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Results: 1 - 15 of 62
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-05-27 17:59 [p.7528]
Madam Speaker, in light of the extensive protection for conscience rights in the charter; in the statute originally passed, Bill C-14, which the member opposite mentioned; and in the Carter decision, I am personally unaware of a single instance of a prosecution having been levied against an institution for compelling a doctor or nurse to provide MAID.
I wonder if the member opposite can provide this House a single example of such a prosecution, a human rights complaint at the provincial level or a wrongful dismissal suit. I am struggling to understand the problem she is trying to identify and address with this private member's bill.
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-05-27 18:03 [p.7528]
Madam Speaker, I rise today to speak to Bill C-268, the protection of freedom of conscience act.
This bill proposes to create two new offences to protect the freedom of conscience of health care professionals in the context of medical assistance in dying, or MAID. The first offence would prohibit using violence or threats of violence, coercion or any other form of intimidation to compel a health care professional to take part in MAID. The second offence proposed would criminalize persons who refuse to employ or dismiss from employment health care professionals because they refuse to take part in MAID.
Protecting the freedom of conscience of our health care professionals is obviously a laudable goal. We have all recently debated Bill C-7, which amended the Criminal Code's MAID regime to remove the reasonably foreseeable death criterion. Some Canadians are very much in favour of MAID for anyone with decision-making capacity, others are profoundly opposed to it in any circumstance and many have opinions that fall somewhere in between those two positions. Many of my constituents in Parkdale—High Park, for example, are largely in favour of MAID, in favour of providing autonomy to Canadians and to empowering them with the tools to reduce suffering, with important safeguards being put in place to protect those who are vulnerable.
Our government understands that medical assistance in dying is deeply complex and personal. We were proud to have passed Bill C-7 in March of this year, which responded to the Superior Court of Quebec's September 2019 Truchon ruling and to the emerging societal consensus on the specific issues relating to MAID. We remain committed as a government to protecting vulnerable individuals and the equality rights of all Canadians, while supporting the autonomy of eligible persons to seek medical assistance in dying. We are working with the provinces and territories to implement the changes in Bill C-7 and ensure adequate access to health care support services and medical assistance in dying to all Canadians who wish to seek it.
This range of views also exists among health care professionals who are the ones directly involved in MAID, whether it be providing MAID, assessing a person's eligibility, dispensing the substances, being consulted or supporting the patient. Clearly there are practitioners who do not want to be involved in MAID at all and there are others who find meaning in responding to the wishes of their patients who are suffering by providing MAID.
Let us get to the heart of what is being moved by the member opposite. The Canadian Charter of Rights and Freedoms protects freedom of conscience and religion from government interference. That is subsection 2(a) of Canada's charter. That freedom is subject to reasonable limits prescribed by law that can be justified in a free and democratic society. It is important to keep in mind that the charter, not the Criminal Code, is the source of that constitutional protection for freedom of conscience and freedom of religion.
I also think it is critical to underscore that the Criminal Code does not in any way compel anyone's participation in MAID. Let me be crystal clear on this point, because it was raised by the member opposite. Concerns about conscience protection also arose in 2016 when she and I were both members of this House, when we enacted Canada's first MAID regime. In order to be abundantly clear, while the preamble already articulated this, our government supported an amendment to Bill C-14, which added to the Criminal Code. I am going to read it for the purposes of clarity. This amendment was to subsection 9 of section 241.2, which states, “For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.” We have the charter, we have the preamble and now we have subsection 9.
This provision exists to protect the conscience rights of medical practitioners, but it will not stop there. The entire MAID regime was prompted by the Supreme Court's decision in Carter. I will read from paragraph 132 of the decision of the court, which said, “In our view, nothing in the declaration of invalidity which we propose to issue would compel physicians to provide assistance in dying.” The court itself has been crystal clear on this issue.
