Madam Speaker, before I begin, I would like to state that I am splitting my time with the hon. member for Winnipeg North.
We have a serious issue before us, the issue of Bill C-7. It has been an excellent debate so far and an excellent opportunity for members on all sides to talk about this issue because it goes to our morality and to our own conscience, and we are hearing from all sides about this. I want to say that we got it wrong with the last piece of legislation; we got it wrong with Bill C-14. I want to commend the Attorney General for coming forward with Bill C-7.
I would also like to recognize a few members who were vocal advocates, working on the justice committee with Murray Rankin at the time; the hon. member for Saanich—Gulf Islands; my friend, the hon. member for Don Valley West and many other members of the Liberal caucus who tried to advance medical assistance in dying so that it would be constitutional.
I am here today to speak in support of Bill C-7, which proposes amendments to medical assistance in dying legislation. Members are aware that the Superior Court of Quebec found the eligibility criterion of reasonably foreseeable natural death from the Criminal Code made legislation to be unconstitutional. The court delayed the effect of the ruling to allow both the federal and Quebec legislatures to respond. The government has agreed with this basic principle of this decision and is now proposing to amend the Criminal Code.
Bill C-7 proposes to repeal the requirement that natural death be reasonably foreseeable. It would create two sets of safeguards: one for those whose death is reasonably foreseeable and another for everyone else. Some of the existing safeguards for those who are dying would be relaxed, and for everyone else there would be a different set of safeguards based on the current ones with some additions and clarifications.
Bill C-7 proposes to continue to use the expression, “reasonably foreseeable” natural death, but as an element that determines which set of safeguards to use and not to use it as an eligibility criterion, which was the issue in the Truchon case.
The proposal to distinguish MAID requests on the basis of whether a person's death is reasonably foreseeable is consistent with the view that MAID for people whose death is reasonably foreseeable presents less risk and complexity than other circumstances, and that the assessment of requests should be tailored to these different types of cases. Having a reasonably foreseeable natural death would also be a critical element for another proposed amendment in the bill. Currently, the MAID law requires the practitioner to give the patient the opportunity to withdraw consent or to affirm their consent just before MAID is provided.
This requirement for final consent is a safeguard; however, it has also caused some MAID patients to choose to end their lives earlier for fear of losing their capacity to provide final consent and, sadly, for some to be denied MAID entirely after losing capacity. I would also like to point out that others chose to decrease their intake of painkillers prior to MAID being provided, to ensure they retained capacity to consent, which leads to an increase in suffering.
BillC-7 would allow for a possible waiver of requirement for final consent for individuals whose death is reasonably foreseeable but where there are fewest risks and complexities in providing MAID to a person who is no longer able to consent. Permitting this proposed waiver of final consent would respond to scenarios like that of Audrey Parker of Nova Scotia, who was diagnosed with terminal cancer that had spread to her brain leaving her uncertain as to how long she would have the capacity to consent. Because she feared losing capacity before her preferred date to receive MAID, she scheduled MAID and ended her life earlier than she wanted. She openly expressed how she felt unfairly forced by the limitations of the MAID law to schedule MAID sooner than preferred and called for amendments to the Criminal Code so that others like her would not be denied the freedom to choose their preferred date to receive medical assistance in dying.
I would recommend that all members listen to the speech in the previous session from the hon. member for Dartmouth—Cole Harbour. I believe Audrey Parker was a constituent of his. He powerfully used her own words to show us where we went wrong, the impacts our failures in the previous legislation had led to, and the impacts on her life. We owe it to people like Audrey Parker, who have been assessed and approved for MAID, to respect their need for freedom in making end-of-life choices. As a compassionate society, we know we can do better to support these individuals. These amendments seek to do just that.
Waiving final consent is, however, an ethically complex question. This is because it involves MAID being administered to a person who is no longer able to consent, or to withdraw the consent they previously gave. Bill C-7 proposes a new approach for patients whose death is reasonably foreseeable, who are assessed and approved for MAID when they have the capacity, and who make very specific arrangements with their practitioner in which they give consent in advance to MAID being administered on a specific day, even if they have lost capacity by that day.
I fully support permitting advance consent for this group of individuals, but at the same time, I note that certain protections must be in place. Specifically, if on the specified day for MAID, the patient has lost their capacity and they nonetheless actively show signs of resistance to the MAID procedure, or behave in a way that indicates a refusal, the practitioner must not follow through on the procedure.
Medical practitioners at the round table expressed concerns in relation to the emotional burden that could arise from such situations, for them and for family members. They talked of possible disagreement with family members on whether to end the life of a person who appears to resist the procedure. A similar situation led to the prosecution of a MAID provider in the Netherlands and made headlines around the world. That situation is what we wish to avoid here in Canada.
That is why Bill C-7 proposes an additional provision that states that signs of resistance from the patient would make the advanced consent invalid on the specific day and going forward. While an incapable person could no longer withdraw their consent from a legal perspective, given their track record and decision-making capacity, it is proposed that MAID not be permitted under this circumstance. The approach provides much needed clarity for practitioners and family members that MAID be prohibited if the patient is resisting. The bill would also make it clear that an anticipated reflexive response, like flinching when the needle is inserted, does not count as resistance.
It is important to be clear, however, that this amendment is not about advance requests. Advance requests for MAID refer to a situation in which a person puts in writing they would want to receive MAID at some later date when they are not able to consent to it, if circumstances arise that they predict would cause them unbearable suffering.
In this situation, a person is not asking for MAID now. Instead, they are putting in writing that they want it at a later date on the basis of anticipated suffering that has not yet happened. The most likely scenario would involve people who are diagnosed with conditions that could lead to dementia, such as Alzheimer's. These people would want to have a plan in place if their worst fears should come to pass.
Bill C-7 does not propose to allow MAID on the basis of advance requests. MAID in these circumstances would be extremely complex, would avoid ethical challenges and would require more time to consider such measures. In speaking to the Attorney General, I voiced my concern that we need to spend more time considering these measures. I hope that the issue will be studied during further upcoming parliamentary review of the MAID legislation.
Taking more time to study advance requests is consistent with the approach of the Government of Quebec, which is also moving forward to hold public consultations on the issue so that all of its dimensions can be better understood.
MAID is one of the most sensitive and challenging social issues we are currently faced with. Recognizing how deeply personal this issue is to so many people, and to so many members of this place, the government has listened carefully to the diverse opinions of Canadians and has considered the expertise shared by experts, MAID providers and other experts in the development of this important piece of legislation. Bill C-7 responds to the Superior Court of Quebec ruling, but it also achieves balance that respects personal autonomy, while protecting the vulnerable as well as equity rights for all Canadians.
For these reasons, I call on all members to support the bill.