Speech on Bill C-7, An Act to amend the Criminal Code (medical assistance in dying)

As delivered October 19, 2020.

Mr. Speaker, it is a privilege to have this opportunity to rise and speak on Bill C-7, an act to amend the Criminal Code (medical assistance in dying).

Not long ago, we in the House debated the merits of Bill C-14. I was a member of the justice committee when the committee was seized with doing that. That opened the door to physician-assisted death in Canada.

I want to begin my speech today with the same words that I used to open my speech on that bill: I believe in the sanctity of life, and I believe that all life, from conception right through to natural death, has value, has worth, and has purpose.

A pastor friend of mine told me a story that had happened just prior to the passing of Bill C-14 in 2016. A woman the pastor knew who had battled stage IV cancer for 10 years, savouring every moment of that time with her grandbabies and family, was told by one of her care workers, “I bet you cannot wait for the assisted-suicide bill to pass.” The pastor recalled the desperation in her tears when she called to recount her story, asking, “Has my life only become a burden to society?”

After the legislation was in effect, another woman was reunited with her childhood sweetheart and engaged to get married when her fiancé discovered that he had stage four cancer. Together they mustered up every possible hope for a future together, only to have their hopes dimmed by repeated offers for medical assistance in dying.

As the House now considers an expansion of MAID, I think it remains vitally important that the worth of every person is reaffirmed and underscored. It must be our priority in this place to remind every Canadian that they have value regardless of their age. They have value regardless of their ability. Their dignity is not determined by their suffering or their autonomy. It is intrinsic. It is inherent. Their lives are worth living.

I think these statements are important, because the reality is that every time we talk about expanding access to MAID, we send a troubling message to those who may be vulnerable: the idea that, if certain conditions or factors are present, somehow a person’s life has less worth; the idea that ending a person’s life is a mere medical decision among any number of medical decisions.

Expanding eligibility cannot be about removing safeguards and fundamentally redefining the nature and role of assisted death. This bill intends to offer assisted dying to individuals who are not dying, whose lives are still viable. This is a contentious issue that has been raised by multiple legal voices because assisted death was previously sold as an option only when death was imminent, or reasonably foreseeable.

In just four short years, we have embarked beyond that final stage of suffering. The whole health care system is feeling the pressure for acceptance of MAID, says Nicole Scheidl. Doctors and medical staff are feeling this pressure. Scheidl adds that the most terrifying thing about MAID is how it will impact the future of medicine, as only doctors comfortable with MAID will go into medicine, unless perhaps some provision is made for conscience rights.

Cardus executive vice-president Ray Pennings warns us that Bill C-7 does not take the protection of conscience rights seriously. He writes: “Conscience rights are Charter rights…including the rights of medical professionals not to participate in MAID in any way and the rights of hospices and other institutions not to cause the deaths of people in their care.”

There are other valid concerns as well: psychological suffering in combination with other permanent injuries potentially justified under MAID, the elimination of the 10-day waiting period, the requirement for only one independent witness as opposed to two, the waiving of final consent, and also that a witness cannot be a primary caregiver.

Even in its current form, internationally, MAID raises flags. When the United Nations Special Rapporteur on the rights of persons with disabilities visited Canada in 2019, she noted that she was extremely concerned about the implementation of MAID from a disability perspective. She flagged that “there is no protocol in place to demonstrate that persons with disabilities have been provided with viable alternatives when eligible for assistive dying.” She highlighted “claims about persons with disabilities in institutions being pressured to seek medical assistance in dying, and practitioners not formally reporting cases involving persons with disabilities.” Her advice was to “put into place adequate safeguards to ensure that persons with disabilities do not request assistive dying simply because of the absence of community-based alternatives and palliative care.” Instead, Bill C-7 goes the opposite direction in order to expand eligibility.

Let us not forget that every choice we make has a ripple effect of different magnitudes. Mother Teresa once said, “I alone cannot change the world, but I can cast a stone across the waters to create many ripples.” The world can be changed for better or worse. When vulnerable people start feeling like they are only a burden to society because of our actions, we need to consider what kind of culture we are creating.

