Proceedings of the Standing Senate Committee on
Legal and Constitutional Affairs
Issue No. 9 - Minutes of Proceedings - May 12, 2016
OTTAWA, Thursday, May 12, 2016
(22)
[English]
The Standing Senate Committee on Legal and Constitutional Affairs met this day at 10:30 a.m., in room 160-S, Centre Block, the chair, the Honourable Bob Runciman, presiding.
Members of the committee present: The Honourable Senators Baker, P.C., Batters, Boisvenu, Cowan, Dagenais, Eaton, Jaffer, Joyal, P.C., McIntyre, Plett, Runciman and White (12).
Other senators present: The Honourable Senators Cools, Kenny, Lankin, P.C., and Pratte (4).
In attendance: Lyne Casavant and Maxime Charron-Tousignant, Analysts, Parliamentary Information and Research Services, Library of Parliament.
Also present: The official reporters of the Senate.
Pursuant to the order of reference adopted by the Senate on Wednesday, April 20, 2016, the committee continued its examination of the subject matter of Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying). (For complete text of the order of reference, see proceeding of the committee, Issue No. 8.)
WITNESSES:
UNICEF Canada:
Marvin Bernstein, Chief Policy Advisor.
Euthanasia Prevention Coalition of Ontario:
Alex Schadenberg, Executive Director;
Hugh Scher, Legal Counsel (by video conference).
As individuals:
Joan Gilmour, Professor, Osgoode Hall Law School, York University.
Errol Mendes, Professor, Faculty of Law — Common Law, University of Ottawa.
Canadian Association of Advanced Practice Nurses:
Maureen Klenk, Nurse Practitioner.
Canadian Paediatric Society:
Dr. Dawn Davies, Chair, Bioethics Committee.
The chair made a statement.
Mr. Mendes, Mr. Bernstein, Ms. Gilmour and Mr. Scher each made a statement and, together with Mr. Schadenberg, answered questions.
At 11:32 a.m., the committee suspended.
At 11:37 a.m., the committee resumed.
Ms. Klenk and Dr. Davies each made a statement and, together, answered questions.
At 12:29 p.m., the committee suspended.
At 1:06 p.m., pursuant to rule 12-16(1)(d), the committee resumed in camera to consider a draft report.
It was moved that the committee allow the transcription of today's in camera meeting, that one copy be kept in the office of the clerk of the committee for consultation by committee members (present) and the committee analysts, and that the transcript be destroyed by the clerk when authorized to do so by the Subcommittee on Agenda and Procedure but no later than at the end of this parliamentary session.
The question being put on the motion, it was adopted.
(See Minutes of Proceedings of May 17, 2016.)
It was moved that the committee recommend that the bill be amended to remove the portion of the preamble that the Government of Canada should explore other situations in which a person may seek access to medical assistance in dying, namely situations giving rise to requests by mature minors and requests where mental illness is the sole underlying medical condition.
After debate, the question being put on the motion, it was adopted, on division.
It was moved that the committee recommend that the bill be amended to remove reference to a nurse practitioner in every instance throughout the bill where such an individual is allowed to assess eligibility, approve requests and administer medical assistance in dying, including prescribing or providing a substance.
After debate, the question being put on the motion, it was negatived, on division.
It was moved that the committee recommend that the bill be amended to limit the capacity of a nurse practitioner, when providing a person with medical assistance in dying, to administering a substance to that person, at their request, that causes their death.
After debate, the question being put on the motion, it was negatived, on division.
It was agreed that an observation be included in the report to say that the committee raises a serious concern about the fact that counselling a person to die by suicide or abetting a person in dying by suicide (section 241(1)(a)) is not included in the exemption for medical assistance in dying.
It was moved that the committee recommend that the bill be amended to specifically limit the "exemption for person aiding patient'' so that it does not apply to a person who knows or believes that he or she is a beneficiary upon the death of the person making the request, or a recipient, in any other way, of a financial or other material benefit resulting from that person's death.
After debate, the question being put on the motion, it was adopted.
It was moved that the committee recommend that the bill be amended to remove the provision that defines "grievous and irremediable medical condition'' (section 241.2(2) of the Code) and use instead the language found in Carter v. Canada (Attorney General).
After debate, the question being put on the motion, it was negatived, on division.
