44th Parl. 1st Sess.
February 13, 2024 10:00AM
Mr. Speaker, the member for Salaberry—Suroît is a tough act to follow. This is not easy, because we all have someone in mind when we talk about this. We have all lost loved ones over the past few months and years. We all have gone through different experiences. Some people request medical assistance in dying, others do not, but one thing is certain: this is a very sensitive topic. It is with great humility and sensitivity that I rise today to speak to Bill C-62, an act to amend An Act to amend the Criminal Code (medical assistance in dying), no. 2, something we have been talking about for a long time.
We must act by considering the fact that, currently, the Government of Quebec's Bill 11 does not include non-neurocognitive mental disorders as being eligible for medical assistance in dying and that Quebec wants to fill the administrative void surrounding the federal government's position on the subject of mental disorders relative to neurocognitive disorders. Therefore, I am not here to repeat my whip's testimony. I am here to provide some background and talk about Quebec's specificities. I will close by going into more detail about the Bloc's position.
First, in 2014, Quebec passed the Act Respecting End-of-Life care after five years of consultations and of working together across party lines. I want to emphasize that the work was non-partisan. In 2015, the Supreme Court ruling in Carter indicated that some provisions of the Criminal Code that prohibited medical assistance in dying contravened the Canadian Charter of Rights and Freedoms. In 2016, the Liberal government passed Bill C-14, in response to Carter. In 2019, the Quebec Superior Court ruled in favour of Nicole Gladu and Jean Truchon, who claimed that excluding people whose death was not reasonably foreseeable from eligibility for medical assistance in dying was discriminatory. As a result, the court ordered that federal and provincial laws be amended before December 18, 2020.
In 2021, after a pandemic-related delay, Parliament passed Bill C‑7, which created two pathways to medical assistance in dying: One for those whose death is reasonably foreseeable and one for those whose death is not reasonably foreseeable. Quebec simply chose to drop the end-of-life criterion. Bill C‑7 required that an expert panel be created to review MAID and mental illness. The Expert Panel on MAID and Mental Illness was formed in August 2021 and produced a final report containing 19 recommendations. Recognizing that the legislation was flawed and that issues related to medical assistance in dying remained unresolved, Bill C-7 created the Special Joint Committee on Medical Assistance in Dying, composed of members of the Senate and members of the House of Commons, which had a five-part mandate.
The joint committee tabled an interim report on June 22, 2022. There was not much time between the tabling of the joint committee's report, which was initially expected in 2022, and the March 17, 2023, deadline for excluding people from MAID for mental illness, so members postponed eligibility for one year to allow the committee to finish its work. The goal was to give the professions involved more time to develop standards of practice. At last, in February 2024, the joint committee produced its final report. The report contains only one recommendation. Bill C‑62 implements the report's recommendation by postponing eligibility for MAID MD-SUMC, for mental disorders, for three years and by forcing the creation of a joint committee one year before the report.
Sections 241.1 to 241.4 of the Criminal Code govern medical assistance in dying in Canada. What is more, under the law, the government is required to oversee the use of medical assistance in dying via the Regulations for the Monitoring of Medical Assistance in Dying. I am providing all of this background to illustrate that the government could have and should have taken action a long time ago.
Second, in Quebec, medical assistance in dying is governed by the Act Respecting End-of-Life Care. The activities surrounding medical assistance in dying are supervised by the select committee on end-of-life care. In June 2023, the National Assembly of Quebec passed Bill 11 to expand access to medical assistance in dying in Quebec and harmonize Quebec's legislation with the Criminal Code. There are some notable changes to Quebec's legislation. Minister Sonia Bélanger and her colleagues Roberge and Jolin‑Barette held a press conference on February 7 calling on the government to include a provision in the Criminal Code that would allow Quebec to move forward with advance requests, because, even though Quebec's legislation allows it, the Criminal Code does not.
Although doctors who choose to go ahead with advance requests are unlikely to be prosecuted by Quebec's attorney general, the risk of a civil lawsuit is still there, and that will make many doctors think twice about granting advance requests. Quebec's National Assembly has passed a unanimous motion demanding that the federal government legislate on the issue.