When I asked the member, in the context of the debate this evening, whether there is any evidence of criminal prosecutions against institutions that are compelling physicians or nurses to provide MAID, instances of a wrongful dismissal suit or a human rights complaint, the member was not able to provide a single instance of such a situation arising, which begs the question whether there is actually an acute problem that the member is trying to address or whether, apropos of the question posed by my Bloc colleague, this legislation is simply an attempt to address a broader concern about MAID generally that perhaps is held by the member opposite and members of her caucus.
While there may be requirements for practitioners to participate in MAID in some form, it is at the level of regulation of these practitioners as professionals. That was raised by the member for Esquimalt—Saanich—Sooke. For example, in Ontario, The College of Physicians and Surgeons has an effective referral policy for MAID. It requires that practitioners refer their patients in good faith to a non-objecting, available and accessible physician or agency if they do not personally want to participate in medical assistance in dying. That policy was challenged in court under subsection 2(a) of the charter, the very provision that I put to members in this chamber. In 2019, the Court of Appeal for Ontario upheld the policy and that policy was never taken to any higher level of court afterward. That is the highest example of a court ruling in this country on whether effective referral violates the charter. It does not, according to Canadian jurisprudence.
This is one example of an effective referral policy from a regulatory body created by provincial legislation that aims to reconcile patient access to MAID with physicians' freedom to refuse participating in MAID. As the Ontario Court of Appeal noted, it is a solution that is neither perfect for the patients nor perfect for the practitioners, when questions like MAID raise difficult moral issues that are hard to reconcile with absolute perfection.
I would also note that neither of the offences the bill proposes would have an impact on an effective referral policy from a regulatory body. Such policies are not using violence, threats or intimidation to compel participation in MAID and the colleges that would issue them are not the health care professionals' employers. The offences proposed in this bill are not aligned with that particular objective of the bill.
I also have some questions about the proposed offences. The offence of intimidation reflects an opinion that I think we all hold. Health care professionals should not be the victims of violence, threats of violence or intimidation, whether it is to force them to provide medical assistance in dying or for any other reason. That is such a fundamental principle that the Criminal Code already sets out offences that prohibit such behaviour, regardless of who the victim is and regardless of the objective of the violence, threats or intimidation.
What is more, we have not heard about any doctors being forced by threats, violence or intimidation to provide medical assistance in dying, or MAID. Although the offence of intimidation set out in Bill C-268 may send a message regarding the importance of not engaging in such behaviour to force a health care professional to provide MAID, it would duplicate the offences currently set out in the Criminal Code, such as assault, uttering threats, extortion and intimidation. In fact, it would not provide any additional protection and seems to target a problem that we have no proof even exists.
The employment sanctions offence raises questions about the appropriateness of using the criminal law, which is a very blunt tool that brings about significant consequences, including the deprivation of liberty to punishing employers who refuse to hire or who would fire health care professionals because they did not want to take part in MAID.
Again, I think many of us would agree that practitioners should not face employment consequences if they object to participate in medical assistance in dying, but this seems to me like an improper use of the criminal law to try and push feelings of conscience and religion in the workplace.
I reiterate that our government is committed to the protection of health care workers, now more than ever, given how much they have worked for Canadians during this pandemic. As well, we are committed to ensuring that all Canadians have access to the right of medical assistance in dying. Our government is proud of what we have achieved in Bill C-14 in the last Parliament, and Bill C-7 in this Parliament.
I look forward to working with the Special Joint Committee on Medical Assistance in Dying to review where medical assistance in dying in Canada will be going with respect to the laws on MAID in Canada and recommending any necessary changes.
I urge all members to keep these things in mind as we continue our study of Bill C-268, a private member's bill.
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-03-12 12:02 [p.4982]
Madam Speaker, yesterday, we moved a very important step closer to passing the critical changes to medical assistance in dying, through Bill C-7. We listened through this process to more than 300,000 Canadians. We heard from countless experts. We spent more than 45 hours of debate on this important legislation. However, the job is clearly not done yet.
