44th Parl. 1st Sess.
October 05, 2022
- Bill C-230 is an amendment to the Criminal Code of Canada that aims to protect health care professionals from being intimidated or discriminated against for their refusal to participate in medical assistance in dying (MAID). The bill makes it an offense to intimidate a medical practitioner, nurse practitioner, pharmacist, or any other health care professional in order to force them to be involved, directly or indirectly, in providing MAID. It also makes it an offense for employers to refuse to employ or dismiss a health care professional solely because they refuse to participate in MAID. The purpose of this bill is to safeguard the freedom of conscience and religion of health care professionals who object to being involved in MAID.
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Mr. Speaker, I rise in the House today to speak to a private member's bill, Bill C-219, the Canadian environmental bill of rights, brought forward by the member of Parliament for South Okanagan—West Kootenay.
Before I speak to the bill, I would like to take this opportunity to recognize former MP Linda Duncan for her important work on this bill in previous Parliaments.
I would also like to acknowledge that, much like the bill's former sponsor, the bill's current sponsor, the member for South Okanagan—West Kootenay, has dedicated much of his career to being an educator and proponent of conservation and environmental protection. I thank him for his important work in these areas.
Returning to Bill C-219, the bill proposes to recognize the right of every person residing in Canada to a healthy and ecologically balanced environment and to amend the Canadian Bill of Rights to include this right as part of the right to life, liberty and security of the person. The bill also sets out a number of procedural rights. These include the rights to access information and participate in environmental decision-making, request reviews of federal environmental laws and policies, and access courts and tribunals for matters regarding the protection of the environment.
While the purpose of Bill C-219 and its proposals are intuitively appealing at first glance, upon deeper reflection and examination, they raise a number of significant legal, practical and policy concerns.
The government recognizes that environmental stewardship is essential for the well-being and prosperity of Canadians, and it is devoted to working with the sponsor and all members of Parliament to secure a healthy environment.
The Minister of Environment and Climate Change has been mandated by the Prime Minister to follow the clear direction given by Canadians, to take bold, concrete action to build a healthier and more resilient future. More specifically, the Minister of Environment and Climate Change was tasked with recognizing the right to a healthy environment in federal law and introducing legislation to require the development of an environmental justice strategy.
We have taken action to meet these commitments. On June 13, a right to a healthy environment was recognized under the Canadian Environmental Protection Act, 1999, known as the CEPA. With the passage of Bill S-5, work is under way to begin developing an implementation framework, which must be completed within two years of royal assent. It would set out how the right must be considered in the administration of the CEPA and, thus, bring the lens of a right to a healthy environment to the programs that the CEPA enables.
The government has also committed to making an environmental justice strategy a reality by supporting a private member's bill, Bill C-226, an act respecting the development of a national strategy to assess, prevent and address environmental racism and to advance environmental justice. Instead of introducing its own bill, and in line with the government's support of Bill C-230, the government reaffirmed support for Bill C-226.
If Bill C-226 passes, the national strategy would provide an opportunity to examine the link between race, socio-economic status and exposure to environmental risk, as well as to discuss how best to address environmental risks faced by historically marginalized communities.
It would help structure discussions on addressing these inequalities and discrimination, which are the root causes of many vulnerabilities. It would also complement other efforts that contribute to advancing environmental justice in Canada, even where the cause of environmental injustice or environmental racism may not have been directly identified or acknowledged. Supporting and advancing these initiatives is where our focus should be now, especially given the flaws in Bill C-219.
I will now turn to outlining a few specific issues with Bill C-219. Although both bills recognize a right to a healthy environment, the approach in Bill C-219 is at odds with the approach that was taken with Bill S-5, which is now in the amended CEPA.
I will first talk about the path we are currently on following the passage of Bill S-5 and then address how Bill C-219 clearly departs from it. As we know, Bill S-5 recognized that every individual in Canada has a right to a healthy environment under CEPA, the cornerstone of federal environmental protection laws. The right to a healthy environment is a new concept in federal law. Given this, Bill S-5 included clear and robust provisions on the process to describe how this right would apply under CEPA and how it would be reported upon annually.
Bill S-5 proposed that the meaning of the right under CEPA be developed in consultation with Canadians and elaborated upon through a concrete implementation framework to ensure that the right is meaningful and tailored to the regime at hand. That framework, which is now under development, will set out how the right will be considered in decision-making. It will also describe how related principles, such as environmental justice, nonregression and intergenerational equity, will be considered. I believe these additional details are very important.
Bill S-5 provided a concrete path for clarity and greater certainty over time on what adding a right to a healthy environment to CEPA will mean. It also included related amendments that would support the protection of that right, built from established procedural rights and specific provisions for public participation, including public comment and notice periods and the right to request investigations into alleged offences.
While we are already on this well-considered path, which has been carefully studied here and the other place, Bill C-219 proposes a very different path. The approach in Bill C-219 is unclear. It would likely lead to uncertainty in its application and we would have to resort to the courts to resolve the issues. The bill recognizes the right to a healthy environment, which is still a novel and undefined concept, but it does not set out its meaning or provide a process, such as the implementation framework in Bill S-5, to work out the definition and how it applies. That very likely means it is the courts that will determine what it means in the course of litigation.
The right to a healthy environment in Bill C-219 is broad and applies to all federal laws, and it is difficult to predict how it would be interpreted by the courts. We must avoid environmental rights being so unclear that timeliness and certainty in federal decision-making are compromised and the right becomes a burden falling on litigants to operationalize.
The approach already adopted via Bill S-5 is different, and I will remind the House that it is also better. Our approach is centred on public consultations and proposing a concrete way to elaborate on the meaning and the content of the right through an implementation framework. It applies only to CEPA, the pillar of federal environmental protection laws. This is what an issue of this novelty and complexity demands.
If Bill C-219 goes ahead, we would end up with two different versions of the right to a healthy environment in federal statutes, one set out in CEPA through Bill S-5 and another set out in Bill C-219. This would result in two different framings of the right and two ways to implement it. The misalignment between the two approaches could hamper progress on this important and complex issue and slow down decision-making across government. If the main objective is to truly secure a healthy environment for Canadians, moving forward with the approach that is now set out in the amended CEPA is the only prudent approach. We cannot just suddenly endorse and bring in the new and uncertain elements of Bill C-219.
Bill C-219 would also make changes to the Federal Courts Act and the Canadian Bill of Rights. The Canadian Bill of Rights is not an appropriate statute for a new environmental right. As I said earlier, our government is committed to taking bold, concrete action to build a healthier and more resilient future with measures that are clear and effective. The proposed Canadian Bill of Rights amendment could provide neither clear nor effective guidance on this front.
The Canadian Bill of Rights only codifies pre-existing rights as they were understood in 1960. For more than 60 years, that has been its sole purpose. Its interpretation always refers back to those historical origins. With the proposed amendment, Parliament would recognize and declare, through section 1 of the Canadian Bill of Rights, that there “have existed” historical rights that have already included a right to a healthy and ecologically balanced environment.
It is uncertain how courts would attempt to interpret this new but backward-looking right, what pre-existing content they would find in it and where they would look for it. Not only would the amendment be wholly unclear, but it would introduce significant uncertainty into the interpretation of the Canadian Bill of Rights itself.
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Mr. Speaker, I would like to start my comments with respect to Bill C-226 and acknowledge that we are here today on the traditional unceded territory of the Algonquin people. The land acknowledgement is really important in understanding why we are talking about this bill. It is because what we are discussing really impacts the marginalized, racialized and indigenous communities of this country, which have struggled with environmental injustice for decades.
I am honoured to rise this evening to speak to Bill C-226 because, as mentioned, this bill has been sponsored by the member for Saanich—Gulf Islands. I will note, as she did, that it was first introduced in the 43rd Parliament by a friend and colleague, Lenore Zann, who is the former member of Parliament for Cumberland—Colchester. I had the honour and privilege of working on that bill in the 43rd Parliament with my colleague from Victoria. As the member for Saanich—Gulf Islands noted, bringing the bill to this point really does feel like a mothering process in many ways. We are getting to see this day come for what we knew, as women, was so important for so many vulnerable communities across this country from coast to coast to coast, and we are getting the bill to where it is today in the chamber.
Until its introduction in the previous Parliament, environmental racism had been recognized as a problem for quite a long time, particularly in the United States, but it was still a fairly new concept here. We were not sure how to address it or discuss it. With its passage, this legislation would require for the first time a national strategy to address environmental racism. This whole process, whether it was in the 43rd Parliament or where we are now, has encouraged us to finally have this important conversation because many women and many leaders across this country have been having this conversation and pushing this issue for decades.
