An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)

This bill was last introduced in the 42nd Parliament, 1st Session, which ended in September 2019.

Sponsor

Status

This bill has received Royal Assent and is now law.

Summary

This is from the published bill. The Library of Parliament often publishes better independent summaries.

This enactment amends the Criminal Code to, among other things,
(a) create exemptions from the offences of culpable homicide, of aiding suicide and of administering a noxious thing, in order to permit medical practitioners and nurse practitioners to provide medical assistance in dying and to permit pharmacists and other persons to assist in the process;
(b) specify the eligibility criteria and the safeguards that must be respected before medical assistance in dying may be provided to a person;
(c) require that medical practitioners and nurse practitioners who receive requests for, and pharmacists who dispense substances in connection with the provision of, medical assist­ance in dying provide information for the purpose of permitting the monitoring of medical assistance in dying, and authorize the Minister of Health to make regulations respecting that information; and
(d) create new offences for failing to comply with the safeguards, for forging or destroying documents related to medical assistance in dying, for failing to provide the required information and for contravening the regulations.
This enactment also makes related amendments to other Acts to ensure that recourse to medical assistance in dying does not result in the loss of a pension under the Pension Act or benefits under the Canadian Forces Members and Veterans Re-establishment and Compensation Act. It amends the Corrections and Conditional Release Act to ensure that no investigation need be conducted under section 19 of that Act in the case of an inmate who receives medical assistance in dying.
This enactment provides for one or more independent reviews relating to requests by mature minors for medical assistance in dying, to advance requests and to requests where mental illness is the sole underlying medical condition.
Lastly, this enactment provides for a parliamentary review of its provisions and of the state of palliative care in Canada to commence at the start of the fifth year following the day on which it receives royal assent.

Elsewhere

All sorts of information on this bill is available at LEGISinfo, an excellent resource from the Library of Parliament. You can also read the full text of the bill.