We finally brought the unfortunate obstruction by the official opposition Conservative Party to an end in the House. Now it is up to the other place, the Senate, to complete this bill's journey so that these critical changes can become law and suffering can end for Canadians.
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-03-11 16:52 [p.4928]
Madam Speaker, with respect to the last comment, the consultations included 300,000 Canadians reaching out online, and many meetings conducted around the country by the three ministers, me, and two other parliamentary secretaries, where we heard from stakeholders, including persons with disabilities.
I want to touch on the parliamentary secretary's experience in the House and ask him how he interprets what I see as a bit of double standard. We have had the Conservative justice critic state in the Telegraph-Journal in New Brunswick that we need to have extended hours for debate. Yet, to the point made by the member from the Green Party, when the proposition was put to the Conservatives on three occasions for extending debate on these very Senate amendments, it was turned down.
How does the parliamentary secretary reconcile those two positions?
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-03-11 17:06 [p.4930]
Madam Speaker, I thank the member opposite for his contributions. To begin, I do not think we are going to apologize for not only responding to Truchon, but also expanding on the regime to address the Audrey Parker amendment, which is critical for Atlantic Canadians and all Canadians.
Second, we did hear, and the member opposite knows this, at committee from Dr. Gupta, Dr. Gaind and other people on the mental illness issue.
Third, I take strong opposition to the member saying, which I wrote down, “the government deems the work of Parliament is a nuisance”. That is absolutely illogical when we are entertaining the acceptance of three amendments by the Senate, a chamber of Parliament, showing that the work of Parliament is not only venerated, it is validated.
I would like to point out to the member opposite the logical inconsistency of his own statements to the Telegraph-Journal in his own province when he said that we need to sit evenings and weekends to deal with the very important amendments that have been suggested, but then his party did an about-face in rejecting three different opportunities to do just that.
Could the member please respond?
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-03-11 17:21 [p.4933]
Madam Speaker, I thank the member for South Surrey—White Rock for her contributions at committee and for her contributions today through the deeply heartfelt and very personal speech she just gave. However, I take issue with some of the points she raised.
First, with respect to coercion, the evidence indicates that no discipline or prosecution has taken place against any doctor or nurse in this country in the five years we have had MAID. Second, the notion that we would have the most permissive regime on the planet should these amendments pass is speculative. We know, for example, that the safeguards we would put in place are yet to be determined and that in the Benelux countries, for example, minors can avail themselves of medical assistance in dying. That is not on the table here.
No one takes issue with the fact that we need supports for people who have a mental illness, but I would ask the member opposite to comment on the Truchon case. As she is a lawyer, I know she reads jurisprudence, just as I do.
In the Truchon case, the court said that people with disabilities need to have the autonomy and competence to make decisions about their lives and—
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-03-11 17:36 [p.4935]
Madam Speaker, this narrative of abandonment that we are hearing from Conservative interveners in today's debate is a bit concerning. The view of the court and the view of our government is that we are trying to empower individuals to make choices, including difficult choices. I commend to the member opposite the fact that Monsieur Truchon and Madame Gladu were persons with disability who were seeking constitutionally protected access to the MAID regime.
The notion that the amendments proposed by the Senate are radical and outrageous, to quote the member opposite, is false on its face. Collecting race-based data and other data about vulnerable communities accessing MAID is important. So too is having a joint study, which are two amendments to which we have agreed.
Does the member opposite agree and appreciate that we are not proposing to allow access to those with mental illness as a sole underlying condition, tomorrow or even next month, but only after a one-year review by an expert panel followed by a one-year review by Parliament, so Parliament can do the work that the member seeks to have done, which is test the safeguards to ensure that embarking in this area is done in a measured and appropriate manner that protects vulnerabilities?
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-03-11 17:58 [p.4938]
Madam Speaker, the member indicated that the message being sent is that persons who are mentally ill are not needed, valued or worthy.