Third, the Bloc Québécois will vote for the bill on the condition that the postponement is for one year, not three. The Bloc Québécois believes that eligibility for people suffering from mental disorders must be postponed so that Quebec, the provinces and professional bodies can create a framework for their MAID practices. However, it should not be postponed indefinitely. The Bloc Québécois believes that postponing eligibility by three years will prolong the suffering of individuals who could be eligible for MAID and is contrary to their rights as guaranteed by the charters. The Bloc Québécois wishes to point out that the report of the Expert Panel on MAID and Mental Illness, as well as the Collège des médecins du Québec, emphasized that the safeguards—namely irremediability, severe physical or mental suffering, and free and informed consent—currently provided for in the Criminal Code are sufficient to allow access to MAID where mental disorder is the only underlying condition.
In our supplementary opinion attached to the report of the Special Joint Committee on Medical Assistance in Dying, the Bloc Québécois points out that, even though preparations on the ground for medical assistance in dying when a mental disorder is the sole underlying medical condition are not yet complete across Canada, this does not change the fact that several professional associations, including the Collège des médecins du Québec and the Association des médecins psychiatres du Québec, would still like it to be made available in the future.
The Bloc Québécois also acknowledges the requests made by several provinces to postpone eligibility. It should be noted that many countries have adopted policies on medical assistance in dying specifically for mental disorders.
The Bloc Québécois deplores the government's failure to be proactive and the Conservatives' obstruction on the issue of medical assistance in dying when a mental disorder is the sole underlying medical condition and on the issue of advance requests. We fear for the patients who will have to turn to the courts to assert their rights while also bearing the burden of their illness.
Finally, the Bloc Québécois condemns the fact that this bill does not distinguish between mental disorders and neurodegenerative diseases, such as Alzheimer's and Parkinson's. Quebec's law makes that distinction. It would allow people suffering from the latter category to access medical assistance in dying, as advocated by the Quebec government. In the Bloc's opinion, the social consensus on these illnesses is stronger, and it would have liked to see the Criminal Code brought into line with Quebec's end-of-life care law by allowing advance requests.
In his supplementary opinion on MAID, the member for Montcalm, whom I would like to congratulate for all his work on this issue, went into great detail on the reasons that justify MAID when a mental disorder is the sole underlying condition. The position of the Collège des médecins du Québec perfectly sums up the importance of allowing advance requests for medical assistance in dying, as well as medical assistance in dying when a mental disorder is the sole underlying condition. While admitting it needs more time to ensure its members are ready, the Collège des médecins du Québec has established five guidelines for assessing eligibility for medical assistance in dying.
In conclusion, the Bloc Québécois has a humanist view of medical assistance in dying that is grounded in philosophical principles and ethical arguments that reflect the evolution of Quebec society. Medical assistance in dying recognizes the right of individuals to choose for themselves, to determine the conditions for a healthy and dignified life. Medical advances allow us to sustain life, but that does not preclude the need and right of the individual to define what is an acceptable life. Section 1 of the Quebec Charter of Human Rights and Freedoms states that every human being has a “right to life, and to personal security, inviolability and freedom”.
Quebec society believes that the right to life includes the right to die. In that context, we need to see medical assistance in dying as a right that gives the individual the option of avoiding terminal suffering and medical paternalism in order to maintain their dignity. By allowing medical assistance in dying, we allow people to choose how, when and where they want to pass away.
Medical assistance in dying only makes sense if the person's free and informed consent is respected. The word “free” means voluntary and without constraint, and the word “informed” means with all the information needed to make such a decision. Meeting this condition is necessary for accessing medical assistance in dying.
The principles we stand for concerning medical assistance in dying are equally valid in cases of mental illness. Let us not forget that the possibility of access to MAID does not mean automatic eligibility. However, when the Quebec select committee was doing its work, it made a distinction between mental disorders and neurodegenerative diseases. The commission concluded that although there was no consensus on mental disorders, there was a consensus on neurodegenerative diseases. With that in mind, the Quebec government opened the door to advance requests. Advance requests allow an individual to determine the conditions under which MAID should be administered when they have lost the capacity to consent because of their illness.
In its second report, the Special Joint Committee on Medical Assistance in Dying expressed its support for advance requests. All parties, except the Conservatives, who are against any form of medical assistance in dying, voted in favour of the recommendations.