Votes

June 16, 2016 Passed That a Message be sent to the Senate to acquaint their Honours that this House: agrees with the amendments numbered 1, 2(d), 2(e), 4, and 5 made by the Senate to Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying); proposes that amendment 2(c)(i) be amended by replacing the text of the amendment with the following text “sistance in dying after having been informed of the means that are available to relieve their suffering, including palliative care.”; proposes that amendment 3 be amended in paragraph (b) by adding after the words “make regulations” the words “that he or she considers necessary”; respectfully disagrees with amendment 2(a) because requiring that a person who assists to be free from any material benefit arising from the patient's death would eliminate from participation the family members or friends most likely to be present at the patient's express wish, and this would violate patient autonomy in a fundamental and inacceptable manner; and respectfully disagrees with amendments 2(b), 2(c)(ii), and 2(c)(iii) because they would undermine objectives in Bill C-14 to recognize the significant and continuing public health issue of suicide, to guard against death being seen as a solution to all forms of suffering, and to counter negative perceptions about the quality of life of persons who are elderly, ill or disabled, and because the House is of the view that C-14 strikes the right balance for Canadians between protection of vulnerable individuals and choice for those whose medical circumstances cause enduring and intolerable suffering as they approach death.
June 16, 2016 Failed That the motion be amended by: ( a) deleting the paragraph commencing with the words “respectfully disagrees with amendments numbered 2(b), 2(c)(ii), and 2(c)(iii)”; and ( b) replacing the words “agrees with amendments numbered 1, 2(d), 2(e), 4, and 5” with the words “agrees with amendments numbered 1, 2(b), 2(c)(ii), 2(c)(iii), 2(d), 2(e), 4, and 5”.
May 31, 2016 Passed That the Bill be now read a third time and do pass.
May 31, 2016 Failed That the motion be amended by deleting all the words after the word “That” and substituting the following: “Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), be not now read a third time but be referred back to the Standing Committee on Justice and Human Rights for the purpose of reconsidering Clause 3 with a view to ensuring that the eligibility criteria contained therein are consistent with the constitutional parameters set out by the Supreme Court in its Carter v. Canada decision.”.
May 30, 2016 Passed That Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), {as amended}, be concurred in at report stage [with a further amendment/with further amendments] .
May 30, 2016 Failed “Health, no later than 45 days after the day”
May 30, 2016 Failed “(7.1) It is recognized that the medical practitioner, nurse practitioner, pharmacist or other health care institution care provider, or any such institution, is free to refuse to provide direct or indirect medical assistance in dying. (7.2) No medical practitioner, nurse practitioner, pharmacist or other healthcare institution care provider, or any such institution, shall be deprived of any benefit, or be subject to any obligation or sanction, under any law of the Parliament of Canada solely by reason of their exercise, in respect of medical assistance in dying, of the freedom of conscience and religion guaranteed under the Canadian Charter of Rights and Freedoms or the expression of their beliefs in respect of medical assistance in dying based on that guaranteed freedom.”
May 30, 2016 Failed “(3.1) The medical practitioner or nurse practitioner shall not provide a person with assistance in dying if the criteria in subsection (1) and the safeguards in subsection (3) have not been reviewed and verified in advance (a) by a competent legal authority designated by the province for that purpose; or (b) if no designation is made under paragraph (a), by a legal authority designated by the Minister of Health in conjunction with the Minister of Justice for that purpose. (3.2) The designation referred to in paragraph (3.1)(b) ceases to have effect if the province notifies the Minister of Justice that a designation has been made under paragraph (3.1)(a).”
May 30, 2016 Failed “(3.1) As it relates to medical assistance in dying, no medical practitioner or nurse practitioner may administer a substance to a person if they and the medical practitioner or nurse practitioner referred to in paragraph (3)(e) concur that the person is capable of self-administering the substance.”
May 30, 2016 Failed “(d) their imminent natural death has become foreseeable, taking into account all of their medical circumstances.”
May 30, 2016 Failed
May 30, 2016 Failed “(f) they have, if they suffer from an underlying mental health condition, undergone a psychiatric examination performed by a certified psychiatrist to confirm their capacity to give informed consent to receive medical assistance in dying.”
May 30, 2016 Failed “(f) prior to making the request, they consulted a medical practitioner regarding palliative care options and were informed of the full range of options.”
May 30, 2016 Failed
May 18, 2016 Passed That, in relation to Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), not more than one further sitting day shall be allotted to the consideration at report stage of the Bill and one sitting day shall be allotted to the consideration at third reading stage of the said Bill; and That, 15 minutes before the expiry of the time provided for Government Orders on the day allotted to the consideration at report stage and on the day allotted to the consideration at third reading stage of the said Bill, any proceedings before the House shall be interrupted, if required for the purpose of this Order, and in turn every question necessary for the disposal of the stage of the Bill then under consideration shall be put forthwith and successively without further debate or amendment.
May 4, 2016 Passed That the Bill be now read a second time and referred to the Standing Committee on Justice and Human Rights.
May 4, 2016 Passed That the question be now put.
May 4, 2016 Passed That, in relation to Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), not more than one further sitting day shall be allotted to the consideration at second reading stage of the Bill; and That, 15 minutes before the expiry of the time provided for Government Orders on the day allotted to the consideration at second reading stage of the said Bill, any proceedings before the House shall be interrupted, if required for the purpose of this Order, and, in turn, every question necessary for the disposal of the said stage of the Bill shall be put forthwith and successively, without further debate or amendment.

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:35 p.m.
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Liberal

Nathaniel Erskine-Smith Liberal Beaches—East York, ON

Mr. Speaker, my friend spoke of intrinsic and instrumental value, and I want to get at that muddled philosophy of intrinsic value. If we respect the intrinsic value of an individual, we respect the individual's choice. That individual's choice matters if we respect that individual as having intrinsic value.

I wonder what the member thinks of autonomy, of the individual, and of liberty if he thinks intrinsic value of the individual is so fundamentally important.

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:35 p.m.
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Conservative

Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB

Mr. Speaker, let me say two things.

First, the idea of autonomy is built on a foundation of intrinsic human value. If one believes that humans have value, that has consequences, obviously, for one's desire to give them choices. Also, however, a belief in intrinsic human value with dignity can limit choices if individuals wish to, in a dramatic way, harm themselves in a way that denies their intrinsic value. The basis of autonomy is this respect for intrinsic human dignity in all cases, in all circumstances, which must be preserved.

The amendments that I have proposed are not ones that in any way derogate from autonomy with respect to euthanasia or assisted suicide. There are things like advance review, a guaranteed offer of palliative care, conscience protection for physicians, and more robust criteria, which will actually ensure that people who have suicidal ideations for short periods of time do not access this so-called service when, in fact, their longer-term desires are to live. These are things that protect a more robust notion of autonomy in all cases.

Clearly, whatever one thinks of the underlying question, let us marshal our energies in the direction of fixing these problems in the bill to protect both human dignity and values of autonomy.

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:40 p.m.
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NDP

Pierre-Luc Dusseault NDP Sherbrooke, QC

Mr. Speaker, my colleague is proposing to improve the bill, but he just asked all members to oppose it at second reading. I do not understand how he can reconcile those two statements.