What I would reiterate for her is that this issue about persons with disabilities and their competence and autonomy was squarely before the court in Truchon. What the court squarely found in paragraph 681 of the decision is that there is a “pernicious stereotype” about persons with disabilities, and that is “the inability to consent fully to medical assistance in dying.” The decision goes on to say:
Yet the evidence amply establishes that Mr. Truchon is fully capable of exercising fundamental choices concerning his life and his death. As a consequence, he is deprived of the exercise of these choices essential to his dignity as a human being due to his personal characteristics that the challenged provision does not consider.
As such, he must be provided access.
The issue is clearly about providing value and dignity and worth to persons—all persons, including persons with disabilities—and ensuring that they have the competence and autonomy to make decisions, including very serious decisions, after careful consideration, about the timing of their passing.
I wonder if the member for Yorkton—Melville would like to comment on that aspect of the Truchon case.
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-03-11 19:08 [p.4948]
Madam Speaker, by way of clarification, first, the constant pressure that the member referred to simply does not exist. There is no evidence anywhere in this country of any discipline or criminal prosecutions against any medical practitioner in the entire history of MAID's being available the last five years.
Second, the notion of the impact on the vulnerable would be addressed by one of the Senate amendments that we are proposing to adopt, which is to collect race-based data and data on persons with disabilities.
Third, respecting the issue of the courts' never having dealt with the issue of mental illness, while it not addressed squarely in Truchon, it was addressed in a case that comes out of that member's province, the E.F. case, through the Alberta Court of Appeals, which found that mental illness should be a condition for which MAID is made available.
Would the member opposite agree that the community of persons with disability is not a monolith? Chantal Petitclerc, the senator who sponsored the bill, is a person with a disability. Steven Fletcher, a former Conservative cabinet minister, is a person with disability. Both have spoken eloquently, as have the litigants in the Truchon case, about the need to ensure that their autonomy and their competence is respected.
Would the member agree with that statement?
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-03-11 19:25 [p.4951]
Madam Speaker, I thank the member for Sarnia—Lambton for her commentary, but I find it is much in the same vein as many of her party colleagues in terms of the level of hyperbole and the terminology that has been used. She has used terms about things being offensive. Many of the members who have spoken this evening are missing some of the fundamental points about this legislation.
Regardless of the discussion on mental illness, entry into the entire discussion of MAID requires informed and voluntary consent and that people be enduring an intolerable level of suffering. That is exactly what we are trying to address.
The second point about the inconsistency in approach is not borne out by the facts, because $11 billion was committed by our government in 2017 to address palliative care and mental health supports. She urged us to “spend more time”. Twenty-four months is the time that will be spent to ensure that when this clause sunsets, there will be a review by an expert panel and at least 12 months of deliberation by Parliament. Is that the type of time that the member opposite is seeking?
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-03-11 19:39 [p.4953]
Mr. Speaker, I point out that the issue of discrimination was squarely before the court in Truchon and the findings are exactly the opposite: that not making MAID available to those who are not at the end of life, including persons with disabilities, violated their competence, their autonomy and their dignity.
The second point is that scrutiny has been provided with respect to this bill. One hundred and thirty-nine MPs have spoken, and 45 hours of debate have occurred. On three separate occasions, given the opportunity to extend debate to discuss these very amendments, the Conservative Party turned it down.
Would the member opposite agree that it is entirely speculative to say that the only thing that will be offered to persons who are mentally ill is MAID, which I believe is what she effectively just stated, given the fact that even under the current regime of Bill C-7, prior to the Senate addressing it and working to amend it, there were already protocols in place, such that one must be informed of counselling, mental health supports, disability supports, community services and palliative care, and that those must have been discussed and appropriately considered?
