift coming to the province of Alberta and all the way to Edmonton.

    That's the intent of the bill, and that's why I came up with it.

     Thank you.

    I'll cede my time to Ms. Konanz.

     Thank you, Mr. Mazier.

    Thank you, Ziad, for bringing this forward. I was proud to second it, and I want to thank you for telling your story, which I think really affected everyone in the House who heard it.

     What you did encourages others to become living donors and also teaches all of us about the process. I know I learned a lot from seconding this bill, listening to your story and listening to the others who spoke to it.

    Also, as a new member, I want to say that it was really nice to see all parties come together and agree on something so wholeheartedly. It was really encouraging for me as a new member.

     Since you're the expert on this now, I wanted to ask you this: How does our country compare with other countries in the donation of organs? This seems like a necessary thing to do. Why is it necessary? I think I heard there are 4,000 on the waiting list. How do we compare to other countries per capita?

     The number of people waiting is not coming down, especially in the kidney area. I introduced another bill in 2016, Bill C-223, to establish a national registry for organ and tissue donations. The bill did not make it through second reading to committee. It was more complicated than this one, and the urgency was on the lack of donations.

    When the organ is coming from a living donor, that is a much easier process, because you know what you're dealing with. It gives the health care system enough opportunities and time to examine the body and to understand. The likelihood of the organs surviving and living in recipients' bodies is much higher, as is the safety of both sides through the whole process of preparation.

    That's why, as the population in Canada grows, the numbers are not really improving. We need to do more, because that helps everything—all the steps, in all the ways and in all directions—and makes a huge difference in the lives of all Canadians.

    That sounds great. We are setting up a reward system here, which is great—anything to get this moving and happening.

    It's not necessarily a Canadian thing and just Canadians who are resisting it. Around the world, it's difficult to get organ donors, I imagine.

     Yes, it's an international problem. Every country has its own challenges when it comes to that.

    We do have pride in our health care system. I believe that we could do better if we had more awareness. Our situation as a family has taught a huge community around us about the importance of this. A lot of people were not aware that you can donate part of your liver to a relative, to a friend or even to someone you don't know.

     Thank you. I'm going to cede my remaining time to MP Bailey.

    Thank you to my honourable colleague.

     I want to thank you for your—

    I have a point of order.

    I apologize. I did not answer my phone, but I was under the impression that we would at least go through the first round for six minutes and then—

    We are doing that, Mr. Mazier.

     Okay. Are we going to get a second round to do some cleanup?

    I'll have to ask.

    I'll ask the committee right now.

    Can we make sure that after the next round there is time if we have any more questions?

    Some hon. members: Agreed.

    Dan Mazier: Okay, thank you.

    You have 30 seconds. Go ahead, Mr. Bailey.

     Again, I wanted to thank my honourable colleague. I really believe that what you have proposed is going to create awareness and help people understand the importance of signing the backs of their driver's licences or whatever each province requires to become an organ donor.

     In my life as a funeral director, I worked very closely with the cornea donation program at the funeral home, so I'm very familiar with organ donation, and I think recognition for living donors is very important.

    Thank you for your work.

     Thank you.

    We've just gone 25 seconds over, and now I'm going to go to the Liberals.

    Ms. Sidhu, you have three minutes.

     Thank you, Madam Chair.

    First of all, I would like to thank my friend Ziad for his leadership and dedication in bringing forward this important legislation.

    I know how hard it is for you. Thank you for sharing Tyler's story. You have my best wishes for his health.

    When someone is becoming a donor, they make a deeply personal sacrifice to give someone else a second chance at life. I believe this bill highlights significant barriers that many Canadians experience. Can you talk about those barriers and how you can raise awareness around them?

    Thank you so much for doing this.

     Thank you, MP Sidhu. Thank you for your support as well.