On the one hand, he wants to improve the bill, and on the other hand, he is asking us to vote against it at second reading, in order to scrap it and allow the government to come back with a new bill. That is exactly what he said at the end of his speech.

Does my colleague think it is possible to improve the bill and thus prevent the legal vacuum that would exist on June 6, the one that he referred to?

In order to prevent that vacuum, we need to at least pass the bill at second reading to try to improve it. Then, at third reading, we can assess it again, and if my colleague wants to vote against it, he will be free to do so. However, at second reading, we need to be responsible and examine it more thoroughly, in order to make changes like the ones he just suggested.

If the majority of members reject the bill at second reading, the government will have to start from scratch and come back with a new bill. It will be even more difficult to meet the June 6 deadline.

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:40 p.m.
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Conservative

Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB

Mr. Speaker, that is a good question. It is an issue of timeline. If this bill passes overwhelmingly at second reading, it goes to committee, it comes back with virtually no time left. If the government chooses not to make necessary amendments, it will leave members of Parliament with a much narrower set of options.

I suggest we take a stand against the government, with its bullying effort of closure. Let us take a stand against the big problems in this bill and reject it at this reading stage. There is plenty of time for the government to bring back a new bill if it works to achieve substantial consensus among members of Parliament. However, if we support the legislation at second reading and the bill passes at this stage, we will lose necessary time to do a more fundamental review.

Of course the bill can be amended at committee, but the various things I have advocated are substantial enough that we are better off rejecting it and asking the government to come back with something that is substantially better. It is the only way to send a clear message that the absence of protections for the vulnerable are necessary to ensure that people do not die who should not die. The absence of those protections in this bill is so fundamental that we must vote this bill down until we can be sure they will be included.

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:40 p.m.
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Conservative

Harold Albrecht Conservative Kitchener—Conestoga, ON

Mr. Speaker, we have heard many extremely poignant statements over the past few days in this chamber. Here are a few of them, not necessarily word for word, but the essence is there: This is by far the most crucial question we have faced in this chamber in the past 10 years. We are experiencing a fundamental shift in society. Centuries of thought are being overturned. Thousands of years of the understanding of the sacred gift of human life are being discarded.

The Liberal member of Parliament for Winnipeg Centre stated:

Perhaps this is just another step on the road of moral relativism that we are in nowadays, but even our judiciary cannot serve as a balance between the different societies making up Canada. We are in a sorry state. We have truly entered a new age, one of the throwaway culture where all boundaries are starting to crumble.

He goes on to say:

From an indigenous perspective, I look at this bill and I cannot support it, because it leads to a place where I do not believe we are looking out for the interests of all people within our society. It is not allowing us to fully comprehend the needs of everyone who makes up Canadian societies, but really, it is taking us down a path that is very dangerous, and we do not know where it ends.

This comment is true not only for our indigenous communities, but also for the overwhelming majority of all Canadians who are informed by their faith, whether that be Jewish, Muslim, Sikh, or Christian.

I want to read from a very insightful blog that I came across today.

...from its very first sentence the bill sounds the final death-knell, for all public purposes, of Abrahamic faith. The Carter/C-14 doctrine of autonomy is a clear repudiation of that kind of faith and the establishment of a new faith in man as utterly independent of God. One does not need to be Abrahamic to understand this. If the Parliament of Canada recognizes personal autonomy as extending a moral right to determine the manner and timing of one’s own death, and to take one’s own life or another’s life, it necessarily recognizes the person—and [Parliament] itself as a deliberative body of persons—as lying outside of all putative divine authority in such matters. In short, the C-14 preamble is the final repudiation of the Charter preamble. “The principles of fundamental justice”...now operate independently of any reference whatsoever to the supremacy of God. The link between “the supremacy of God and the rule of law” is decisively severed.

He then goes on to quote Nietzsche:

What were we doing when we unchained this earth from its sun? Whither is it moving now? Whither are we moving? Away from all suns? Are we not plunging continually? Backward, sideward, forward, in all directions? Is there still any up or down? Are we not straying, as through an infinite nothing? Do we not feel the breath of empty space? Has it not become colder? Is not night continually closing in on us? Do we not need to light lanterns in the morning? Do we hear nothing as yet of the noise of the gravediggers who are burying God? Do we smell nothing as yet of the divine decomposition? Gods, too, decompose. God is dead. God remains dead. And we have killed him.

Over the past few days in the House, we have heard from many members with a wide variety of positions. Let me first say that I am very thankful that the government decided not to follow through with all of the recommendations made in the Liberal-dominated special joint committee report and decided rather to incorporate many of the comments of the dissenting report created by me and other members of the Conservative Party.