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-03-11 19:53 [p.4955]
Mr. Speaker, earlier the member posed a question for one of my colleagues about associations or groups that support the direction of this legislation. I would put it to him that the Quebec Psychiatric Association has raised valid questions about how this could be handled going forward, not purporting to have all of the answers but at least guiding some of the conversation, as well as Dying with Dignity.
Second, I would put to him that there is a serious danger with regard to the expiration of the last court deadline extension that was granted. If it lapses, then the safeguards, which the member opposite and some of his party colleagues have termed “insufficient safeguards”, such as the 90-day assessment period and having at least one expert among the panel of assessors being an expert in that particular condition, would lapse in their entirety.
He talked about choice at the end of his commentary. The narrative I would put to him is that we, on this side of the aisle, believe that this bill, in its current incarnation and with the amendments proposed by the Senate, is about facilitating choice, including very permanent and serious choices for those—
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-02-23 12:51 [p.4433]
Mr. Speaker, first, the notion that there is homogeneity with respect to persons with disabilities on this issue is far from the truth. The Senate's sponsor of the bill is a woman with a disability who supports the initiative of the government, as does a former minister in the Conservative government of Stephen Harper, a gentleman named Steven Fletcher.
Second, hopefully the unfortunate insinuation will not be left on the record that somehow appointments by the current Prime Minister to the Senate are doing work as an end run around what the government's position had been all along. What the Senate is actually doing is taking a sober second thought, as it is constitutionally charged to do.
My question to the member is this. The notion that the Senate amendments are being taken on holus bolus is inaccurate. What is being contemplated is with respect to taking the mental illness exclusion from 18 months to 24 months for the sunset. Within those 24 months, there would be within one year a task force of experts charged with providing recommendations about how this could be done appropriately, and there would be a further 12 months for Parliament to consider how to do so and whether to do so.
Do those kinds of safeguards address the concerns that the member is raising?
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-02-23 13:00 [p.4435]
Mr. Speaker, I am very pleased to participate in the consideration of the amendments proposed by the Senate to Bill C-7, which seeks to amend the Criminal Code provisions on medical assistance in dying.
Our colleagues did a lot of work on Bill C-7 and proposed reasoned amendments following careful deliberations. The Standing Senate Committee on Legal and Constitutional Affairs heard from a variety of witnesses as part of two different studies. I followed the debate at second and third reading and thought that the speeches given in the Senate reflected the range of perspectives shared by the many witnesses.
It is therefore with great respect for the work of the Senate that we are examining the amendments it is proposing to Bill C-7. As the minister explained, there are three amendments that we plan to support, with some adjustments.
The first relates to the collection and analysis of data about the race of persons seeking MAID. Let me say here that we have heard extensively in the House of Commons and the Senate about the need for better and more robust data collection with respect to MAID. That data has been collected since MAID first entered into the legislative landscape, but certainly improvements can be made.
It is important now, especially during Black History Month, to note that one of the Senate amendments proposes tracking the analysis of data on the race of persons who are accessing MAID. This is important because we have clearly seen a light shone on the important issue of systemic racism in Canada, North America and around the planet. We need to understand how racialized persons, because of their inherent vulnerability, may be disproportionately impacted by MAID and address that vulnerability with our legislative response.
I would say, however, as articulated by previous speakers, including the minister, that the amendment the government proposes to make to this portion of what the Senate is suggesting would make it more inclusive in light of all of the witness testimony given in both the House and the Senate. By that I mean in addition to race-based data, data about disability and indigenous identity would be collected and analyzed. This, of course, is important, especially and specifically as we broaden the MAID regime to circumstances where death is not reasonably foreseeable, in response to the Truchon decision, which creates the real possibility that people will seek and obtain MAID because of vulnerabilities in their lives as opposed to their health conditions. I am grateful to the Senate for proposing this important legislative change.
The second Senate amendment the government supports, with some adjustments, is the sunset clause that attaches to the mental illness exclusion. We heard extensively about this from the previous speaker and in other interventions that have been made. The Senate amendment proposes a sunset clause of 18 months. The government is suggesting that the sunset clause be extended to 24 months.