It comes at a time when Canadian society has a renewed focus on trying to understand the essential work of combatting both systemic racism and climate change. For many it was a question of how these things go hand in hand, but they do. Environmental racism really has to be part of the conversation when we talk about climate change. We cannot ignore what was really a blind spot for many in terms of addressing what environmental justice is.
We have talked about unconscious bias when it comes to racism and the potential unintended consequences, even in the House recently, of the many issues we are discussing that lead to racism in our society. Being Jewish, I see a rise in anti-Semitism now as well. We have to talk about these things, even when they are uncomfortable, and environmental justice is included in that.
We are in the process of updating the Canadian Environmental Protection Act at this time. It is a very good sign that here in this place, we are making sure that environmental racism and the right to a healthy environment are part of the debate and the discussion tonight, as well as in the environment committee and other spaces.
Environmental justice and the impacts of environmental racism are now an important part of the national conversation and not just here in this chamber but with the many folks we have met along the way. Whether we look back at Bill C-230 in the 43rd Parliament or we look at Bill C-226 today, the advocates across Canada have really been pushing us along and mothering this bill in many ways. It is important to define and frame the conversation so that we understand why it is so important.
Environmental racism happens when environmental policies or practices, like the placement of polluting industries, result in a disproportionately negative impact on groups or communities based on race or colour. Affected marginalized communities often lack the political power to influence decisions or advocate for stronger standards. That is why they rely on us, as parliamentarians and as these women's voices, to push this along.
It has become increasingly apparent that environmental benefits and harms are not shared equally. We talk about equity in many other aspects of Canadian life, but it is important that it is placed clearly here as well because environmental justice and environmental equity should be shared equally among all members of our society. This is not a new problem, but it is a new realization. Those in power have not discussed this in terms of addressing it with our marginalized groups, who have finally said it to us. Dr. Ingrid Waldron shared that for 70 years, communities in Nova Scotia have been waiting for us to have a substantive discussion on this. That time has come.
Indigenous and racialized communities, particularly those with lower socio-economic status, bear a disproportionate share of the environmental burdens and consequences when we deal with pollution, exposure to toxic substances, and land and water degradation. There is no magic bullet to fix this. I do not think anyone in good faith would suggest that the bill's purpose is to do that. I know that in previous debates, some of my Conservative colleagues said there is no point as we will never get it done. There is no magic way to fix systemic racism. There is no magic way to fix climate change. However, we have to start. We have to begin the process, and Bill C-226 clearly has the first steps.
At the end of the day, we want to make sure that no one's health is compromised and no one's quality of life is compromised because of where they live or, more importantly, because of who they are. This is about ensuring the health and dignity of all peoples regardless of their background. It is not a bill of one-off action. I know my colleague from Saanich—Gulf Islands has asked for us to consider a more robust approach than the national strategy, but I really want to applaud that we have gotten here to the first step.
Communities across the country have been affected, whether through higher rates of cancer and other diseases or through the destruction of local habitats and natural environments. At the end of the day, we have to address those environmental impacts so that the quality of life for these communities going forward, after years of disproportionate impacts, starts to change.
I know my time is coming to an end, so I want to circle back to the idea of women. I think there is a really important role for them to play. The member for Saanich—Gulf Islands, the member for Victoria and I have been involved in this process, as have others. As women, we are the ones who notice things first. We are the observers, often in silence, of the damage being caused around us. We know when things are off. We know when someone is not okay. We know when someone's health has been compromised because we have watched it from generation to generation.
To each of the women who were part of the journey for Bill C-226, including Dr. Ingrid Waldron, we have heard the journey to get to this point. The passing of this legislation today is really about the work of the women of these communities who have been fighting for the health of their communities, the health of their families, the health of their children and the health of the future so they can promise their children and generations going forward a safer and cleaner environment. Frankly, there is no other option than to push forward and contemplate these things.
In answer to my colleague in an earlier debate who said we will not get this done, I will share something that comes from my own tradition. We say, “It is not upon you to build the kingdom, but it is your responsibility to begin the work.” Women have been doing the work on this, from our friend Lenore Zann to those who are here today to the women of the many indigenous and racialized communities across this country who care about the future and health of generations to come. By putting this into law, we are acknowledging their work and putting a process into place.
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, seconded by the member for York Centre, moved that Bill C-226, An Act respecting the development of a national strategy to assess, prevent and address environmental racism and to advance environmental justice, be read the third time and passed.
She said: Mr. Speaker, there are not really words to describe the joy, pleasure and deep sense of gratitude when a private member's bill gets to third reading, and the member who has proposed it gets to stand before colleagues, to both ask for further support and express gratitude for the support the bill has received.
I want to begin by acknowledging that we are here on the territory of the Algonquin Anishinabe people. To them, I express a deep meegwetch every single day that we stand on their territory. Part and parcel of what we are addressing in the piece of legislation today is the impacts of the history of settler culture on Turtle Island and the impacts of policies of exploitation, of amassing fortunes, of capital raised and capital in bank accounts based on taking natural capital, taking it from what is alive to what is dead, at which point we see profit.
We also see a disproportionate impact for those people who are racialized, low-income or indigenous and the distance between those people and the large profits that are amassed quite far from where they have been exploited.
The concept of environmental racism may be new to some people in this House, but it certainly was not a new concept to the first member to bring this bill forward. Although Bill C-226 came to this House what feels like a long time ago, in terms of Private Members' Business it was not that long ago. This bill came to this Parliament on February 2, 2022 at first reading.
However, that was not its first incarnation. Its first incarnation was as Bill C-230. It was a private member's bill of a Liberal member of Parliament, who was at that time the member for Cumberland—Colchester. I can say her name out loud here. That is one of the sad things about this. When one of our friends and colleagues is not re-elected, their name is speakable. I thank Lenore Zann, who brought this bill forward. She is still rooting for it. We are still working together. In the previous Parliament, she did me the honour of asking me, a Green Party member of Parliament, to be her official seconder, even though she is a Liberal. It is quite unusual to ask someone from another party to second a bill, and I was honoured to do so.
We worked together on this, and it got all the way through second reading and all the way through the environment committee. It had amendments made to it in the last Parliament, and then, as we all know, there was an election that intervened, and the bill died on the Order Paper.
Since that time, in bringing it back, I have had so much support from so many members whose names I cannot say here because they are still members and working hard to help. I want to start, of course, by thanking the Minister of Environment, who, as minister, has this in the mandate letter, but in discussions that were enormously collaborative he decided that perhaps it might advance more quickly as my private member's bill.
We really have a sense of urgency about getting the bill passed. As we know, the House calendar can get clogged with government bills. This one was ready to go, and I drew a low number in the lottery, so we moved forward.
From the very beginning, I had the support of my friend, the member for Victoria, who also laid hands on this bill. One could describe this bill as having many midwives. This is a process and we are not done yet. There is the hon. member for Nunavut and the hon. member for York Centre, who is seconding the bill here tonight. We had hon. members from many parties, including the hon. member for Aurora—Oak Ridges—Richmond Hill, the hon. parliamentary secretary from Winnipeg South and the hon. member for Toronto—Danforth. I know I am going to leave people out if I keep going.
I have many friends in the other parties, and I wish I had been able to convince my Bloc Québécois friends to support Bill C-226.
Unfortunately, right now, they are not on my side when it comes to this private member's bill, but perhaps they will change their minds before the final vote. I hope so. Right now, the Conservatives are opposing this environmental justice effort.
I would have loved to have every member of Parliament in this place support the legislation, but thank heaven, and thank all the members who have seen it in their hearts to support the bill, we have the votes for third reading support, please. Today is the last moment of debate at third reading.
I have another 10 minutes, and I do want to speak to the issues that this bill addresses.
We can name the places and think of them, and they conjure much longer stories, such as Grassy Narrows. What does environmental racism mean when we would allow Reed Paper to contaminate the community of Grassy Narrows with mercury, decade after decade?
The Sydney tar ponds are now cleaned up. However, for decades it was a racialized community with a Black population who came from the Caribbean to work in the steel mill. The land where the steel mill and the tar ponds were located was a toxic mess of carcinogenic toxic waste. It was the fishing grounds of the Mi'kmaq First Nation.
Pictou Landing, more recently, is still at threat from Paper Excellence, which bought the mill that was shuttered.
There is the illegal dumping of toxic waste in the Kanesatake First Nation, there is the Wet'suwet'en territory, and we can add Athabasca Chipewyan First Nation, where Imperial Oil's Kearl mine leaked toxic waste for nine months. Not the regulator, not the province and not the company ever thought to warn the community.