While Bill C-14 is a huge improvement from the very permissive, wide-open regime recommended by the joint committee, the legislation falls far short in protecting some of our most vulnerable Canadians, and as a result, I cannot support it.

First, there is no firm commitment to conscience protection for doctors and other health care workers who for a variety of reasons may not want to participate in any fashion in physician-assisted suicide. This includes the need to make a referral to a participating doctor.

While the preamble states boldly that that it is “desirable to have a consistent approach to medical assistance in dying across Canada”, and later refers to “respect the personal convictions of health care providers”, there is no section in the actual clauses of Bill C-14, no clear, unequivocal statement that no doctor or health care worker would be under any obligation to participate.

Just as important, what about health care institutions and hospices which, because of the core values they embrace, may not want to have physician-assisted suicide available in their institutions? What about a hospice which raises upward of 50% of its own revenue from private donations and which relies largely on armies of volunteers and donors who believe in the inherent and intrinsic dignity of human life? My fear is that if any of these institutions are forced into situations in which they are obligated to engage in physician-assisted suicide, the community may face the very real possibility of losing those volunteers and donors, and ultimately, may in fact lose the very institution itself. This would be a tragic unintended consequence of not guaranteeing conscience rights to doctors, health care workers, and institutions.

These changes must be included in Bill C-14 if we are to respect the professionals and institutions that provide excellent quality of health care every day.

There also needs to be a clear commitment to providing palliative care as a real and viable option. To offer physician-assisted suicide without a meaningful offer of available and palliative care is to provide no option.

Let me quote Dr. David Baker:

Without a right to palliative care, Canadians will soon be receiving publicly funded physician assistance to die because it [palliative care] is not available. This will infringe their s. 7 Charter right to life, liberty and the security of their persons and their section 15 equality rights as Canadians with disabilities and seniors.

Another important amendment that is needed is to have a system of prior review. There needs to be a legal system in place to ensure that no coercion occurs and to ensure that the two independent witnesses are in fact independent and that the two independent doctors are in fact independent.

Dr. Trudo Lemmens, the chair on health law and policy at the faculty of law at the University of Toronto stated:

...some eligibility criteria are inevitably quite open to interpretation, which makes it all the more problematic that an assessment of competency and informed consent by two physicians is seen as sufficient to ensure compliance. I continue to support a prior review system as reflected in the Vulnerable Person Standard, which is supported by a wide and inclusive coalition of patient and disability advocacy groups, health professional organizations, health care institutions and individuals with a wide variety of ideological and religious affiliations.

While I am fundamentally opposed to the taking of human life at any point, if we are to adopt legislation as a House of Commons, if we are going to go down this road, we need to be sure that we have far more stringent safeguards included in the bill.

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:50 p.m.
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NDP

Pierre-Luc Dusseault NDP Sherbrooke, QC

Mr. Speaker, I would like to thank my colleague for his speech and his long-standing work on this issue.

I was wondering if he could acknowledge this evening that a hypothetical new law would provide freedom of choice. People who are dying or whose health is very fragile will always have the option of accessing medical assistance in dying, which is now protected under the charter. These people will always be able to choose that option or continue to live out their days as they do at this time.

Does he acknowledge that, even with a new legislative regime, this does not change the fact that every patient who is dying will always be able to choose whether or not to access this service? Therefore, this respects the conscience of the individuals and their families, but also the freedom of choice and the rights of patients who might want to use this service. Does he acknowledge that under a new legislative regime, patients will always have choice and people will not be forced to use these services?

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:50 p.m.
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Conservative

Harold Albrecht Conservative Kitchener—Conestoga, ON

Mr. Speaker, it has been pointed out by a number of my colleagues that while freedom of human choice is a freedom we personally have, when we implement a regime like we are considering here, we are not just choosing for ourselves but we are choosing to have a person, a medical practitioner of some sort, obligated in some fashion to participate in our choice. It is on those points that the House has struggled over these past few days.

The one clear commonality among the concerns that we have expressed is the concern that we need to protect the conscience rights of those medical practitioners who for one reason or another may not wish to participate at all, either directly in implementing a physician-assisted suicide act or in referring to a person who would in fact carry out the patient's wishes.

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:55 p.m.
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Conservative

Mel Arnold Conservative North Okanagan—Shuswap, BC

Mr. Speaker, the member mentioned that we were going down a path that we may not be able to turn around. He spoke about eligibility as open to interpretation. I wonder about some of the definitions in the bill. What really bothers me is the lack of definitions and the lack of clarity. I would like to know if the member would like to comment on this.