Second, and very importantly, we are requiring that the Minister of Justice and the Minister of Health ask a group of experts to make recommendations on safeguards, protocols and guidance for MAID on the basis of mental illness alone. Those experts would be required to report back to the ministers within one year, which would leave an additional year for the government to consider what safeguards should be legislated and for Parliament to consider things when enacting any subsequent legislation.
I want to give some context surrounding the sunset clause because it is obviously a pressing matter for today's debate and a pressing issue for all parliamentarians.
The government's position is that it needs more time to consider and enact safeguards for the population of people whose sole underlying condition is a mental illness. The Minister of Justice was always clear that the questions of whether MAID for mental illness should be allowed and, if so, what safeguards were needed would be studied in the course of an upcoming parliamentary review.
What the sunset clause would do, in combination with a requirement for an expert review, is commit to a definite timeline for eligibility of persons whose only medical condition is mental illness. This would reduce the risk that some Canadians would feel the need to challenge the exclusion before the courts should they believe it is unconstitutional. It would also provide them with the certainty that two years following royal assent of Bill C-7, eligibility on the basis of mental illness would be considered with the requisite safeguards attached.
This point about potential constitutional challenges is not an academic point alone. We know this is a complicated issue that balances competing constitutional rights. Obviously we know from the Truchon decision that there has been litigation with respect to the old Bill C-14, and virtually all observers recognize that there is very likely to be constitutional challenges related to the current bill, Bill C-7, should it be enacted. In fact, we heard testimony about this at a House of Commons standing committee. Some witnesses said the exclusion of mental illness alone could perhaps give rise to a section 15 challenge. We are trying to ensure that Canadians who are concerned about this exclusion would have a remedy that is not via the court process, but rather through the task force of experts and the parliamentary study that would follow therefrom.
We heard a lot from the previous member about evidence and whether the government believes in evidence-based approaches. I would reiterate for the record that absolutely we do, and some of that evidence relates to a very specific document in the submissions that were made by the Association des médecins psychiatres du Québec.
In November 2020, the Quebec association of psychiatrists, or AMPQ, published a very informative discussion paper on access to medical assistance in dying for people with mental illness, which underscores the reasons that the government believes that a 24-month sunset clause is needed.
The work of this association will no doubt be foundational to the expert review of this issue. It points to some possible solutions, but they are fairly complex. That is why we need to carefully consider solutions that could work nationally.
The association is of the view that whether a mental illness is incurable or not can “only be determined at the end of a long process, after attempting several treatments and assessing their effects”. The association further notes that before coming to a conclusion on eligibility a psychiatrist “should explore other aspects that shape the patient’s life experience and consider strategies to improve the social circumstances that add to the suffering”. This dovetails exactly with some of the interventions made in the last portion of the debate by members of the NDP, who talked about supports that surround a person's life circumstances, such as income security, housing security and so on.
Going back to the submission from the association, it notes, “Psychiatrists must be involved as both the first and second assessors”, and also notes, “access to psychiatric care varies significantly from one region to the next.”
In light of all of these considerations, the Association des médecins psychiatres du Québec suggests that we create a new administrative body with regional offices dedicated to MAID on the basis of mental illness that would coordinate such requests, identify MAID assessors and providers, and ensure access to psychiatrists. It also suggest that such an administrative body could monitor the assessment process in real time instead of after the fact.
I highlight this in some detail because I believe the association's discussion paper is focal to why we as a government believe that a 24-month sunset clause is needed. The work of the association will no doubt be foundational to the expert review of this issue. The paper points to possible solutions, some of which are fairly complex in nature, which underscores the need for careful consideration of what could work nationally. Further, I underscore that government and Parliament will need time to make decisions about which safeguards should be codified in federal MAID legislation as a matter of criminal law relating to mandatory access across the country.
I will now turn to the third amendment.