In those cases, if members wonder what environmental racism is, they can just ask themselves this question: Can they imagine that happening in Westmount, the south end of Halifax, or any of the settler-culture neighbourhoods, which are the wealthy neighbourhoods, the white neighbourhoods? Would Imperial Oil have dared to poison a neighbourhood of their wealthy shareholders with the toxic waste seeping from the tar, from the tailings, from bitumen production in the oil sands? The answer that presents itself is obviously no. That is the difference.
There is a lot of academic work that has been done on this, so I do want to start by giving an enormous vote of thanks to Dr. Ingrid Waldron, who is the champion of environmental racism and promotion of environmental justice in Canada. Her book There's Something in the Water was turned into a film documentary. If members want more information on this, they can find it on Netflix. On Netflix, there is a film documentary made by Canadian actor Elliot Page. He based the documentary on Dr. Waldron's book.
Dr. Waldron founded the ENRICH project, which stands for environmental noxiousness, racial inequities and community health project.
Dr. Waldron's work has been central to this. Dr. Waldron worked in a collaborative fashion with Lenore Zann in developing this bill in the first place.
What does it look like? What kind of definitions does one bring to bear? Dr. Waldron's definition is more, but it includes this: “the disproportionate location or siting of polluting industries in communities of colour, indigenous communities, Black communities and the working poor.” It is pretty comprehensive. We know what that means.
However, it is more than that. Dr. Waldron has also said it is “how racist environmental policies...have enabled the cultural genocide of Indigenous, Black and other racialized peoples”.
Having looked at environmental racism, the question is this: What is it that Bill C-226 would do about it? It would demand of government to develop a strategy to promote environmental justice.
What does environmental justice look like? We do not have to look too far. Tomorrow, in this place, U.S. President Joe Biden will be speaking to us.
I hate comparisons where Canada does not look good compared to the United States of America, as I like the smugness of knowing that we set a good example, but unfortunately, we do not look good on environmental racism or climate. In 1994, the U.S. President acknowledged and created a program, by executive order, in the U.S. Environmental Protection Agency to promote environmental justice.
The environmental justice program and the U.S. EPA this year will spend $100 million on programs at the community level to assist communities to have the tools they need to fight the polluters back; get cleanups; prove that the cleanups are needed; prove the health information; get access to epidemiologists, toxicologists and lawyers; and get the chance to beat back the polluters. The polluters will always say, “There is not enough here to poison anyone. That would be quite far-fetched.” Environmental justice programs make the difference by empowering communities so that the polluters do not get away with murder, and I do not mean that purely rhetorically.
The U.S. EPA defines environmental justice as “the fair treatment and meaningful involvement of all people regardless of race, color, culture, national origin, income, and educational levels with respect to the development, implementation, and enforcement of protective environmental laws, regulations, and policies.”
We have a long way to go in this country, but we are not without a road map. We know what can be done. If we get this bill through third reading today and send it to the other place, it will then need to have the support from the government of the day and the support of the finance minister to fund the programs, so that communities of colour, indigenous communities and poor communities are not left without access to environmental justice.
We have made some changes in Bill S-5, the Canadian Environmental Protection Act, thanks to the Senate. There is more recognition in that bill of aspects of environmental justice and environmental racism.
We are making progress. We are inching along, but we need to be bolder. We need to move fast. It is my deep hope that, if this bill passes, it will go through the Senate relatively swiftly. We will then be able to say to every Canadian that justice includes the right to a healthy environment, that justice includes climate justice, that justice includes the indigenous peoples who live in Saanich—Gulf Islands, that the Department of Fisheries and Oceans no longer can say, “Sir, one cannot harvest any shellfish from one's traditional waters because we have decided, without doing any testing, that that shellfish is probably not safe to consume.” It is safe to consume, all right. It is just that it is an indigenous community and taking away their right to fish is perfectly okay with DFO, with no testing.
These are issues that can be solved. As someone who stands before us as a woman of privilege, by the colour of my skin, I am deeply honoured to work with the communities for whom this legislation will make an enormous difference, for all of the babies, the sons and daughters, of the peoples in those communities.
I ask members to please assist this bill to be more than a strategy, to be more than a private member's bill, but to be the law of the land to create new rights and bring environmental justice to every Canadian.
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Mr. Speaker, I have a petition in support of Bill C-230.
The petitioners, who come from across Canada, are concerned about doctors and health care professionals who might be coerced into engaging or supporting euthanasia against their conscience. They want these conscience rights and second options to be protected. The petitioners note that doctors deserve freedom of conscience and that the Canadian Medical Association has confirmed that conscience protection would not be a limit to their use. The petitioners also describe how, during the Special Joint Committee on Physician-Assisted Dying, witnesses stated that conscience rights should be protected by the government in the response to the Carter decision.
The petitioners are calling on Parliament to enshrine in the Criminal Code protection of conscience rights for physicians and health care workers from coercion or intimidation, so that they would not have to provide or refer for assisted suicide or euthanasia.
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Mr. Speaker, I have a petition today from many Canadians who are concerned about the lack of conscience rights for medical professionals. They strongly support the aim of Bill C-230, so it is truly disappointing that the Liberal government does not respect the rights of many.
As I said in my speech on this matter last week, I truly believe that as a society we must find a way to give Canadians something without taking something away from others. The protection of conscience rights does just this by ensuring lawmakers can, in good conscience, give access to certain medical procedures without unjustly compromising the existing freedoms exercised by others.
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I declare the motion defeated.
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Pursuant to order made Thursday, June 23, the House will now proceed to the taking of the deferred recorded division on the motion at second reading stage of Bill C-230 under Private Members' Business.
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Pursuant to an order made Thursday, June 23, the division stands deferred until Wednesday, October 5, at the expiry of the time provided for Oral Questions.
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Madam Speaker, I am thankful for the opportunity to close the debate on my bill, the protection of freedom of conscience act.
I believe this is a straightforward piece of legislation. It would make it an offence to intimidate a medical professional to participate in medically assisted suicide, directly or indirectly, or to dismiss from employment or refuse to hire a medical professional simply because they refuse to take part in medically assisted dying.
With the removal of safeguards, the slippery slope that many predicted when medically assisted suicide was decriminalized has come to fruition. Additionally, the courts and government legislation have expanded medically assisted suicide far beyond what was conceived in the Carter decision of 2015. Now, those who promote euthanasia support medically assisted suicide for the mentally ill, with some even believing that children should be eligible. This is creating turbulent and stressful times for many in the medical field.
Given this expansion of medical assistance in dying, there is the growing concern or objection among many medical professionals, whether they support MAID or disagree with it, that they may be forced to participate, even if they do not believe that it is in a particular patient's best interest based on their expertise and knowledge of the patient's history. More and more are becoming aware of the erosion of respect for their professional judgment and the precious relationship between the health care provider and their patient.
Unlike what some are trying to portray, this bill does not relitigate the legality of MAID, nor does it seek to impede a patient's access to MAID. Rather, it seeks to protect a medical professional's charter right not to participate in medically assisted suicide when they cannot in good conscience do so.
Section 2 of the Canadian Charter of Rights and Freedoms specifically says:
Everyone has the following fundamental freedoms:
(a) freedom of conscience and religion;
During the first hour of debate, my colleague, the member for St. Albert—Edmonton, reminded us that the Supreme Court's ruling in the Carter decision was predicated on two things: “a willing patient and, as importantly, a willing physician.” He went on to note that in the decision, the Supreme Court stated the following: “we note...that a physician’s decision to participate in assisted dying is a matter of conscience and, in some cases, of religious belief”.
Protecting individuals from coercion of this nature is not foreign to the Criminal Code of Canada, as found in section 425. If Parliament can enshrine criminal penalties for employers for coercing employees not to form a union, then surely we can provide similar protection for medical professionals when dealing with conscience protections.
Throughout the pandemic, we saw just how important every doctor, nurse and medical support worker is to our system. I do not want even one of these amazing men and women to leave Canada or leave the profession because they are faced with a situation of having one of their most precious rights violated.
With Bill C-230, I have put forward comprehensive yet simple legislation that is important to medical professionals from coast to coast. I would welcome a committee's examination of it, as well as any recommendations to improve it.
In closing, it is an honour to have introduced a private member's bill of substance and consequence in this place and to have members debate it. I humbly ask all members to vote in favour of it at second reading so that it can be sent to committee for further study.