Kory Earle, the president of People First of Canada, a national organization representing people with intellectual disabilities, expresses his concern that everything is already more difficult for people with intellectual disabilities, including exclusion, isolation, housing, resources when abused, education, securing jobs, social lives and finding friends. He further adds that even their word in court is not considered credible. Mr. Earle explains, “everything, and I mean EVERYTHING, is more difficult for people with intellectual disabilities. Many, many other things should be made easier. This [assisted death] is not one of them.”

Passing Bill C-7 is sending a message that individuals with disabilities are no longer safe. This concern is echoed in a joint statement by over 140 lawyers who fear the perception this bill gives, if even unintentional, the perception that life with a disability is inferior and if ratified by law, we diminish the choice to live with dignity and exasperates systemic discrimination.

On top of this, Canada has tragic statistics around suicide. An average of 10 people die by suicide every day. Statistics reveal that nine of those 10 individuals faced a mental health problem or illness. I know and appreciate that those suffering solely from mental illnesses are not eligible for MAID under Bill C-7, but we are nonetheless sending a devastatingly mixed message.

The former Liberal member for Winnipeg Centre raised these concerns when we were first considering Bill C-14. As he observed the rash of suicides in several first nations communities at that time, he expressed concern that “we haven’t thought out the complete ramifications that a decision like this might have on indigenous communities that seem to be suffering greatly.” In his speech, he shared one of his memories as a six-year-old child. His family was facing serious financial hardship, forcing his mother to go off in search of work. He and his younger brother were to stay with their father, who he described as “a residential school survivor, an alcoholic, and a member of gangs” with a “terrible temper”. The rest I will quote directly from the former member. He said:

“I remember climbing a tree in the back yard and wrapping a rope around my neck at the age of six… I wrapped that rope around my neck and thought, “Should I jump off into this universe, which is before me?” It was in that back yard that somehow I made the decision to climb down out of that tree and unwind that rope from around my neck. If in my life I had seen, or I had known, that my grandmother had somehow used physician-assisted dying or physician-assisted suicide, or others in my family had completed the irreparable act, then it would have made it much more difficult for me to continue.”

We must be mindful of the messages we send through this debate and always affirm life, but we must also do more than just offer words. We need to ensure that individuals facing end of life have access to the end-of-life care they deserve.

There are important questions we need to be asking to ensure those who are suffering truly have a choice between living well and pursuing MAID. For example, how do we better love those who live in unbearable pain, whatever form that pain takes? Feeling loved gives inherent strength to those losing hope. How do we show people how their lives teach us? How do their contributions strengthen us as individuals and a society? How do we instill in all people that they are not a bother, a financial burden or a disruption to deal with, but that their life is treasured? We must foster this type of society that affirms life and the pursuit of well-being.

As four physicians suggested in the National Post in response to the proposed legislation, increasing health care personnel, improving our quality of care, enhancing our palliative care options and ensure quicker access to psychiatric care would all be more advisable. Instead, we are “fast-tracking death on demand and dismantling the…[earlier] safeguards that were put in place to protect the vulnerable.”

We have all heard that only 30% of Canadians have access to palliative care and disability supports, which is possibly why there were 50 religious leaders who wrote an open letter urging us to consider that. It states: “Palliative care administered with unwavering compassion, generosity and skill expresses the best of who we are. Rather than withdrawing from those who are not far from leaving us, we must embrace them even more tightly, helping them to find meaning up to the last moments of life. This is how we build compassionate communities.”

Furthermore, the joint statement by 140 lawyers explains that singling out non-life threatening illness and disability as eligibility criteria for assisted death undermines section 15 of the Canadian Charter of Rights and Freedoms’ protection against state action that directly or indirectly stigmatizes persons living with illness or disability, or would write people off because of their impairment.”

Do we not long for a Canada where we support one another? Where we give one another hope and encouragement during dark times? We have the ability to instill optimism and reassure many Canadians – those struggling with mental illness, those living with disabilities, and so many more – that we want to build a Canada that affirms their right to life. I know we are concerned about where each ripple lands in terms of the signals this legislation sends.

Let me conclude that I can appreciate that Bill C-7 is responding to the Quebec Superior Court in Truchon but its judgment was focused on the Charter rights of only two plaintiffs—not the rights of the more vulnerable who will get caught up in its ripples. Our job as parliamentarians is to factor in the rights of everyone—including our most vulnerable.