As a final point, the federal government therefore has no reason to drag its feet or to deny Quebec's request.
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- Feb/13/24 5:00:45 p.m.
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Mr. Speaker, I am glad my colleague from Montcalm has arrived. He can answer that question as well as I can, and he must have heard a thing or two from the Conservatives at the Special Joint Committee on Medical Assistance in Dying. I sincerely sympathize with him. As my whip herself said earlier, we can hardly believe what we have been hearing since this debate began.
I am speaking today because I have been hearing about this bill from seniors' groups ever since I was named the critic for seniors. They have certainly made me aware of this issue. Seniors' groups in Quebec want this freedom of choice.
I have said this before, but I will say it again because I think it is appalling. Anyone who says that seniors are going to food banks to request medical assistance in dying is engaging in blatant and serious disinformation.
This debate reinforces my conviction about why states must be secular. This is an example of why it is dangerous to let religious elements participate and pay for a political party's leadership race in Canada.
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- Feb/13/24 5:03:06 p.m.
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Mr. Speaker, I talked about the Conservatives' obstruction. Unfortunately, I could also talk about the Liberals' inaction, which is why we are still here today, why this file was delayed. What is more, they are asking us to wait another three years. Enough is enough.
As for my colleague's remark, the Conservatives are bringing up cases that might have more to do with the justice system. Before being elected, I worked on the issue of elder abuse. These are isolated cases and they have more to do with the justice system.
In the case at hand, we are talking about professional bodies. I talked about it in my speech. We are also talking about a joint committee made up of senators and MPs who worked hard and proved that the safeguards are there and that, no, it is not true that a person can ask for medical assistance in dying as easily as ordering food in a restaurant.
It is not true. There are safeguards and, in Quebec, this is clearly understood. What we need to do is to let ourselves be guided by the scientific evidence and by what professional bodies are saying, not by isolated cases and regressive religious attitudes.
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Madam Speaker, if I may, I would like to wish my daughter Naomie a happy second birthday and tell her that mommy loves her very much. It is a bit in keeping with the theme of the bill before us, since we are talking about children, and I am certain she is paying close attention right now.
Some bills are tricky to explain, especially when they are about children, and particularly given that, in Quebec, we are crazy about our kids. That being said, I want to state from the outset that the Bloc Québécois will be voting against Bill C-273 to prevent it from being studied in committee. I will begin by explaining why we made this decision. I will then describe the context surrounding this bill and, finally, I will explain why it is a bad idea masquerading as a good one.
First of all, the Bloc Québécois is once again advocating a balanced position on this sensitive issue. We are going to be the adults in the room. As such, we believe that the law must include reasonable defence mechanisms to help maintain public confidence in our rule of law.
The bill essentially aims to repeal section 43 of the Criminal Code, which provides a defence to parents as well as teachers if they use reasonable force to correct a child. This could be described as child discipline and parental discipline.
Section 43 states, “Every schoolteacher, parent or person standing in the place of a parent is justified in using force by way of correction toward a pupil or child, as the case may be, who is under his care, if the force does not exceed what is reasonable under the circumstances.” That is clearly stated.
Second, as we have seen in the media, a movement has taken off in recent years. This movement calls for an end to all forms of corporal punishment of children and young people, including the repeal of section 43 of the Criminal Code. A number of stakeholders and groups like Corinne's Quest have expressed their support for the idea that parliamentarians should remove this provision from the legal framework once and for all. Initiatives with that goal have been introduced in the House of Commons and the Senate as recently as 2022.
It is important to recall that, in 2004, the Supreme Court considered the issue and upheld the constitutionality of section 43. It can be used as a defence to charges of assaulting a child. To avoid legal pitfalls, we believe it remains relevant to the exercise of parental or teaching authority, as long as it is reasonable.
In Canadian Foundation for Children, Youth and the Law v. Canada, the highest court interpreted section 43 of the Criminal Code. Section 43 was challenged on the basis of sections 7 and 15 of the Canadian Charter of Rights and Freedoms, which guarantee the right to security of the person and the right to equality respectively, but it was not struck down because the protection it offers is limited. As a result, it does not exclude the possibility of charges being brought and possibly even criminal sanctions being imposed when excessive force is used against a child.