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Madam Speaker, I rise in support of Bill C-230, presented in this House by my friend and my colleague, the member for Carlton Trail—Eagle Creek. The bill we are debating today is worth more than a casual dismissal, as I have heard done in this debate by so many.
The bill, if supported, would provide the protections for charter rights of medical professionals who object to providing or participating in medical assistance in dying, which is something that many Canadians are concerned are not there. This is not a debate about medically assisted dying, on which my own convictions are based on a deeply held personal experience and one I would not wish on anyone in this House.
It is also insulting to hear that some members in this House think that it is exercise in politics. This is a debate that is often used in the simplification of applying a litmus test to carelessly sift people into buckets based on how they see a very complex societal issue, to which some so easily assign a check mark or an X. I also support a woman's right to choose. I always have. I always will. I support the LGBT community and its rights, and not as a check mark but as someone who is a proud member of it.
Canadians have varied opinions on MAID based on deeply held personal circumstances, beliefs and experience. One member in this House said, before opposing these important provisions in the bill, which aims to codify them in law, that he did not see the need for them.
However, I do want to reiterate and emphasize some points that are important to this conversation and should be important to members of this House and Canadians alike. Medical assistance in dying is a deeply held moral and conscientious issue that has legal and ethical questions beyond a simple difference of opinion. We know that from the debates in this House. The medical professionals have a duty to do what is in the best interests of their patients and provide them with the best advice on how to move forward with their care. I will say that this is personal and I will say that I went through it. In this case of medical assistance in dying, there are professional and ethical considerations that should be weighed with the highest degree of importance and a caution that touches on the deep moral convictions that I do not believe have been adequately addressed in the current context of our laws.
That said, this bill aims to add two new offences to the Criminal Code. It does not pronounce on whether conscience-rights protections are somehow up for debate. They are not, despite some members' suggesting that this bill would aim to do things that it would not do.
I do believe that it is important to state, for my colleague and those before her who brought this to the House in a piece of legislation, what it actually says and not fall into an issue that we are not debating today. One, the bill would make it an offence to intimidate a medical practitioner for the purpose of compelling them to take part directly or indirectly in the provision of medical assistance in dying. Two, it also would make it an offence to dismiss or refuse to employ the medical practitioner on that same basis. The debate suggests that the provisions in the Criminal Code already do this, and that is simply not the case.
While the Criminal Code does not compel a medical professional to provide MAID, there is nothing in the Criminal Code that specifically protects medical professionals when they are pressured or coerced into participating in or advising on medical assistance in dying.
Not wanting to discuss this does not make the conversation go away. The bill is a direct response to disability rights groups and groups who are calling for these provisions and who understand first-hand that it is a problem. This bill is a direct response to the first nations groups who have called for this and understand that it is a problem. This bill is a direct response to legal experts. It is a response to mental health professionals who understand that this is a problem. Therefore, saying that it is not a problem does not make it not a problem.
This bill would make certain that medical professionals who choose not to take part in or to refer a patient for assisted suicide or medical assistance in dying would never be forced or coerced to violate their charter rights.
The Ontario Medical Association specifically called for an amendment like this in the bill passed by the government, to provide greater conscience protections for medical professionals, acknowledging that although the current clause in the government's bill, “for greater certainty”, exists, it does not actually do the thing it is supposed to do, which is protect freedom. It cannot be enforced. That is the problem that this bill, which was brought to this floor for debate by my colleague, would correct.
This bill addresses the gap and would close it by establishing two spelled-out and very targeted offences. Stakeholders are calling on those additional safeguards, and any discussion of answering this call should not be callously dismissed. It should be thoughtfully considered on behalf of all Canadians, and certainly those who have asked for provisions like this.
Members opposite have stated throughout the debate a jurisdictional argument, and that it somehow infringes on provincial jurisdiction. It is hard to see it as anything but political when one argues that conscience rights legislation somehow interferes with jurisdiction while simultaneously believing that the legalization of medical assistance in dying does not do the same thing.
To go back to the code for a second and the notion that existing provisions in the Criminal Code already produce satisfactory protections, if that were the case, this bill would not be necessary. However, I believe that notion ought to be challenged, because it is simply not the case. The evidence from those affected should trump the dismissal of evidence from politicians claiming it to be trivial, or worse, not even acknowledged.
This bill would do just as much to protect patients as it does medical professionals, which is something that has not been talked about, by protecting the fundamentally important relationship between a physician and a patient. It would do so by ensuring the advice their physician is providing is free and clear of coercion. That should be a priority, not a land mine we cannot discuss. We should have these discussions here, because they are important and the provisions do not exist as they currently talk about in the code.
There have been laws that created unintended consequences of doctors being forced to participate in providing a patient's death, regardless of whether they believed it was in the patient's best interest or not. The current provisions cannot possibly claim that the Criminal Code already protects the conscience rights of medical professionals, not if one reads the code. The clause I mention confirms only that the Criminal Code is not the source of obligation to participate. It does not state it as an offence. It must actually articulate it as an offence in order for people to effectively deal with it as an offence and in order to enforce it. That is what we are talking about.
Without conscience rights, doctors are constrained to provide medical assistance in dying, regardless of whether it is their professional opinion or is in the best interest of the patient, regardless of their moral, ethical and personal convictions and regardless of their own beliefs. Without the necessary protections, they may be coerced and they may be intimidated, and those rights would have no value as a result.
Many of us today might be or might have been in a situation where a loved one has a difficult choice to make about their health. Why would we not want our loved ones to receive the best possible care, the most options and the best options from good doctors, based on advice that has not been coloured by possible intimidation?
Over the past years, we have seen just how much Canadians depend on our health care system and how crucial doctors and medical professionals who work in that system have been. Every Canadian has, or at least a number of Canadians have experienced or are experiencing now how important the system is, and making sure that system works is even more important.
We need to create a work environment for medical professionals that protects them, supports them, encourages them and attracts the most qualified people possible to the profession. I encourage members in this House to support the passage of this protection of freedom of conscience act. I hope those with deeply held conviction will understand what my hon. colleague is trying to achieve for patients, doctors and those wanting to see them protected.
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Madam Speaker, it is my pleasure to rise today to speak to Bill C-230, the protection of freedom of conscience act. My colleague from Carlton Trail—Eagle Creek has worked hard to bring this legislation forward, and I applaud her for doing so. Right off the bat, though, I do want to say that my hon. colleague and I come at these issues from opposite ends, but I thank her for encouraging me to share a different perspective on the matter.
I support a woman's right to seek an abortion, and I always will. I support Canadians having access to medical assistance in dying, and I always will. In fact, I proudly supported the legislation that made access to medical assistance in dying possible several years ago. However, I also respect that a medically assisted death is not acceptable for a large number of Canadians, especially those who hold strong religious convictions where their teachings prohibit such acts. Today I find myself standing strongly to defend those who disagree with my fundamental beliefs. If we want others to defend our rights and freedoms, we have to be willing to defend theirs.
Rights and freedoms are a two-way street. As I said in 2016, while debating MAID, this is a complex issue for which there are strong opinions on both sides. Trying to solve and encapsulate such complex emotional issues into legislation is always a challenge and it will never be perfect. As such, I strongly supported the original legislation's requirement that there be a review at the five-year mark to re-evaluate the legislation. I feel that this thorough re-evaluation has never taken place and breaks faith with the spirit of the original legislation, so I would strongly urge the Liberal government to undertake a deep review of the MAID legislation and address its shortcomings. The trust of Canadians is being put to the test and it does not have to be this way.
I have also been a very strong advocate for palliative care and will continue to be. My dear friend, Lou Winthers, who worked for me in my constituency office for many, many years, was the executive director of Rosedale Hospice in Calgary. My family and I volunteered there and saw directly the importance of palliative care. Also, my late father-in-law, David Macdonald, was the executive chef at the Rosedale Hospice in Calgary. He spent much of his long career as an executive chef in many of the prime hotels throughout the country. He spent his final years cooking for the dying in the hospice.
As many members know, I was widowed when my wife passed away from breast cancer. That journey, more than any other, showed me that palliative care is necessary and timely access to it is critical. In fact, one of the conditions on which I supported MAID was that we simultaneously and strongly support palliative care. One cannot replace the other. They are both needed. The fact is that palliative care remains grossly underfunded and access is hit-or-miss depending on where one lives and when one needs it.