    Awareness—being able to talk around a table, at a coffee shop, at events or anywhere, and being able to discuss and make people aware of how important it is—is a big deal. When we see someone who was ill and they received a kidney, liver or heart, and, when we see the life of that person—we see him or her walking on the street, talking, going back to work, engaging with the community and all of that—this is what we need to do: We need to bring this in front of as many Canadians as we can, across the whole large country that we have.

    I think the core element of this bill is to provide that opportunity and have it available on a daily basis, if possible. Especially when the award is there, people will learn more. More communities, more members, more work colleagues and more friends...everybody will be able to learn, and that further encourages the ability and intention, among Canadians, to come forward and donate.

     I mean, people can live with one kidney. You don't need two kidneys. If you have that will to donate, save someone's life and improve life—as I said, not just for the individual and his or her own family but the whole community and, further, the whole country—that is a worthy goal. That's the intention of what we're doing here.

     Madam Chair, I want to share my time with Ms. Jaczek or—

    Yes, I will call on them. Thank you.

     Mr. Eyolfson, you have three minutes, please.

    Thank you, Chair.

     Ziad, thank you for doing this. I was quite honoured to support this.

     In my medical career, I looked after patients who were organ recipients. I looked after patients who ultimately died because they didn't live long enough to receive their transplants.

     I was also very honoured, during my first term in Parliament, to work with Len Webber. If you remember, his bill, which simply put a box you could check on your tax form, was passed. It has been credited with registering an additional 2.5 million organ donors. You're following in some very good footsteps.

     I know an objection came up to the post-nominals, because that's supposed to recognize sacrifice or, perhaps, injury.

    You donated a portion of your liver. That involved surgery. Is that correct?

    Yes, it was major surgery.

    It was major surgery—exactly. I've worked on several surgical services. I know that there are risks to surgery. There's the risk of complication. There's risk [Technical difficulty—Editor]. There's the pain of recovery.

    Would you not agree that doing this does represent a very significant sacrifice?

     As a father, the hardest decision I ever made was to do what I did, because, at the time, in 2003, the success rate of those surgeries was about 65%, maybe 70%. Nowadays we're looking at maybe 90%. It was a tough decision. Even after all the examinations that were done on me and my son, and the doctors being convinced that this was 100% a good decision, they spent three or four hours before they proceeded with cutting my liver, because they had some difficulties when they went through.

    It was a very long surgery. It was a very tough decision, but I'll tell you that, if you can do it, saving anybody's life, not just your own, is worth all the pain and sacrifice. It's a big decision. That's why whoever comes forward to do that deserves more than a medal and recognition.

    Thank you.

     I would agree, just from your statement, that what you did represented very real physical and, I would say, mental sacrifices, so thank you for doing that. I do support the use of the addition of a post-nominal to recognize exactly the sacrifice that you went through for this, so thank you.

    Thank you again for your support.

    Thank you, Mr. Eyolfson.

     I now go to Monsieur Garon for six minutes, please.

    Thank you, Madam Chair.

    Good afternoon to my fellow members. This is a return of sorts for me. I've been on the committee before, with Ms. Sidhu, among others.

    Mr. Aboultaif, Mr. Blanchette‑Joncas sends his regards. He couldn't be here today.

    I'm very moved by your bill. We could feel the emotion in your presentation. It was both very personal and very human. You've shown how this bill extends beyond your personal experience and serves the greater good, helping to raise awareness. That's very moving.

    Mr. LeBlanc, too, had his own experience, and his story affected people all across the country. We saw him come back healthy. We saw not only how organ donation saves lives, but also how afterwards, recipients return to their productive, happy selves, contributing to society and their families—so much so that it's impossible to tell they were ever sick.

    In short, you are to be commended for introducing this bill.

     Obviously, we have a few questions about how this will take shape. In Quebec, the kidney foundation has a program to honour living donors, also by awarding medals. I believe you know about that. The organization charged by the department of health and social services to administer the program is Transplant Québec. It holds ceremonies and awards medals to donors, including posthumously.