The third amendment being proposed by the Senate, which the government proposes to support with some modifications, relates to the notion of the parliamentary review. The government has repeatedly committed to facilitating the start of the parliamentary review required by Bill C-14 as soon as possible following the adoption of the current Bill C-7. Our proposed adjustments to the amendment proposed by the Senate would ensure that all of the relevant issues are front and centre for the joint parliamentary committee that would undertake this work. I underscore the notion that it is joint, because it would be a combined study by the Senate and the House of Commons, similar to what we saw prior to the advent of the original Bill C-14. Its mandate would look at things that were contemplated by the original intended review of Bill C-14, such as requests by mature minors and issues that relate to advance directives.
In addition, we would include palliative care and safeguards for persons with disabilities within the scope of that mandatory joint parliamentary review by the Senate and the House. We also proposed to adjust the timelines, so they are both realistic in a pandemic environment but still ambitious, given the seriousness of the issues at hand. These are important features we feel would enable us to move forward in a collaborative manner involving the work of both Houses of Parliament, as well as the work of all legislators from various parties.
I would note parenthetically that, obviously, the member for Esquimalt—Saanich—Sooke has been very instrumental in leading the charge and a call for a study in Parliament of the previous bill, Bill C-14. Some of what we are proposing incorporates his views on the scope of what that review should look like.
Finally, there are two Senate amendments that, in the government's view, cannot be supported.
The first is the amendment to the mental illness exclusion itself. While I appreciate that some have advocated for greater clarity around what mental illness means in this context, the government is concerned that this particular amendment, as drafted by the Senate, implies that neurocognitive disorders are ordinarily understood as being mental illnesses, which, in fact, may not be the case. The federal government will work with its provincial and territorial counterparts to ensure a consistent application of the mental illness exclusion until it sunsets.
The second Senate amendment we propose to reject is the amendment to expand the waiver of final consent. Providing MAID in the absence of final consent is extraordinary and carries risks, and we acknowledge that. The Senate amendment goes beyond the scope and principle of Bill C-7, which would permit the waiver of final consent only in narrow circumstances that present the fewest risks. Any expansion of advance consent or proposal for advance requests, which are sometimes called advance directives, will involve greater risks and should be the object of careful consideration by the parliamentary review.
It has always been the notion that the issue of advance directives should be contemplated only after consideration by the broader parliamentary review. This was the case with the previous Bill C-14, and it is certainly the case now with what we are proposing as a government with respect to the parliamentary review that should ensue herefrom.
In the time I have remaining here, I would like to canvass a couple of points.
One is the notion that has arisen during the discourse of today's debate that somehow the government and de facto the Senate are somehow pursuing a route that is putting undue focus on facilitating an end of suffering, including facilitating the passing of an individual, as opposed to making the condition of life more viable and also more supported. That assertion is categorically false. The government's record over the last five and a half to six years speaks for itself in terms of the supports we have put in place, whether they are in long-term care, home care or supports for mental illness.
It relates to, as the previous member mentioned, a unanimous consent motion being passed regarding a suicide hotline. The supports we have put in place, such as the Canada health and social transfer, and a few intensive efforts to address home care and palliative care, are significant investments. We are ensuring that people are making such significant decisions based on the full understanding of what options are available to them and what supports are available to them. Can more be done? Of course, more can be done. I think that is what is important about what arises from a debate such as this.
The second thing I want to underscore is something that arose many times when Bill C-7 was in our chamber the first time, meaning its second and third readings prior to being sent to the Senate, which has again arisen today in the context of today's debate, and that is this idea that persons with disabilities are somehow being victimized, targeted or unfairly treated by this particular bill. I will raise a couple of important points, which I think are really important for all members of Parliament to understand. I have raised these points before, but I will reiterate them.
