Speeches | Second reading of Bill C-14, Medical Assistance in Dying

03 June 2016

Hon. Grant Mitchell: Colleagues, I want to echo the sentiments of senators who have spoken already in congratulating our colleagues for their participation and work in the joint committee, in the Committee of the Whole with the ministers, in the pre-study and in this debate. There are times, many times, more than I think Canadians understand, that the Senate soars and this is one of those times. It has been enormously impressive and I would like to applaud the decision for having it televised. I would like to have seen more of it televised, but at least the Canadian public got a chance to see our Senate for a period of time at its very best.

I think we have all been moved by the very personal stories that we have heard in here. This is a deeply emotional issue, and I expect that every one of us has had an experience with a close family member, close friends, in an end-of-life situation.

I am struck by the fact that a good deal of this debate has been focused on expanding the scope of the legislative regime defined in this bill. In the course of that argument, as you might expect, the arguers, the presenters, have certainly emphasized what isn't in this bill. I'd like to take a moment to emphasize what this bill actually contains and what it actually does, because this bill is not nothing. This bill is profoundly significant. It takes a culture and a society that has not addressed state medically assisted suicide and implements that deeply within our legislative and cultural social structure.

It brings into effect medically assisted dying that has never been in effect before. This has been legislated by only six national governments in the world, only one of which has advance directives, with which they are struggling to this very day. This is a significant change in the social and cultural mores and norms that define our society and will result in multiple medical professions having to alter fundamentally their culture of care and sustaining life.

I should note that while I respect greatly what Senator Plett has said, I believe that it will not require this of medical professionals, whose right to conscientious objection is protected in this bill.

There is nothing in this bill that says there cannot or will not be more, that this legislative regime cannot or will not be expanded. In fact, it provides specifically for next steps to deal with those matters that senators have argued are required to complete the legislative framework around assisted death. I would expect that the force of this debate will encourage the government to expedite these next steps. The tenor, the power and the force of this debate will not be lost in the months to come.

The process of developing the legislative regime I believe reflects the demands of day-to-day governance in the practical world. In fact, I think it can be said that Bill C-14 has been forged by debate and consideration, but it has also been forged by the practical challenges of governance, of establishing a regime to deal with the many complications and dangers of properly and prudently implementing medically assisted death.

There are 14 federal, provincial and territorial jurisdictions in this field that have to be coordinated and consistent. There are multiple medical professions with the requirements of their professional governing bodies that also have to be coordinated and consistent in their efforts across the country. This is not simple work.

There is the imperative that all vulnerable people on both sides of this issue need to be protected, and that is work that requires deep prudence and consideration.

The bill takes one very significant step dealing with foreseeable death. In resting on foreseeable death, this bill moves beyond but directly reflects — and this is important to me — the experience in our medical system with end-of-life practices, largely involving decisions to stop treatment. This bill is about end of life, about foreseeable death — less complicated than the expansions being called for in this debate. But then it initiates specific legislated measures for structured study, debate and preparation for next steps, which are even more difficult and more complicated.

Constitutionally, I'm not convinced that the Supreme Court would reject this bill in its current form. There are certainly learned scholars on both sides in Canadian debate and in this debate in the Senate. There is doubt about the assertion that it isn't constitutional. While I'm not a lawyer, clearly, I can see that much has changed since the Supreme Court ruling, and I can see that the demands made by the Supreme Court have been met in many ways by this bill.

The bill, I reiterate, accepts assisted death. The point has been in debate that, somehow, the government argued its case three times, lost it three times and then just implemented these elements into the bill. That's not the case. The government argued against assisted death, and now assisted death is in this bill. That is a result of the significant response to the Supreme Court ruling. In addition, as I've said before, the bill requires further study of critical areas of expansion. That's a significant response to the Supreme Court ruling.

The bill also implements, as referred to the in the ruling specifically, a "complex regulatory structure" to address assisted death. That raises the question, outlined in the statement made by the court, that the courts must accord the legislature a measure of deference and that a high degree of deference is owed to Parliament's decision to impose an absolute prohibition on assisted death. They're talking about deference, so these are significant differences between what the situation was on February 5, 2015, just before that case was ruled on, and what the situation is today.

Arguments have been made about the sky not falling if there is no bill. I accept that it may not fall, but I'm pretty sure that it will become very, very cloudy.

For those particularly concerned about conscientious objection, so well argued by Senator Plett, it should be noted that this is not protected at all in the guidelines developed by professional governance groups across the country — not in a single place. In fact, it is quite the contrary. Physicians in these guidelines are directed at the very least to refer.

For those wanting more, wanting expansion, these same guidelines to a jurisdiction forbid advance directive. For those concerned about safeguards, safeguards in the guidelines are inconsistent and not backed by the force of legislation. Moreover, for those wanting more in this legislative regime, whatever form such a bill would take, it would surely include the elements of this bill. This bill is not inconsistent with what can become and what can in fact follow.

In essence, I would argue that voting against this bill or delaying it because it does not protect conscientious objection will result in an inconsistent series of professional association regimes that do not protect conscientious objection. Risking this bill's passage because it does not go far enough will result in the same regimes that are limited in any event by ruling out advance directives. They don't go further either. Or, delaying or defeating this bill risks losing elements we have now while working on further additions that any bill that goes further would surely include anyway.

I believe Bill C-14 has captured a critical balance between the pressures brought by the court to do something quickly and the prudence required to go further carefully.

Please click here to read this speech in French / Veuillez appuyer ici pour lire ce discours en français.

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