    I would like you to confirm that you plan to rely on those organizations to continue recognizing living donors. I would also like you to tell me how this new distinction adds value.

    Thank you very much, my friend. That's a very good question.

    That question came during the second reading speech in the House from one of your colleagues in the Bloc Québécois.

    Yes, obviously this is a collective effort, and after this it's going to take a lot of continuing work across the country from all the stakeholders and all the people and organizations involved.

    I know Quebec is doing better than some other provinces. On a personal note, I've already mentioned that I'm very grateful to Quebec for the liver that my son got at the last minute.

    Let's put it this way: All of us are going to have a major responsibility to improve the system we have. There's a lot of work ahead for me and the minister and the team, to make sure that we get this through in a proper way to get the best result out of it.

     I'm curious as to how the bill will be implemented. In a case like Dominic LeBlanc's, where a citizen of another country who does not live in Canada donates an organ to a Canadian, could the donor qualify for this distinction?

     This whole process has to be within the current provincial health care system, whether in Quebec or in Ontario or in Alberta. In those parameters, we know that this will be the safest way to make sure that if a medal might be awarded to a non-Canadian, it will be examined throughout the health care systems of the provinces. That's the safeguard we have, and that's why we will continue working within those parameters.

    According to the comments we heard initially, awarding a medal could be seen as an act of partisanship or, at least, the appearance of an act of partisanship. The King Charles III’s Coronation Medal comes to mind. At one point, the number of recipients had hit a million, and nearly everyone had one lying around in their office or bag.

    I have trouble seeing how that could happen in this case. I understand that the requirements for awarding a medal to someone are very serious and standardized, that a specific process has to be followed. I'd like to hear your thoughts on that.

     Yes, I heard that comment in the speech that was delivered before this committee.

    There's no comparison, not by any stretch. That's not to deny the argument. It's just to make sure that we....

    This is a completely different thing. The process is going to be completely different. The nomination process is going to be completely different. Imagine someone donated, and a friend or family member pointed at that person for the nomination. Then the records will be coming from the hospital. The whole thing is completely different from just nominating someone.

    It's just that—

     The collective effort of all and the support I got from all sides of the House showed that this is a non-partisan issue. It will never be a partisan issue.

    The chair is just about to tell me that I have 40 seconds left.

    Yes, you have 40 seconds.

    Mr. Aboultaif, what do you say to people who argue that awarding this distinction could be likened to a compensation of sorts for donating an organ?

     The purpose of the bill is to encourage people to donate. People act from a good heart and sometimes they feel.... I remember that when my son needed the second liver, hours before the Quebec one arrived we had a visitor who said, “I'm willing to do it now if I can.” You can imagine. This is beyond.... We need to encourage people, of course. We need to. The whole process is to make sure we have more donors lining up to save Canadians' lives. This way, we know that we can achieve that needed goal.

     Thank you.

     I'm going to ask the committee if there's unanimous consent to go for one more round.

    Yes? All right. That's good. As the chair, I had to ask that question.

    Yes, I think we're good on this side. The Conservatives are good.

     Before we move to that second round, I would like to welcome our expert from the Privy Council Office, Mr. Girouard. He is available for any questions members might have on the legislation.

    Good day, Monsieur Girouard.

    Now I'm going to go to the second round. Do I have names?

    We don't have more questions. We're good.

    You wanted a second round, Mr. Mazier.

    He asked me, and I passed.

     I keep getting this changing scenario, guys.

     We do not have a second round now. Is that it?

    That's correct.

     Thank you. That's good. That was originally the idea.

    Now, do you all have in front of you the agenda prepared by the legislative clerks?

     I'm going to start by saying to you that, pursuant to Standing Order 75(1), consideration of clause 1, which is the title, and of the preamble is postponed. We do that at the end. I will begin with clause 2.