What we are talking about here is autonomy and the autonomy of individuals to make choices about the end of their lives and their passing, and that butts up against the need to protect vulnerable people. It is an important balance, and that is what is at the heart of this. This makes it probably the most difficult issue any of us have dealt with, at least it has been for me in my five and a half years as as parliamentarian. That being said, people need to understand that the case that was brought before the courts that we are responding to now was brought by two individuals: Monsieur Truchon and Madame Gladu.
Both suffered from disabilities, but because they were not near the end of their lives, they were prevented from accessing the MAID regime under Bill C-14. This is because it was, at that point and even now, until the law is potentially changed, an end-of-life only regime.
I want to read for members what the court analyzed with respect to that, because we have heard a lot in this discussion that somehow what we are trying to do in Bill C-7 is discriminatory of persons with disabilities. The notion of discrimination under section 15 was squarely in front of the court in the Truchon case, and what the court said is quite the opposite. I am quoting from paragraph 678 of the Truchon decision. The court said:
The requirement at issue reveals a legislative regime within which suffering takes a back seat to the temporal connection with death. Where natural death is not reasonably foreseeable, the consent in suffering of the disabled are worthy only of the sympathy of Parliament, which has adopted a protectionist policy toward every such person, regardless of his or her personal situation. As soon as death approaches, however, the state is prepared to recognize the right to autonomy. This is a flagrant contradiction of the fundamental principles concerning respect for the autonomy of competent people, and it is this unequal recognition of the right to autonomy and dignity that is discriminatory in this case.
The judge went on, in paragraph 681:
By seeking to counter only one of the stereotypes that the disabled face—vulnerability—the challenge provision perhaps perpetuates another probably more pernicious stereotype: the inability to consent fully to medical assistance in dying. Yet the evidence amply establishes that Mr. Truchon is fully capable of exercising fundamental choices concerning his life and his death. As a consequence, he is deprived of the exercise of these choices essential to his dignity as a human being, due to his personal characteristics that the challenged provision does not consider. He can neither commit suicide by a method of his choosing nor legally request this assistance.
I read this into the record to remind parliamentarians that discriminating against anyone in Canada should not be countenanced. However, what was squarely before the court was whether the old regime was discriminatory against persons with disabilities who want to make autonomous choices about their passing, but were not near the end of their lives. The court found, conclusively, that the old regime was discriminatory. That is what prompted this and other changes to the legislation.
I think it is very important to understand that. When I, and others, talk about the heterogeneity among people with disabilities, that is what we are driving at. It is not for Parliament, in my respectful view, to impede, limit or curtail the competence and autonomy of persons, including persons with disabilities, who want to make significant choices about how and in what manner to end their suffering.
I think a compassionate response by this Parliament, a response that entrenches dignity, requires us to do the opposite. I know it is difficult. I know it is moral. I know it is an issue fraught with a lot of personal conviction, and that it is a difficult task for many of us, but that is the task before us as parliamentarians. As somebody who is familiar with discrimination law, I wanted to correct the record, in terms of what I have heard in today's debate and previous debates, about how discrimination plays into the analysis.
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2021-02-23 13:20 [p.4438]
Mr. Speaker, I thank the member opposite for his contributions today and in the past to this debate over the last many years.
The issue with respect to the social context and listening to disability rights organizations is one I concur with, and one I think our government would concur with. We cannot look at the perspectives and statements made by persons with disabilities without understanding the social context they are in, and the jurisprudence in the way the courts interpret discrimination bears that out.
I agree with him in that regard, but the point I made today and previously is that there is as much differentiation in the disability community as there is in many other communities, to echo the words of the member for Sherwood Park—Fort Saskatchewan, whether that relates to other marginalized groups, other vulnerable groups, etc.
With respect to the sunsetting and having a wide open study as opposed to a study that relates specifically to the mental illness condition, I have confidence in what we will hear from stakeholders. That is why I spent some time with the Quebec association of psychiatrists review. It provided extensive analysis about what it believes would be required should it be entertained, but it never presumed the end result of such a study. The medical establishment would—
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