Both MAID and palliative care rely on medical professionals. These professionals are people, real people, with personal beliefs, personal convictions and personal experiences. I can understand that not all medical professionals support abortion or MAID, and I support their belief that they should not be forced to perform certain procedures that put them at odds with their conscience, their beliefs and their community. Quite frankly, I would not want to have a procedure performed on me by anyone who did not believe in what they were doing. Would it not be better to know if one's doctor or nurse was willing to put 100% effort into their work before the procedure started?
Protecting conscience rights ensures that both the patient and the medical staff are fully informed and aware of issues when giving consent. I do not need to go into detail to explain the importance of informed consent in the medical process, but I believe protections of conscience rights are an important aspect of the whole informed consent process.
The whole process of dying is deeply personal and individually unique. Sometimes, a person will have experiences with the dying that leave lasting impressions, and I feel compelled to share one here tonight.
On a Thursday in August 2020, a constituent, Sophia Lang, wrote to me to tell me she had been approved for MAID. She said:
You have no idea how much peace of mind that gives me: that there is a merciful way out of needless pain and suffering. I thank the Lord each day that I have that option for when life is no longer worth living.
She went on to say:
However there is a problem. One needs to have mental faculties to be able to consent at the very end. That is a reason that many people—and I may be one of them—choose to activate MAID early: for fear of being unable to consent at the end. I wish you, as my representative in parliament, to help improve the law so that advance directives are made legal. Many people would be able to live longer and at peace.
Imagine my shock when I later learned that we were having these exchanges in her last days. She died just four days after our last exchange, as I learned through the Calgary Herald obituaries. She never mentioned how close she was to leaving this world in any of our emails. I found it so powerful that when she had so little time left on this earth, she spent precious moments advocating for those who would follow in her footsteps.
Sophia has been gone for two years now, but her voice is not silent. I will continue to support access to MAID, advocate for proper advance directives and strongly call for a better palliative care system in Canada. At the same time, I will defend and speak for those who have conscience objections to these procedures.
I truly believe that as a society we must find a way to give Canadians something without taking something away from others. Protection of conscience rights does just this by ensuring lawmakers can, in good conscience, give access to certain medical procedures without unjustly compromising the existing freedoms exercised by others.
As Democrat politician and American lawyer Joe Andrew famously said, the hardest decisions in life are not between good and bad or right and wrong, but between two goods or two rights. I believe we can find a common ground on these issues, and we must. We need to find a way to make rights compatible and find a way to give something to some without taking away from others.
I call on all members of the House to support getting the bill to committee. I think this is an important conversation we need to have as a Parliament. Again, I understand that my colleague and I have fundamental disagreements on issues like MAID and abortion, but I hope we have demonstrated to our colleagues that when members do share common ground on an issue, like conscience rights, we owe it to Canadians to work together.
I would also like to say that the National Day for Truth and Reconciliation is an opportunity to make Canada better. It is a moment to reflect on our failures of the past, the impact they continue to have today and how we can bring about the healing that is required. We are a nation of nations, a people of peoples, and we have an opportunity to use this occasion to better ourselves and our country.
I hope all Canadians reflect on their individual and our collective responsibilities to bring about changes that are needed. True truth and reconciliation is our shared path to a better Canada.
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Madam Speaker, this private member's bill, in my view, is an attempt to override the patient's right to access information about, and to have access to, a legally provided medical service based on the personal beliefs of the service provider.
It is not about intimidation of health care professionals. Health care professionals already have that protection. No one who objects for conscience reasons is required to participate in any medical service to which they object, but professional organizations do require service providers to provide referrals for those seeking assistance if they are unable or unwilling to provide it.
Let me be very clear. Currently, medical professionals are permitted to opt out of providing a service if they object on moral or religious grounds. With that right, they also have an obligation to the patient and, as such, they are required to provide the patient with a referral for that service.
The Conservatives should know that the right for patients to access information and referrals for service has been tested in the courts. In fact, in January of 2018, the Ontario Superior Court of Justice upheld the College of Physicians and Surgeons of Ontario's policy on effective referrals and the Ontario Court of Appeal confirmed that decision in May of 2019. Justice Herman Wilton-Siegel wrote in the unanimous ruling, “the evidence in the record establishes a real risk of a deprivation of equitable access to health care, particularly on the part of the more vulnerable members of our society, in the absence of the effective referral requirements of the Policies.”
What we are debating here today is another attempt by the Conservatives to limit the patient's right to access medical assistance in dying. They are simply trying to create fear and division in the community and trying to find a back door to deny patients access to services. If patients cannot access services, what would that mean?
A constituent in Vancouver East wrote to me about the implication of a loved one not being able to access medically assisted dying. He was clear to say that it would just mean more pain and excruciating suffering, to the point where he said he was certain the loved one would take their own life no matter how dangerous or the means.
Is this what the Conservatives really want to do? Do they want to drive people to this point of desperation? I should hope not, yet here we are debating this bill. The effect of this bill, if passed, would mean exactly that. The impact of this bill would be particularly devastating in rural and remote communities where there are already fewer health care providers and services.
Aside from medically assisted dying, I fully expect this bill, if passed, would have other implications in other health services. It is entirely plausible that others will seek a similar exemption from providing abortion services. The potential implications for women's rights are very real as it could be used as a precedent to restrict access to family planning and abortion services. Already women in the LGBTQ2+ community are faced with barriers to access abortion and family planning services.
In Canada, there remain huge barriers to timely access to abortion services. The problem is especially acute in many of the rural, northern and remote communities. LGBTQ2+, non-binary people and migrant workers also face far too many barriers to access reproductive health care.
New Democrats are in full support of the community's calls to ensure access to abortion and other reproductive health care services in rural and remote regions. There must be free and universal access to contraception. The government must eliminate barriers to access for reproductive health care for marginalized groups, including undocumented people and two-spirit, transgender and non-binary people. Access to health care services is enshrined in the Canada Health Act. Instead of finding ways to limit access, all parliamentarians should be working on finding ways to ensure access.
I would note that the special committee has actually started looking further into the issues around MAID, although that committee's work began late and with much delay. Nonetheless, that work has started, and some of the key questions that it is addressing would add to the issues around assisted dying, which has already been debated in the House. However, the bill before us, in my view, would not add to that issue. In fact, the bill is clearly trying to create division and a divide in the community. It is trying to stoke up fear where fear should not exist. Health care workers and professionals are protected. They have the opportunity to opt out. They have the right to opt out, so the bill is entirely unnecessary.
I would be remiss if I did not note the fact that the bill is back again for the second time, even though the first time it was tabled it went nowhere. I have to wonder about that, because all 338 of us in the House of Commons hold our breath after each election to see if, in the lottery draw, we would get the opportunity to table a private member's bill or motion to be debated and voted on the House. However, this member has chosen to bring back a bill that has already gone through the process and went nowhere. There are so many other urgent issues to debate, and I could rattle off a number of them.
As the immigration critic, I could talk about bringing forward policy changes by way of a bill or a motion to address the immigration situation, the immigration processing delays and the backlog that exists in our system right now. There are over two million people waiting to find out what is going to happen to their lives and unable to move forward because of immigration processing delays.
We could actually bring forward a bill to talk about the blocking of family reunification. For so many families, spousal sponsorships are being blocked because they are unable to see timely processing of their spousal sponsorship. They cannot even bring their loved ones here to Canada with a visitor permit because of section 179(b) of IRPA regulations. In fact, I have, sitting on the Order Paper that I could table any time, a bill on striking section 179(b) so that we could ensure family reunification takes place for loved ones and stop creating barriers for them to even come and visit their loved ones on a travel visa.
We could be talking about the Afghan crisis. So many Afghan interpreters and their families are in danger right now and unable to get to safety because the government has put a cap on the special immigration measure numbers for Afghans who served this country. We could also be talking about the drug poisoning crisis or the housing crisis and putting an end to the financialization of housing.
Any number of these issues are worthy of debate, but the Conservatives chose this one all because they want to stoke up fear. That is shameful.
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Thank you, Madam Speaker. Now I feel I can deliver a speech.
I want to make one thing clear to the House of Commons. I think this is the appropriate time to point it out, and I think everyone here will agree with me. No one is condoning bullying, be it of health care workers or here in the House. We all know people who have bullied others. Bullies are mean-spirited people whose actions betray their insecurity and fear. We all agree on that.
That being said, we are well aware that this bill has nothing to do with bullying or protecting health care workers from bullying. What this bill would actually do is interfere with people's ability to obtain medical assistance in dying. As I said this morning, the Conservative Party is once again exploiting a serious problem to put forward a misleading solution. The party claims this bill will protect health care workers from bullying, but it is hiding the real objective, which is to interfere with medical assistance in dying. As I said this morning, this is populism.