    (On clause 2)

    Ms. Chi, go ahead.

     Thank you, Madam Chair.

     I move G-1. This amendment aims to broaden eligibility for the medal to include bone marrow and blood donations. The criteria will be established in the regulations, and the government intends to follow the criteria established by existing organizations that recognize blood donors who have made significant and sustained blood donations over their lifetime.

    Is there any debate, any discussion?

    Mr. Strauss.

     I just want to say that I love this bill. I was terribly moved by our colleague's story of personal courage. I note that reference to “courage” is made at the beginning of the bill. Undergoing surgery to give an organ does involve a real risk of death, and I assume that the risk of death would have been described to Mr. Aboultaif when he was preparing for surgery. It also touches on my personal family history. My father wrote me a letter the night before he was going to donate a kidney to his brother. Thank God, he survived, and I've never had to read that letter.

    I guess my concern with this amendment is that donating blood does not involve a material risk of death. Some of these surgeries for donating organs can be in the order of a one-in-300 chance of death, compared to a one-in-10,000 chance for bone marrow donation. It's basically unheard of, almost impossible, to die from donating blood. When I think of a medal ceremony, I think of recognizing physical courage, and I wonder if the mover of the amendment could touch on that point. Why has a decision been made to seek this amendment?

     I understand that the amendment was a work in collaboration with the mover and all parties, so maybe the officials can jump in to answer the question as well.

     Yes.

    Mr. Girouard.

     Thank you, Madam Chair.

    There are a number of reasons that Canada bestows honours on citizens and on others as well. Some of them involve courage. Some are for other accomplishments or other ways that people have given to Canada.

    The feeling is that there will be a threshold established by the Governor in Council for blood donations. That threshold will be high enough that the level of donations—the sustained commitment to giving the gift of life to others—will generally take place over decades and not over a short time. That level of commitment is deemed worthy of recognition by those who have moved the amendment.

     I don't want to derail the proceedings. I'm hugely supportive of this bill. I want this bill to sail through this process or as the regulations are devised, if it's by your office or wherever. I just want that recognition that, if you donate blood for decades, you're still not incurring the material risk of physical death that my colleague incurred and that my father incurred when they donated an organ. It seems incorrect to me to put those two....

    By all means, donating blood is important, and it's nice, but it doesn't really incur the same sort of sacrifice. It's unclear to me why they would incur the same sort of reward. I have nothing further to say on the topic. I believe the amendment will pass on division, but I wanted to have that on the record.

    Thanks.

     Mr. Eyolfson, speak to this particular amendment please.

     Yes, I agree with Mr. Strauss. The risk from a blood donation is absolutely minuscule compared to other things, like surgery. However, there are many public recognitions for tremendous amounts of service. People who have volunteered for years have received honours for having benefited the lives of many.

    To my earlier point about risk and sacrifice, that still goes. However, the people we're talking about, who would give blood, even though they wouldn't actually be at physical risk, would spend a tremendous amount of time and effort providing a prolonged, life-saving public service. For that, I think select people who have done this regularly over decades and have saved many lives are also worthy of this honour.

     Helena.

     Thank you. I have a question for Ms. Chi.

    If you brought this forward, why is it so important for you to have this? I'm 100% supportive of this bill, and I want it to pass, but I do agree in a lot of ways with MP Strauss about this. Why do you think it's so important to add this, when it is so different from what was originally asked for?

    I believe this amendment was developed in collaboration with all parties at the table. Yes, I did move the amendment as a procedural thing for the committee.

     I haven't been through this type of thing before, so I want to understand this.

    I will allow Mr. Aboultaif to comment.

     Thank you, Chair.

     I did accept this amendment because, first, we're also aiming to encourage any effort to save Canadians' lives. When you donate blood, that's one of the ways.

    The second thing is that, of course, we have a blood shortage in Canada, and we need to encourage more people to donate.

