moved that Bill C-268, An Act to amend the Criminal Code (intimidation of health care professionals), be read the second time and referred to a committee.
She said: Madam Speaker, I am proud to rise today to begin the debate on my private member's bill, Bill C-268, the protection of freedom of conscience act. I would be remiss if I did not acknowledge this bill is built on the hard work and determination of former members of Parliament. The first iteration that sought to address this issue was introduced by the late Mark Warawa in 2016, but it did not progress when the government introduced Bill C-14.
I do consider it a tremendous honour that my bill is the same number, C-268, as his was. After Bill C-14 was passed into law, my former colleague David Anderson introduced his private member's bill, Bill C-418, which died on the Order Paper when the election was called in 2019.
I would like to thank all those who have been championing this issue for many years and for their willingness to work with me.
Experts throughout Canada provided information and advice, while thousands of Canadians have voiced their support for protecting our fundamental freedoms. While there are numerous dictionaries that define conscience, they are consistent in defining it as an individual's inner sense of knowing the difference between what is right and wrong and that guides their behaviour.
An article by Cardus called “The Imperative of Conscience Rights” references the following:
“Conscience” traces to the Latin conscientia, and is related to the Greek synderesis. While conscientia refers to the application of our moral knowledge to particular situations, synderesis refers to the moral awareness built into each person and that urges us to do good and avoid evil.
Bill C-268 is straightforward as it seeks to enshrine in law a minimum national standard of conscience protections for medical professionals while respecting the jurisdiction of my provincial colleagues to expand on it. It is a response to calls from disability rights groups, first nations, the Ontario Medical Association and many hundreds of medical and mental health professionals to protect conscience rights.
It would ensure the medical professionals who choose to not take part in, or refer a patient for, assisted suicide or medical assistance in dying would never be forced by violence, threats, coercion or loss of employment to violate the freedoms protected in section 2(a) of the charter. This bill also serves to protect the rights of patients to receive a second opinion, and by doing so, would protect our health care system.
In my consultations, I spoke with disability rights advocate Heidi Janz. She told me about being born in the Soviet Union. Doctors told her parents that Heidi would never walk, talk or think and that she would be dependent on others for the rest of her short life. They told her parents to put her into an institution and forget they ever had her. Heidi Janz has severe cerebral palsy.
Her parents did not listen to the dominant narrative of their day. They loved their daughter and believed her life had value. Eventually, they found the support they needed. Today, Dr. Heidi Janz holds a Ph.D. and is an adjunct professor of ethics at the University of Alberta. In her spare time she is a playwright and author, and somehow, despite how busy her life is, she also serves as the chair of the ending of life ethics committee for the Council of Canadians with Disabilities.
Dr. Janz is a remarkable woman. While some might pity her, she will have none of it. She says that everyone talks about how bad it must be to have a disability, but that she chooses daily to live in opposition to that narrative. She also says that disabled people can be so much more than their diagnosis, and that she is proof of that fact.
If it had been up to the dominant view of her day, she would never have had the chance to disprove that narrative. If her parents did not have the option to find the help they wanted to get that crucial second opinion, none of my colleagues in this place would be hearing about this marvellous woman. This is not just a theoretical story.
In a similar vein, earlier this year the Minister of Crown-Indigenous Relations, who is a doctor herself, wrote to her constituents about her experience of ageism in our health care system as it related to her 93-year-old father.
While I will not repeat the whole story, I will just quote her last two sentences:
My Dad got better without needing the ICU, but I remember thinking that as an MD I had been able to firmly take a stand. I worried that other families wouldn’t have been able to question the clear ageism in the choices being put in front of them.
The minister's father and all Canadians have the right to find a doctor who will offer them hope, offer them another choice, offer them a second opinion. All Canadians deserve that same right.
Now, this is anything but a guarantee in Canada. We have passed laws that have the unintended consequence of forcing doctors and medical professionals to provide patients death, regardless of whether they believe it is in their patient's best interest. Bill C-14 and Bill C-7 create a federal standard for medical assistance in dying and assisted suicide, but not for conscience protections. Despite the claims of some, it is patently absurd to argue that a conscience rights bill would somehow interfere with the role of the provinces while the legalization of medical assistance in dying does not.
We are speaking of the very first fundamental freedom laid out in the charter. Ensuring that conscience rights are protected is the responsibility of Parliament and of the Government of Canada, which is why I introduced this bill and why it should be passed. Above all, it is the right thing to do for patients and medical professionals.