At what point does the suffering become too much? Is it at a point when no one else is suffering worse? By removing or aiding in the assistance of the death of those people who are suffering, does that level of suffering and intolerance become a speeding train which we cannot stop, to where it will be ever increasingly different and we will not be able to control it?

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:55 p.m.
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Conservative

Harold Albrecht Conservative Kitchener—Conestoga, ON

Mr. Speaker, my colleague in the Liberal Party, possibly the member for Winnipeg Centre but I am not sure, made a comment the other day, that in the first nations tradition, they always take into consideration how the decision they make today will impact seven generations from now. I thought there was a lot of wisdom in that perspective. Often we look at a decision and we make it lightly without thinking about the long-term consequences. Each of us in this room have made the mistake of making a short-term decision without adequately considering the long-term consequences.

I am very concerned about where we are going with this bill. Many of my colleagues, on both sides of the House, have given illustrations from other jurisdictions that have implemented a regime similar to the one we are considering, in fact in some cases more restrictive than the one we are considering. Yet over time, those jurisdictions have seen an incredible widening of the door, while thinking at first they had adequate safeguards, and in a very short time moving from a smaller number of people accessing physician-assisted suicide to an increase within a period of 15 years, for example, in Belgium I believe, it went from 330 to over 2,200 last year.

If we are to extrapolate those numbers to Canada with a population of three times that of Belgium, we are looking at potentially over 6,000 Canadians dying by physician-assisted suicide in one year. In my opinion, that would be a national tragedy.

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:55 p.m.
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Liberal

Rob Oliphant Liberal Don Valley West, ON

Mr. Speaker, I have one concern for the member. I just noticed the member for Kitchener—Conestoga and the member for Sherwood Park—Fort Saskatchewan have now spoken repeatedly on this. I am concerned that the members on the other side have begun to run out of steam and are repeating themselves. Maybe the Conservatives do not have enough speakers to continue this debate any further. I wanted to bring it the attention of the House that perhaps the members could talk about the problem of getting new speakers on this subject.

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:55 p.m.
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Liberal

The Speaker Liberal Geoff Regan

I am not sure that is a legitimate question in relation to the debate we are having, but I am going to turn to the hon. member for Kitchener—Conestoga, who seems to wish to respond.

Criminal CodeGovernment Orders

May 3rd, 2016 / 11:55 p.m.
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Conservative

Harold Albrecht Conservative Kitchener—Conestoga, ON

Mr. Speaker, I am more than happy to address that question because I know many members in our party still want to speak to the bill. It just so happens that because of the procedural games that were put in today, there was a question of whether anyone would be able to speak tonight. However, now that we have that opportunity, we have had to do some changing around, but there are still more people who want to speak to the bill.

If members look at the comments I made tonight and the comments of my colleague, they will see that we are not repeating ourselves. We are simply telling members about the concerns we have had, and we certainly would not have had time in the 10 minutes that were available to us earlier.

I appreciate the opportunity to speak again tonight to this very crucial issue. There is no issue that this Parliament will be seized with that is more fundamental, not only to this generation but to future generations of Canadians that will follow. I for one want to be able to stand, look my children, my grandchildren, and my great-grandchildren in the eye and tell them that with the information I had available to me I made the decision that was right for Canada.

Criminal CodeGovernment Orders

May 4th, 2016 / midnight
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Liberal

The Speaker Liberal Geoff Regan

It being midnight, pursuant to order made Tuesday, May 3, 2016, the debate is deemed adjourned and the House stands adjourned until later this day at 2 p.m., pursuant to Standing Order 24(1).

(The House adjourned at 12 a.m.)

Bill C-14—Time Allocation MotionCriminal CodeGovernment Orders

May 4th, 2016 / 3:20 p.m.
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Beauséjour New Brunswick

Liberal

Dominic LeBlanc LiberalLeader of the Government in the House of Commons

moved:

That, in relation to Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), not more than one further sitting day shall be allotted to the consideration at second reading stage of the Bill;

and

That, 15 minutes before the expiry of the time provided for Government Orders on the day allotted to the consideration at second reading stage of the said Bill, any proceedings before the House shall be interrupted, if required for the purpose of this Order, and, in turn, every question necessary for the disposal of the said stage of the Bill shall be put forthwith and successively, without further debate or amendment.

Bill C-14—Time Allocation MotionCriminal CodeGovernment Orders

May 4th, 2016 / 3:20 p.m.
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Liberal

The Speaker Liberal Geoff Regan

Pursuant to Standing Order 67.1 there will now be a 30-minute question period. I invite hon. members who wish to ask questions to rise in their place so the Chair has some idea of the number of members who wish to participate in this question period.

The hon. member for Regina—Qu'Appelle.