This morning, a member corrected me, saying that being populist was not necessarily a bad thing. Fine. I should have used the term “demagoguery”. It is demagoguery.
We know full well that this bill does not seek to eliminate the bullying of health care professionals. Its objective is simply once again to obstruct existing legislation in Quebec. What is more, it seeks to allow a medical practitioner or a health care professional to not refer a case to a colleague. That goes against what we have in Quebec.
Obviously, the Bloc opposes this bill, just as we opposed Bill C‑268 in the last Parliament, and just as we opposed the proposed amendment to Bill C-7 when it was studied in committee. We have always been opposed to this. I do not know why it has come up a third time. Apparently, they have run out of topics, when there are so many to work on. If the Conservatives are looking for topics, we can help them with that.
Again, the Conservative Party is presenting us with a bill that has a certain objective, but which is worded differently in order to hide its real objective.
We oppose this bill for two reasons.
First of all, it contravenes the Quebec charter of values, rights and freedoms. There are already laws in place to protect health care workers in such situations involving intimidation. Let me give some examples of legislation that allows health care workers to refuse to provide medical assistance in dying.
Quebec's Act respecting end-of-life care states the following:
A physician practising in a centre operated by an institution who refuses a request for medical aid in dying for a reason not based on section 29 must, as soon as possible, notify the executive director of the institution or any other person designated by the executive director and forward the request form given to the physician, if that is the case, to the executive director or designated person. The executive director of the institution or designated person must then take the necessary steps to find, as soon as possible, another physician willing to deal with the request in accordance with section 29.
Subsection 241.2(9) of the Criminal Code states:
For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.
Health care workers are already protected by the Criminal Code.
Finally, section 24 of the Code of ethics of physicians of Quebec recognizes conscientious objection for medical practitioners, which is the right not to resort to a medical act that goes against their values. It is also recognized in Quebec's Act respecting end-of-life care. The physician is nevertheless required to find another physician.
A physician must, where his personal convictions prevent him from prescribing or providing professional services that may be appropriate, acquaint his patient with such convictions; he must also advise him of the possible consequences of not receiving such professional services. The physician must then offer to help the patient find another physician.
Ontario has a similar provision. Therefore, physicians and health care workers in that province do not need this bill.
Second, we are opposed to this bill because it allows physicians not to refer a case. Let us recall certain statistics. It is all too clear: There is a growing demand for medical assistance in dying, in Quebec as well as in Canada, since these laws were passed.
End-of-life care meets a need and helps ease the suffering of patients who are dying. Since the act came into force, the number of cases of MAID in Quebec has increased year over year. In 2016-17 there were 599 cases and in 2020-21 there were 2,426, which represents a 405% increase.
According to the annual report of the commission on end-of-life care, three-quarters of patients who requested MAID had cancer.
We can all agree that individuals who request MAID do not do so lightly. These people have a right to dignity and that is what is most important in all of this.
A certain balance must be struck and a decision made. That is the issue: striking a balance between an individual's dignity and freedom of conscience and religion. This has already been studied. Quebec has been discussing these issues for 10 years. That was the objective of the bill sponsored by Ms. Hivon, who I would like to congratulate today, and which was adopted on June 5, 2014. A lot of work went into this. Years were spent studying and evaluating these issues. Why not trust the work that has already been done by Quebec in this area?
This seems to be a recurring theme in the House. The federal government starts from scratch without building on what has already been done. It does not have to look far; Quebec is just across the Ottawa River.
The Quebec National Assembly is working on the issue; among other things, the Select Committee on Dying with Dignity was created on December 4, 2009. There is a consensus in Quebec that access to medical assistance in dying should not be restricted. The Quebec National Assembly spent 10 years examining both sides of the issue I just spoke about.
I will conclude here. I repeat: Medical assistance in dying is not designed to go against the values, religions or religious practices of certain Conservative Party members. Medical assistance in dying is an essential measure that allows people to die with honour and dignity. That is in line with Quebec's charter of values and its charter of rights and freedoms.
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Madam Speaker, we are here to discuss Bill C-230, which would amend the Criminal Code to make it an offence to intimidate health care personnel—a medical practitioner, nurse practitioner or anyone who could provide medical assistance in dying. It seeks to create a Criminal Code offence to “protect” health care personnel. These health care professionals, now and in the future, may take part in the provision of medical assistance in dying.
Excuse me, Madam Speaker, but there is a lot of commotion. I would like to give my speech in peace.
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Madam Speaker, I am pleased to participate in the debate on Bill C-230, the protection of freedom of conscience act. I appreciate the contributions of the member for Carlton Trail-Eagle Creek to medical assistance in dying, or MAID, which is a complex and deeply personal issue to many Canadians.
First, I want to acknowledge that the aim of the bill, which is to support the conscience rights of health care professionals, is indeed laudable. The government has always supported conscience rights, which is why, since the very beginning of Canada's MAID framework in a former bill, Bill C-14, these rights have been specifically recognized and acknowledged. However, at the same time, the criminal law is a blunt instrument that should be reserved for the most serious situations.
In my remarks today, I want to raise some questions about whether new offences are an appropriate solution to the legitimate concerns raised by the bill's sponsor. In this regard, it bears recalling the primary reason the criminal law is concerned with MAID in the first place, which is to provide the necessary exemptions to ensure that persons who choose to provide or assist in providing MAID do not face criminal consequences for doing so. The MAID provisions found in the Criminal Code were carefully crafted to respect the autonomy of Canadians, respond to the evolving issues and protect vulnerable persons. In other words, the involvement of criminal law is necessary to permit MAID while ensuring it is carried out in a safe, responsible manner.
However, Bill C-230 seeks to involve the criminal law in two very different ways: first, to create a new MAID-specific intimidation offence, and second, to create an employment sanctions offence. With respect to the former, the intimidation offence, it is worth reiterating that the Criminal Code already provides provisions for several offences that would be available to respond to situations where a health care professional is a victim of coercive or threatening behaviour, including the intimidation offence in section 423 and the extortion offence in section 346.
To me, it is not evident that an additional specific offence is required to protect conscience rights. I should also say that I am not aware of any evidence of health care professionals facing threatening circumstances in the context of refusing to provide MAID or that there is a specific gap that needs to be filled in our law.
I have taken note of the fact that the proposed intimidation offence in Bill C-230 would be a summary conviction offence, which, if enacted, would stand out from other intimidation offences in the Criminal Code. The existing offences are either straight indictable or hybrid offences. In addition to being duplicative of existing offences, the fact that the proposed intimidation offence would only be prosecutable by summary conviction may suggest that intimidating conduct is less serious in a MAID context, which seems counterintuitive.
To further highlight why I have concerns about creating a specific intimidation offence as proposed by Bill C-230, I would like to draw members' attention to a recent example that offers a clear contrast. Last year, as members will recall, unfortunately in some parts of our country there was a threatening atmosphere of intimidation present for many health care professionals who were simply trying to go to work and care for members of their communities during the pandemic. That is why the government responded with Bill C-3, an act to amend the Criminal Code and the Canada Labour Code, which provided new criminal law tools to protect all health care workers and all Canadians who are seeking their care.
I believe Bill C-3 was an appropriate criminal law response to the credible threats to the safety and security of health care professionals and Canadians, but I am not convinced that a similar response is necessary when it comes to the situation of conscience rights and the provision of MAID. It seems to me that the charter and existing criminal law offences already provide the necessary protections for those rights, alongside the specific provision in the current MAID framework that expressly states that nothing in the federal law compels an individual to provide or assist in providing MAID. There is simply no obvious need to supplement what already exists.
Turning to the employment sanctions offence, I am struggling with Bill C-230's proposal to create a new offence that would exclusively target employers who dismiss or refuse to employ health care professionals who choose not to provide MAID. Moreover, in my view, Bill C-230's employment sanctions offence would not address the concerns described in the bill's preamble regarding conscience rights and certain requirements for professionals to make effective referrals for MAID.
As members are aware, in some jurisdictions, the professional orders that regulate health care professions have established requirements that their members provide effective referrals for MAID. While there have been cases where these requirements were challenged, the courts, including the Court of Appeal for Ontario, have upheld them, noting that this is a difficult issue that involves taking into consideration the conscience rights of professionals and the needs of their patients.
I do not believe it would be constructive for Parliament to intervene by creating a new criminal offence such as the one proposed by the bill. Rather, a more productive approach is for the government to continue its efforts to work closely with the provinces and territories on the implementation of MAID in a manner that supports persons who may be considering it and the health care professionals who provide exceptional care to their patients.