Some have tried to frame conscience rights as the rights of the patient versus the rights of the doctor. Nothing could be further from the truth. In fact, conscience rights are critical to how our health care system works. Patients have the right to a second opinion, but there can be no second opinion if every medical professional is forced to provide the exact same list of options.
Health care is fundamentally about the doctor-patient relationship. Take the case of a psychiatrist who supports MAID in certain circumstances, but who has spent 15 years counselling a patient who suffers from bouts of depression and suicidality. For 15 years, they have built up an understanding and trust. What would happen if that patient, suffering from a bout of suicidality, should demand assisted suicide? Under the current law, that psychiatrist would be forced to refer the patient to someone else so that the patient could die. The psychiatrist must do this, despite knowing that the suicidal thoughts are temporary, that otherwise the patient is joyful and loves life, and that ending that life is wrong. The psychiatrist's hands are tied. Is that what passes for medical care?
Some might claim that there are safeguards in place to prevent such tragedies, but I ask, are members completely sure? With the passage of Bill C-7, many of the safeguards have been removed. We are talking about ending a human life. There is no room for “maybe” when a life hangs in the balance. Should the first line of safeguards not be the expertise of the medical professionals who know best? If they do not believe death is the answer, should we not at least consider if they are right? This is, after all, a matter of life and death.
Medical assistance in dying and assisted suicide are readily available throughout all of Canada. There are information phone lines, hospitals staffed with willing medical professionals, even email addresses to help set up appointments. In a word, MAID is becoming the status quo. To claim that protecting the conscience rights of medical professionals will somehow block access for those who truly want it is both misleading and nothing but baseless fearmongering.
The Canadian Medical Association stated clearly that conscience protections would not affect access, because there were more than enough physicians willing to offer MAID. This is further reinforced by a McGill study that showed that 71% of recent medical school graduates would be willing to offer MAID.
Every court case on the subject, as well as common sense, has stated clearly that the charter rights of medical professionals are breached when they are forced to either offer or refer assisted suicide or medical assistance in dying. Surely, we are clever enough to ensure access to MAID while still protecting the fundamental charter right to freedom of conscience.
I believe it is no accident that former prime minister, Pierre Trudeau, placed conscience rights as the first of the enumerated rights in our charter. It is an acknowledgement that the state cannot and should not attempt to force any one of us to do what we believe is immoral.
Dozens of first nations leaders wrote to every MP and senator. They said that, “Given our history with the negative consequences of colonialism and the involuntary imposition of cultural values and ideas, we believe that people should not be compelled to provide or facilitate in the provision of MAiD.”
We claim to be a pluralistic, free society. If that is true, it demands of us a tolerance of the moral views of others. Some have argued that protections already exist in Bill C-14. While I applaud the former minister of justice, the hon. member for Vancouver Granville, for ensuring that conscience rights were acknowledged in that legislation, acknowledgement is no longer enough. There are examples of medical professionals being forced or bullied into participation in assisted suicide against their conscience.
Dr. Ellen Warner, an oncologist who has served her patients for 30 years, told me about her experiences. She said:
I think it will shock Canadians to hear of healthcare providers being coerced into participating in MAID, yet such coercion has been happening frequently. A brilliant colleague of mine was bullied into becoming the physician legally responsible for MAID on his hospital ward. It was a great loss to us when he left for a different position. Two other co-workers told me that, despite strong, moral objections, they would carry out MAID if asked to do so for fear of losing their jobs. At one of our staff meetings, a psychiatrist stood up and announced that any physician who does not actively support MAID should not be working at our hospital.
Finally, some have suggested that medical professionals should leave their morality at the door. However, no one truly believes or wants that. As an example, no one would want a doctor to forget their morality if they were offered a bribe to move someone up on a waiting list. If we hold our medical professionals to a higher standard, we cannot then tell them to ignore their personal moral standards. As Dr. Ellen Warner stated, “In the absence of conscience protection, the group with the most to lose are the patients—the people we are all trying to help,”
This bill would protect the doctor-patient relationship by ensuring that doctors and other medical professionals are always able to recommend and provide the care they believe is best for their patient. Canadians need this bill to pass. Canada's medical professionals need this bill to pass. Additionally, they will need individual provincial governments to protect their rights through provincial regulations and legislation.
I encourage all members in this place to do our part and pass the protection of freedom of conscience act.