     The third thing I touched on in my speech was that it will apply when there is a significant number of blood donations. It's a very rare thing to happen, but in case it happens, I believe it happens because it's saving lives. To that extent, the medal will be a good thing to have and will be something to support those efforts.

     Monsieur Garon.

    Thank you, Madam Chair.

     Perhaps this observation will be helpful. Perhaps not. As I understand it, the honour will be bestowed on someone who has made a significant physical donation to save lives over a sustained period of time, and the eligibility criteria will be very high. I may be in the minority here, but I wonder—and I'm not a doctor, obviously—whether it's necessary to rank the level of pain or risk involved. Nevertheless, I'm not sure whether I'm totally comfortable with us, as parliamentarians, taking it upon ourselves to create a hierarchy of pain or risk and set the threshold for awarding the medal.

    Assuming it is possible under the regulations to determine whether a physical donation is significant enough to save lives, I am pretty comfortable putting my trust in those who will ultimately bestow the award. Generally speaking, I think the bar for awarding these kinds of medals is high enough.

    As far as I'm concerned, I would not be comfortable saying that this type of donation is more painful than that type, that a liver donation is more painful than a kidney or bone marrow donation, for example. Personally, I'm not sure I'm comfortable making that decision. For that reason, I support the amendment.

     I think Mr. Girouard spoke to this. I think it's going to be an order in council that's going to look at setting regulations that will set the bar for how many blood donations will fit the criteria.

    Is that it?

     That's correct. Eligibility criteria will be determined or established by regulation. There will be one or more orders in council after the passage of the act, and that's how the thresholds would be established.

     I can't speak to what those thresholds might be, because it would presuppose the decision of the Governor in Council, but I think that if you look at recognition programs now, it would be on the higher end of those.

     Does that answer your question, Monsieur Garon?

    I see no other hands up. We have no more discussion. I shall ask for the vote on the amendment.

    Chair, can we just pass it on division?

     Yes. You don't want to vote. You just want to pass on division.

    (Amendment agreed to on division)

    The Chair: Shall clause 2 as amended carry?

    (Clause 2 as amended agreed to)

    (Clauses 3 to 5 agreed to)

    (On clause 6)

    The Chair: The next amendment is on clause 6. You all have G-2 in your list. G-2 has been replaced by an amended G-2. I hope you have it. That's what we're discussing. All right?

    Ms. Chi, go ahead.

    Thank you, Madam Chair.

    I would like to move a new amendment. The amendment replaces G-2 in your package and has been shared with the clerk and all the members of the committee in both languages.

    I move that Bill C-234 in clause 6 be amended by replacing lines 14 to 18 on page 2 with the following:

     The amendment would also delete from line 21 on page 2 to line 2 on page 3.

     Is there any discussion?

    Monsieur Garon.

    I just want to make sure I understand what the amendment says. Would the amendment make it possible, theoretically, for the Governor General to award the medal to a non-Canadian who donated an organ to another non-Canadian?

     I'm sorry, Mr. Garon.

     Madam Chair, I'd be happy to repeat it.

    According to the new language in G‑2, the Governor General would be able to award the medal to anyone who makes an organ donation without profiting from the donation and who meets the eligibility criteria. The reference to a Canadian citizen and permanent resident is not there.

    I understand that there will be criteria, but theoretically, does this language make it possible to recognize a non-Canadian who does not live in Canada and who makes a donation to a non-Canadian who does not live in Canada?

     I will ask the Privy Council to speak to that.

    Yes, Madam Chair.

     Since the regulations will be structured around those who validate a potential recipient's eligibility—meaning, provincial and territorial health partners—a non-Canadian could, in theory, receive the medal. However, the donation would have to have been made within the Canadian health system.

     Therefore, a donation that did not take place in Canada and that did not involve a Canadian would not be eligible, since the Canadian organizations responsible for validating recipient eligibility would not be able to conduct the necessary checks.

     Are you happy with the answer?