For the reasons I have mentioned, I have significant concerns with Bill C-230. While I agree wholeheartedly with protecting the conscience rights of all health care professionals, including those who choose to participate or refuse to participate in MAID, I am not persuaded that the two offences proposed in the bill are necessary or desirable.
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Madam Speaker, the second petition has to do with conscience rights. Yesterday, my colleague from Carlton Trail—Eagle Creek spoke on her bill, Bill C-230, the protection of freedom of conscience act, and I am presenting a petition today that supports this legislation. The petitioners are concerned about doctors and health professionals who might be coerced into engaging and supporting euthanasia or MAID, and they want conscience rights and second opinions to be protected.
The petitioners ask that protection of conscience rights be enshrined into law, protecting physicians and health care workers from coercion or intimidation regarding providing or referring someone for MAID or euthanasia.
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The time provided for the consideration of Private Members' Business has now expired. The order is dropped to the bottom of the order of precedence on the Order Paper.
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Madam Speaker, I rise in strong support of Bill C-230, the protection of freedom of conscience act, introduced by my friend, the member for Carlton Trail—Eagle Creek.
The bill before us is much-needed legislation to protect the charter rights of medical professionals who conscientiously object to providing or otherwise participating in medical assistance in dying. I want to commend the member for her steadfast leadership in championing conscience rights and for bringing this bill back to the House, as she introduced a similar bill that died on the Order Paper in the last Parliament.
Medical assistance in dying raises profound legal, moral and ethical questions. The trial judge in the Carter decision, which struck down the Criminal Code prohibition against physician-assisted death, stated, “The evidence shows that thoughtful and well-motivated people can and have come to different conclusions about whether physician-assisted death can be ethically justifiable.” This is true of patients, and it is true of medical professionals.
Medical professionals have a duty to do what is in the best interest of their patients and to provide the best possible advice based upon their judgment and experience, all of which are grounded on moral and professional convictions. In the case of medical assistance in dying, there are professional, moral and ethical considerations of the highest weight.
In the Carter decision, the Supreme Court predicated its decision on two things: a willing patient and, as importantly, a willing physician. At paragraph 132 of the Carter decision, the court said that nothing in its pronouncement would compel medical professionals to participate in MAID. The court went further in stating that, “However, we note...in addressing the topic of physician participation...that a physician’s decision to participate in assisted dying is a matter of conscience and, in some cases, of religious belief.” In other words, again, it requires a willing patient and a willing physician.
Now, there are those who would say that this legislation is redundant, that it is not needed, and that in terms of medical assistance in dying, conscience rights of medical professionals are already protected. They would point to the pronouncement in Carter. They might also cite Bill C-14, which includes a preamble that expressly recognizes conscience rights as well as a “for greater certainty” clause in the Criminal Code, which simply provides that “for greater certainty, nothing in this section compels an individual” to provide MAID.
While the intention of Parliament was to protect the conscience rights of medical professionals when Bill C-14 was debated and passed—and I was there for, and actively participated in, that debate and the study of that bill at committee—in practice, conscience protections and the rights of medical professionals are not being respected across Canada. There is a gap, and that is why, when Bill C-7 was studied at the justice committee, we heard from medical professionals who expressed serious concerns about pressure and coercion in providing MAID.
Indeed, the Ontario Medical Association wrote to our committee and specifically called on the committee to amend Bill C-7 to provide greater conscience protections for medical professionals, given that the “for greater certainty” clause, although better than nothing, simply does not have teeth. It is not enforceable. In that context, while the Criminal Code does not compel a medical professional to provide MAID, there is nothing in the Criminal Code that specifically protects medical professionals when they are pressured or coerced to provide MAID. This bill addresses that gap and would close it by establishing two targeted offences; namely, it would make it an offence to intimidate or coerce a medical professional with regard to providing or participating in MAID, and secondly, it would make it an offence to dismiss or refuse to hire a medical professional solely on the grounds that they object to participating in MAID.
While this legislation would protect the rights of medical professionals, it must also be emphasized that this bill would just as much protect the rights of patients. The bill would protect the rights of patients by protecting the physician-patient relationship. It would do so by safeguarding the ability of medical professionals to provide their best advice and judgment, free of pressure and free of coercion, to a patient who is considering medical assistance in dying. It would protect patients by protecting their right to a second opinion. There can be no second opinion, or at least a guarantee of a second opinion, in the face of coercion or pressure to provide medical assistance in dying. There can be no second opinion when the only choice offered to a patient is medical assistance in dying as a result of pressure and coercion.
The need to safeguard the patient-physican relationship, which this bill works toward achieving, is all the more needed in the face of the radical expansion of medical assistance in dying in Canada with the passage of Bill C-7, which removes critical safeguards, including the criterion that death be reasonably foreseeable and opens the door to medical assistance in dying for persons who are suffering solely from a mental illness, even though it is never possible to predict when someone who is suffering from mental illness can get better. It is never possible to predict irremediability in the case of a solely mental illness. As a result of the removal of those critical safeguards, vulnerable patients are put at greater risk.
When the conscience rights of medical professionals to exercise their best judgment are protected free of intimidation and coercion, the rights of patients are equally protected. This is a timely, targeted and necessary piece of legislation that would protect the rights of medical professionals and their charter rights and the rights of patients. I urge its passage.
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Madam Speaker, I am pleased though a bit surprised to be speaking on Bill C-230. Less than a year ago, on May 27, 2021, we were in the House debating Bill C-268, the very same bill from the very same member for Carlton Trail—Eagle Creek. While I am a bit in awe of the member's ability to place so highly in the random draw for Private Members' Business in two successive Parliaments, I am also at a bit of a loss to explain why the member would squander her luck on this bill.
There are two reasons I say this. As MPs we get limited opportunities to place bills directly before the House. I had that opportunity in 2013, and I used it to put forward Bill C-279, which sought to add gender identity and gender expression to the list of prohibited grounds for discrimination in the Canadian human rights code and in the hate crime section of the Criminal Code. Though many thought it unlikely, the bill did pass the House with support from MPs from all parties. It took a lot of work to put together that coalition of MPs. While my bill followed a somewhat torturous path, there was always a path forward and it became law.
I wonder why it is that having heard so clearly, in speeches less than a year ago, that there was limited, if any, support for this bill outside her own party, the member for Carlton Trail—Eagle Creek has brought it back again. Since there is nothing to indicate any change of circumstances or any change of heart, this bill will go nowhere this time as well. Failing to bring forth a bill that might have some prospect for passing or reintroducing this bill instead of bringing forward a new bill presenting ideas not already debated here in the House leads me to call reintroducing this bill, at best, a missed opportunity.
The second reason I have for declaring the reintroduction of this bill a lost opportunity has to do with the bill itself. This bill picks up a tiny portion of the extensive and important debates on medical assistance in dying that took place on Bill C-14 in Parliament in 2016 and again on C-7 in the last Parliament. It seeks to take one small and very debatable point and turn it into a wedge issue in the House.
We are waiting for the Special Joint Committee on Medical Assistance in Dying to get down to work on outstanding important and critical issues around medical assistance in dying, but as that committee has yet to get under way, I want to take this opportunity today to restate the principle that has guided New Democrats through these debates.
We believe that medical assistance in dying is an important tool for helping to end unnecessary suffering for patients facing end-of-life issues and for avoiding the unnecessary suffering of their families, who have to accompany them on this journey. This is the reason New Democrats will always defend the right of access to information about MAID and access to the service for all those who qualify for assistance in dying and choose to proceed.
In the debate on Bill C-7, many issues arose concerning the challenges Canadians face at the end of life, some of which Bill C-7 addressed directly and some which have not yet been addressed. Two important concerns were front and centre, and these, for me, were the most important. The first was to help alleviate unnecessary suffering by eliminating the waiting period, which was a cause of great concern for patients who feared loss of capacity before they could complete the waiting period and thus make them ineligible for medical assistance in dying and forced to consider suffering.
The second was a change allowing a waiver of final consent. This is a provision I know quite well, personally, as a friend of mine chose to go earlier than she would have liked because of a brain tumour and her fear that she would lose capacity to consent at the last moment and, in doing so, have to continue making her family suffer.
A second challenge was also debated in Bill C-7. How do we preserve as much autonomy as possible for Canadians who are dying? Most of the issues related to this still have to be dealt with at the special joint committee. This includes questions of advance directives, the question of access to MAID for those with mental illness and for mature minors, and whether protections for people with disabilities from being pressured to seek MAID are adequate. I remain frustrated with the delays in dealing with these very important issues. The bill before us is not one of those.
