Madam Speaker, it is a pleasure to be here today because a lot of things need to be said about Bill C-7. For those who are not aware, it is an act to amend the Criminal Code with respect to medical assistance in dying.
Members know I was in Parliament when Bill C-14, the predecessor of this bill, was debated. I heard the debate and discussions about the safeguards that needed to be put in place to make sure we did not go down the slippery slope that many other countries went down when they began to allow assisted suicide and branched further into euthanizing individuals.
Knowing all the discussion and thought that went into the reaction to the Carter case, I am very troubled and disappointed that when the Quebec lower court ruled the reasonably foreseeable death provision was unconstitutional or would not be accepted in Quebec courts, the government did not put this forward to the Supreme Court. I feel as though the Supreme Court was involved in the Carter decision in the first place, as it laid out the provisions it thought would be reasonable. A reasonably foreseeable death was one of them, so this should have gone back to it for commentary before coming to this place.
With that in mind, I am also disappointed that the government has not moved forward on the palliative care provisions that were also a clear recommendation from the special committee that studied the Carter decision. It said that without good quality palliative care, we do not have a real choice.
As members know, I brought a private member's bill to the House on this, which was unanimously supported here and in the Senate. I worked with the health minister of the day to put together a framework across Canada to get consistent access to palliative care for all Canadians, because 70% of Canadians have no access to it. As per the Carter decision and the special committee, if we do not have good quality palliative care, we really do not have a choice.
I was disappointed to not even see “palliative care” mentioned in the fall economic update. The words were not even there. The fact the government would prioritize expanding medical assistance in dying without the input of the Supreme Court and without putting provisions of palliative care in place seems to be the wrong priority. Let us let people live as well as they can for as long as they can instead of encouraging them to die. I think that is where we as compassionate Canadians want to go.
Another thing the Liberal government fell down on is the choice not to do the five-year review. When Bill C-14 came through, one of its provisions was about looking at the situation after five years so we would understand whether or not the rules that were put in place were being followed, were adequate and met the intended purpose. That was not done. This was a perfect opportunity for the government to do that work, because we heard anecdotally that in many cases across Canada, the existing rules and safeguards have not been followed. We need to get a quantitative analysis on that and understand how these things could happen and how we can prevent them from happening in the future.
It is disturbing, then, that the government has decided, without doing the five-year review, to make changes to what is happening with respect to medical assistance in dying beyond what was asked for by the Quebec courts. Doing something without reviewing what one already has in place is irresponsible, in my view.
Given that, I have some concerns. The government has removed many of the safeguards put in place in the bill to keep those unfortunate things that we worried about when we were discussing C-14 from happening. For example, there is the 10-day cooling-off period. As anyone who has had relatives suffering through irremediable conditions knows, they have good days and bad days, and on the bad days they can feel like they want to die.
My mother just died in October. At the very end, she was in a lot of pain. I talked to her about medical assistance in dying and it was not something she wanted; she wanted palliative care. I am fortunate that in Sarnia—Lambton we have palliative care. One day she told me she was really thinking about it, but the next day it was not something she wanted, so I really think that 10-day cooling-off period was an important safeguard.
I am sympathetic with one of the changes that was put in, although it should have been put in after the five-year review. It says that once people have signed off on all the documents and the independent witnesses and others who understand the condition have dotted all the i's and crossed the t's, a person perhaps will not be able to give consent immediately before the procedure. I saw this in my mother's situation. At the end, she would not have been able to verbally communicate or even write to indicate her choice, should that have been her choice.
However, removing the 10-day safeguard was a mistake. The Conservatives brought an amendment to try to put it back in and explained why it was important, but it was not received.
The other thing I found troubling was the removal of the independent witnesses. We cannot even get a will without having an independent witness. It seems to me that for something as important as determining one's date of death, it should be a provision.
In Ontario, there is another difficulty, which has to do with conscience rights. There are people who do not want to participate in medical assistance in dying for religious reasons or for personal reasons of conscience, and that is their charter right. This means they do not want to participate in the act and do not want to refer. They do not want to have anything to do with it. In Ontario, medical people are being forced to at least refer. That is still a violation of their conscience rights, and it is troubling that in the debates on Bill C-7, when I asked these questions the Parliamentary Secretary to the Minister of Justice said there are plenty of safeguards in there and it is okay. No, it is not okay. They are still violating rights of conscience and that needs to be addressed as well.
A modified advance consent was opened up to allow people to indicate, 90 days in advance, that they want to have this procedure. Advance consent was studied by one of the committees chartered by Parliament. Its recommendations said that a lot of things need to be considered before we go down the advance consent path. The government has not really done its five-year review, and I remember the member for Vancouver Granville commenting on this very point. There is a lot to be thought out there, and if we do not do it correctly, we will once again have a situation where the intent of the bill is not going to be met. There are going to be new violations in the way we have heard anecdotally, and that will not be a very good situation.
I was happy to see in Bill C-7 the clarification to indicate that if the sole underlying medical condition is mental illness, individuals are not eligible for medical assistance in dying, although there is some controversy there. I have heard from groups across Canada that are calling on the government to allow individuals whose underlying suffering condition is mental illness to receive medical assistance in dying. I think it is not a good idea, and I believe this is in line with what was said by the committee that studied this part of medical assistance in dying. It said many of the mental illness conditions, such as depression, could be treated. These are treatable conditions, not irremediable conditions, and some are glad to see this loophole closed.
The bill intends to:
permit medical assistance in dying to be provided to a person who has lost the capacity to consent to it as a result of the self-administration of a substance
We talked about this when Bill C-14 was in this place. At that time, we were not sure about the method of application of medical assistance in dying, whether it could be done with a prescription or not, and there was a concern: What if the procedure went wrong and a person cannot give consent? What do we do then? I am glad to see that situation was addressed in the bill.
Overall, those are my concerns with Bill C-7, and I think the government needs to go back to the drawing board on it. As 50% of the Canadian public seem to be concerned about the existing bill, such as people with disabilities and mental illness, let us go back to the drawing board.