    Yes, Madam Chair.

     Good.

     Is there any further discussion on this amendment? No. I will call the question then.

    (Amendment agreed to on division)

    (Clause 6 as amended agreed to)

    (On clause 7)

     Before we vote on clause 7, I think Ms. Chi has an amendment.

     Thank you, Madam Chair.

     I move G-3.

     Does everyone want her to read it for the record? You have it. Are you good with it?

     Did you wish to speak to it?

     No. I'm good.

    All right. Are there any questions or debate? Seeing no debate, shall the amendment carry?

    (Amendment agreed to)

    (Clause 7 as amended agreed to)

    The Chair: We have amendment G-4, which proposes new clause 7.1.

    Ms. Chi.

    Thank you, Madam Chair.

     I move G-4.

     All right. Everyone has G-4 in front of them. Is there any debate on G-4? No. Shall G-4 carry?

    (Amendment agreed to)

    (On clause 8)

    The Chair: Now we'll move to G-5 and clause 8.

     Ms. Chi.

     Thank you, Madam Chair.

    I move G-5.

     Is there any debate on G-5? No. Shall G-5 carry?

    On division.

    (Amendment agreed to on division)

    (Clause 8 as amended agreed to)

     Shall clause 9 carry?

    Shall clause 10 carry?

     Shall clause 11 carry?

    Ms. Chi.

    You're going too fast. Are we on clause 9?

     We're on clause 9, yes. We don't have an amendment for clause 9.

     Okay.

    Shall clause 9 carry?

    (Clause 9 agreed to)

    The Chair: Shall clause 10 carry?

     No.

    Shall clause 11 carry?

    Do you have something, Ms. Chi?

    Not on 11. We're going too fast.

     Shall it not carry?

    Do you have an amendment, Ms. Chi? We don't have one.

    I'm good.

    You're good.

    Shall clause 10 carry?

    I'm voting no.

    Okay. Ms. Chi is voting no.

    What are you saying? Are you going to strike clause 10 and clause 11, then?

     Yes, I thought that was—

    Okay. Can I get that clearly when I say, “clause 10”? Can everybody speak up?

    You're going too fast.

     Can we suspend, please?

     All right. We want to suspend.

     Let's resume, guys.

    Shall clause 10 carry?

    (Clauses 10 and 11 negatived)

    The Chair: Shall the short title carry?

    Some hon. members: Agreed.

    Shall the preamble carry?

    Some hon. members: Agreed.

    The Chair: Shall the title carry?

    Some hon. members: Agreed.

    The Chair: Shall the bill as amended carry?

    Some hon. members: Agreed.

    The Chair: Shall the chair report the bill as amended to the House?

    Some hon. members: Agreed.

    The Chair: Shall the committee order a reprint of the bill as amended for the use of the House at report stage?

    Some hon. members: Agreed.

    The Chair: We have all that, then. That's great, guys. What a way to work.

    Now, before we go, thank you very much, Mr. Aboultaif. Congratulations. I know this is not normal or usual, but I'd like to recognize your wife in the room.

    We're finished with this part of the meeting. I have a bit of housekeeping to go over with the committee, but thank you very much for taking the time, and for a great bill.

    Thank you, Chair.

     Thank you very much to all of you. I appreciate the support.

    Mr. Girouard, thank you for your service.

    To the legislative clerks, thank you for your service.

    I want to let everybody know that the clerk circulated a modified work plan for the study of Canada's pharmaceutical sovereignty. Did you all get it?

    Some hon. members: Yes.

    The Chair: Will the committee approve it or not?

    Hang on.

    I honestly didn't see it.

    Do you want to look at it?

    Yes.

    All right. We will suspend while you look at it.

     Okay. Is everyone happy?

    Some hon. members: Agreed.

    I'm happy to say it's unanimously approved. Analysts, thank you very much for your work on that.

    The meeting is now adjourned.