A third challenge that came up in the debate on Bill C-7 was access to services at the end of life. We learned there are a great many gaps in services in our Canadian health care system for those who are facing death. There are gaps in diagnostic and treatment services depending on where one lives, whether it is a major city with excellent facilities or a rural and remote area. We learned of important gaps in palliative care.
However, instead of addressing these challenges, the challenges of autonomy and the challenges of access to services, Bill C-230 is about something else altogether. What this bill would do is override a patient's right to access information about and to have access to legally provided medical services, based on the personal beliefs of a service provider.
Let me put that in plain language. Let us suppose there are a variety of treatments available to a patient. It does not really matter in this case what they are. If a medical professional believes that one of them should not be available, this bill says there is no obligation on that professional to make sure patients find out all the options available to them. Professional organizations, like colleges of physicians and surgeons, and colleges of nurses, have found this to be unethical behaviour, so they require doctors, to varying degrees, to refer patients to someone who is supportive of those services and who is available to provide those services.
This requirement to refer exists in its strictest form in Ontario as the right of patients to an effective referral, meaning a referral to a health care professional who is available, capable and willing to provide that service. This has been upheld by the courts as a reasonable compromise between the rights of patients' access to medical issues and the conscience rights of service providers. That is the main reason I cannot support this bill. If passed, it would result, on a very real and practical basis, in the denial of access to necessary health services for many Canadians.
Many communities have a very limited number of doctors and if one of those doctors, or even more than one of those doctors, is unwilling to let their patients find out about medical assistance in dying, then we are condemning those Canadians to suffer at the end of life in ways that other Canadians would not have to suffer. No health care professionals are in fact required by law to participate, and that is why I find titling this bill “intimidation of health care professionals” disingenuous at best. Is requiring a referral actually participation in medical assistance in dying? Clearly it is not, and trying to torque a requirement to provide information into participation helps no one understand the real issues of conscience involved in medical assistance in dying.
An equally important reason for opposing this bill is the dangerous precedent that this bill would set. Its role as a potentially precedent-setting bill has already been noted by anti-choice advocates who have been vocal in their support for this bill. They recognize that it would provide a precedent for denying referrals for access to contraception and abortion services, and I want to point out that denials of service and denials of information are very real in our existing Canadian medical care system.
This bill would also be a very bad precedent for current attempts to deny transgender minors the counselling and medical services they need to affirm who they are. Without access to services that others may think are inappropriate, this will leave families with trans minors struggling to find the information and support that their kids really need. If this kind of precedent is allowed, medical professionals would not have to provide a referral to someone who would be providing a medically necessary service.
As I approach the end of my comments today, I cannot end without mentioning yet another unfortunate precedent set in this bill, and that is its use of inflammatory language. I have no doubt, as I said in my question to the sponsor of this bill, of her personal convictions and their strength. However, as sincere as they may be, the language used in this bill conjures up a spectre of the use of violence to intimidate medical professionals, something of which there is absolutely no evidence of happening in Canada. Invoking the spectre of violent intimidation is certainly not conducive to an informed debate on the real issues that are in question here.
I will close my comments today by restating that, on principle, New Democrats are opposed to any legislation that would limit access to Canadians seeking information about or the service of medical assistance in dying. No matter how strong the beliefs others may hold, this right exists to access medically necessary services. There is no doubt that the end of life is a difficult moment for all families, and medical assistance in dying, I still believe, is an important way of ending unnecessary suffering both for patients and families at the end of life. I would not like to see anyone denied access to information they need to make a choice that protects their own autonomy of how their lives end. At this point, let me salute the health care professionals who assist patients and their families through this very difficult process.
Once again, I lament the tendency of not just this member but, indeed, many Conservative members of the House to use private member's bills for scoring political points and sharpening divisions in the House—
An hon. member: Oh, oh!
Mr. Randall Garrison: —instead of looking for opportunities to work together for the common good of Canadians.
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Madam Speaker, the bill we are debating today has to do with protecting the freedom of conscience of health care professionals and practitioners when it comes to medical assistance in dying.
I think we should base our debate on the approach that Quebec took on this matter back in 2010. Quebec studied this issue from 2010 to 2014. The debates were non-partisan. The process allowed for all points of view to be heard and compiled. The focus of the debate was human dignity.
When talking about end-of-life care, we must not forget that the way to protect human dignity lies in freedom of choice. No one can claim to be acting in a patient's best interests if that patient is not allowed to make their own decisions. What is interesting about the Conservatives' bill is that they want the state to be less involved in the economy but more involved in our lives, especially when it comes to death, which is one of the intimate decisions a human being will make.
It is not the state or Conservative members who are going to die in place of the individual, the person who is dying, the patient, so why are they trying to interfere in this decision?
This bill is pointless, and I say this because subsection 241.2(9) already stipulates that no one can be compelled or forced to provide medical assistance in dying against their will.
As I just mentioned, the Quebec legislation should guide us in our debate here today. Section 31 of the Quebec legislation stipulates that medical practitioners cannot be forced to participate directly or indirectly in MAID, and I quote:
A physician practising in a centre operated by an institution who refuses a request for medical aid in dying for a reason not based on section 29 [which sets out all the conditions that a doctor must meet before deciding whether to provide medical assistance in dying] must, as soon as possible, notify the executive director of the institution or any other person designated by the executive director and forward the request form given to the physician, if that is the case, to the executive director or designated person. The executive director of the institution or designated person must then take the necessary steps to find, as soon as possible, another physician willing to deal with the request in accordance with section 29.
This means that a patient who is dying and highly vulnerable should not be burdened with having to take the steps I just mentioned. The bill the Conservatives are introducing today would do just that. It would force these individuals to take those steps at the most vulnerable time of their lives, when they are dying or about to die. However, medical practitioners can refuse to participate directly or indirectly in MAID.
As we heard during the Standing Committee on Justice and Human Rights' study of Bill C-7, some practitioners, citing freedom of conscience, are currently refusing to abide by the Collège des médecins du Québec's code of ethics and forward the request. In other words, they are ignoring the request, which they are not allowed to do.
In Quebec, conscientious objection is defined as follows: “Health professionals must not ignore a request for medical aid in dying. However, a doctor may refuse to administer medical aid in dying because of his or her personal values. The doctor must notify, as soon as possible, the executive director of the institution”.
That is the issue. The Conservatives have introduced a bill to add a provision to the Criminal Code that would make what they call intimidation in health care facilities an offence.
This would be a situation where a health care professional dealing with a family supporting a dying patient—a father, a mother, a brother, a sister—offers end-of-life options without ever mentioning medical assistance in dying. That is the kind of scenario we are talking about.
Quebec was a leader in this area and contributed to advancing the legislation, but there is still a lot of resistance on the ground when a patient requests medical assistance in dying. That can manifest in various ways. The surprising thing is that this resistance stands in stark contrast to what I consider the essence of Quebec's legislation, which was to integrate end-of-life care into the palliative care continuum.
In the current debate, there is one side advocating for palliative care and another advocating for medical assistance in dying. Quebec's legislation did not fall into the trap of such unnecessary division. Palliative care should be accessible, and the continuum of palliative care can give rise to a request for medical assistance in dying. A request for MAID emerges when a patient is given the opportunity to make a free and informed choice.
A person's dignity must not be defined by how they die, and it cannot be compromised because death is considered to be distasteful. To respect a human being is to respect their dignity, and that means respecting their independence and capacity for self-determination until their last breath.
The law enshrines the principle of self-determination throughout our lives, especially when it comes to medical decisions. No one can interfere with my person without my free and informed consent. Why then, at the most intimate moment in my life, would the state interfere in my life and take away my right to self-determination? I can only make a free choice if the practitioner is able to offer me all the choices, including access to palliative care, palliative sedation, and medical assistance in dying. This is a decision that only a dying person can make.
These types of bills and debates take us away from far nobler objectives. There is nothing new here to crow about; it was already set out in the legislation.
I would like members to understand why the Bloc Québécois will oppose this bill. We oppose this bill because at present, in Quebec, some people requesting MAID in a hospital are not being admitted to a palliative care unit. It is shameful that people at the end of their lives must live their last moments in a place that is far from peaceful and far from what is recommended as appropriate for dying with dignity. Why oppose that?
We must focus our efforts on having a continuum of care, working to ensure that palliative care is as available and accessible as possible in all forms, whether at home, in hospices, or elsewhere. A request for assisted death must be viewed not as a failure, but as a success in accompanying an individual towards death.
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