As soon as that force becomes anything more than transitory or trifling force to control the behaviour of a child or as soon as it becomes harmful or degrading for the child, then the protection offered under section 43 no longer applies and the behaviour in question can be considered criminal. This protection is exercised reasonably and the circumstances are taken into account. The Supreme Court found that force may not involve objects, such as rulers or belts, and it may not be applied to the child's head.
The removal of section 43 from the Criminal Code would mean criminalizing the normal behaviour of parents who are trying to put their child to bed and of teachers who have to physically control a child to remove them from the classroom or take them out of a dangerous situation, such as a fight.
Without a protection mechanism, prosecutors can still exercise their discretion to prosecute or not. However, once charged, parents and teachers would lose legal recognition of the educational role they play, which could justify these behaviours. Psychology has shown that removing this legal recognition can have consequences.
Third, the NDP's Bill C‑273 is an all-or-nothing proposal: either repeal section 43 or not. The fact that the NDP is unwilling to compromise when it comes to justifying actions intended to physically control a child or youth stems from its ideology.
An example of a compromise would have been to repeal section 43 but to add a new provision that indicates that the behaviour cannot be criminalized if the force is used to protect the child from a threat or danger, to prevent the child from committing a crime, or when performing the normal daily tasks that are incidental to good parenting.
The NDP's proposal is not the good idea that it appears to be. With the rise in violence in our schools, we cannot take away the few protective measures that teachers have at a time when they need to manage students who are less and less respectful of authority. Criminalizing by default force that is used to reasonably control a misbehaving student does nothing to encourage efforts to recruit educators.
That is a very real issue right now. For example, a Radio-Canada article written by Alexandre Duval last year stated that in 2021, “education centres in Quebec reported twice as many violent acts as in 2018-2019, before the pandemic”. There is no denying that increase, and we cannot add to teachers' mental burden by increasing the risk of lawsuits and taking away their ability to intervene if situations get out of hand. The article states the following:
At the Centre de services scolaires des Affluents in Lanaudière, reports of physical and verbal violence more than doubled over the same period, from 757 to over 2,000. This represents an increase of 164%. A comparable increase of 141% occurred in cases reported at the Centre de services scolaires de la Beauce-Etchemin. Just over 400 violent acts were reported in 2021, compared with 979 last year.
I would like to share a personal story. Before I was elected, because I love children so much, I was lucky enough to work as a monitor in an elementary school, where I had to deal with various situations. I had a ball thrown at my face, which broke my glasses. I saw children in crisis attacking their classmates. This was clearly a safety issue for the student involved and for the others. That is to say nothing of all the times I walked into a classroom and the teacher was trying to get some of the more unruly students under control. I witnessed some pretty disturbing scenes.
This bill would make it difficult for staff to intervene. In fact, I myself would have had concerns about intervening to restore a sense of security in such situations. We have to be extremely careful because the law already exists and we cannot use excessive force on a child. We obviously do not want to harm a child. Earlier I mentioned the 2004 ruling on section 43.
The research I did in preparation for this speech also led me to a report from the Institut national de santé publique du Québec that focused on violence and health and addressed the issue of bullying and violence at school. Violence can occur between students as well. Staff have to be able to take reasonable action if the other students are in danger.
In conclusion, the Bloc Québécois believes that our schools can be safe places for everyone and that our teachers play a key role in preserving a harmonious environment that is conducive to learning. We need to have a legal framework that is respectful of parental and teaching authority, provided it is used reasonably. It is a matter of education, but also of safety. As I was saying earlier, it is also a matter of knowing how we want to intervene with children, but it needs to be done reasonably. That is why we are voting against Bill C‑273. Again, the NDP is proposing an idea that is not as good as it seems and that might end up criminalizing the behaviour of parents and teachers who are acting in good faith.
I would like to point out one last thing. We all want the best education for our children, but we need to keep the tools that we have for taking action and protecting them. No one wants to use excessive force against a child. If there is a problem, then we want the justice system to be able to do its work. What we are seeing right now is that there are risks involved in repealing section 43. There is the risk of additional pressure on staff and the risk of error on the part of some parents. For all of these reasons, once again, the Bloc Québécois will be voting against this bill, which addresses this extremely sensitive issue. Let us remember that, first and foremost, we want to make children's welfare a top priority for elected officials in the House.
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