It was moved that the committee recommend that the bill be amended to add into an operative provision of the bill: "For greater certainty, nothing in this bill allows a person to be granted medical assistance in dying where mental illness is the sole underlying medical condition.''
After debate, the question being put on the motion, it was negatived, on division.
It was moved that the committee recommend that the bill be amended to ensure that, as a safeguard, a person undergoes a palliative care consultation which would include full information about treatment, technology and support options available to mitigate and alleviate suffering, when assessing eligibility to medical assistance in dying.
After debate, the question being put on the motion, it was negatived, on division.
It was moved that the committee recommend that the bill be amended to add "terminal illness'' to the first criterion of the definition of a "grievous and irremediable medical condition,'' so that it reads "(a) they have a serious and incurable terminal illness, disease or disability and have been determined to be at the end of life.''
After debate, the question being put on the motion, it was adopted, on division.
It was moved that the committee recommend that the bill be amended to include a requirement that each request for medical assistance in dying be subject to review and approval by a Superior Court Judge, to ensure that all legal requirements and conditions are fulfilled.
After debate, the question being put on the motion, it was negatived, on division.
It was moved that the committee recommend that the bill be amended to include, as a safeguard, a requirement that a psychiatric assessment of competency be required in all cases where mental illness is present.
After debate, the question being put on the motion, it was negatived, on division.
It was moved that the committee recommend that the bill be amended to remove the requirement that immediately before providing medical assistance in dying, the person shall give express consent.
The question being put on the motion, it was negatived, on division.
At 3:08 p.m., the committee suspended.
At 3:17 p.m., the committee resumed.
After debate, it was agreed that the committee recommend that the bill be amended to maintain, as a safeguard, a requirement to ensure that there are at least 15 clear days between the day on which the request to medical assistance in dying was signed by the person and the day on which it is provided; and add that such delay be increased to 90 clear days where the person suffers from a mental health condition.
After debate, it was agreed that the committee recommend that the bill be amended to specifically deny a person who knows or believes that he or she is a beneficiary upon the death of the person making the request, or a recipient, in any other way, of a financial or other material benefit resulting from that person's death, the ability to sign for the person requesting medical assistance in dying, if that person is unable to sign and date the request.
After debate, it was agreed that the committee recommend that the requirement be maintained that the medical practitioner or nurse practitioner providing medical assistance in dying and the medical practitioner or nurse practitioner who provides the written opinion confirming that the person meets all of the criteria to be eligible for medical assistance in dying, be considered independent if they are not in a business relationship with the other practitioner; nor a mentor to the other practitioner or responsible for supervising their work.
It was moved that the committee recommend that the bill be amended to add a provision that for greater certainty, a medical practitioner or nurse practitioner is free to refuse to provide medical assistance in dying; and that a social worker, psychologist, psychiatrist, therapist, other health care professional, or any institution is free to refuse to aid in the provision of medical assistance in dying; and that they shall not 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 exercising their freedom of conscience and religion 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.
After debate, the question being put on the motion, it was adopted, on division.
After debate, it was agreed that a recommendation be adopted that the bill be amended to ensure that the Minister of Health shall, instead of may, make regulations regarding the provision, collection, use, disposal and exemption of information relating to requests for, and the provision of, medical assistance in dying.
It was moved that a recommendation be adopted that the bill be amended to remove any mention that the Government must initiate one or more independent reviews of issues relating to requests by mature minors for medical assistance in dying and requests where mental illness is the sole underlying medical condition.
After debate, the question being put on the motion, it was adopted, on division.
It was moved that a recommendation be adopted to accept recommendation 7 of the Report of the Special Joint Committee on Physician-Assisted Dying stipulating: "That the permission to use advance requests for medical assistance in dying be allowed any time after one is diagnosed with a condition that is reasonably likely to cause loss of competence or after a diagnosis of a grievous or irremediable condition but before the suffering becomes intolerable. An advance request may not, however, be made, prior to being diagnosed with such a condition. The advance request is subject to the same procedural safeguards as those in place for contemporaneous requests.''
After debate, the question being put on the motion, it was adopted, on division.
After debate, it was agreed that an observation be included in the report that the committee raises a serious concern about the fact that although the bill does not allow advance requests for medical assistance in dying, it does allow a person to self-administer a substance to cause his or her own death potentially months or years after the substance has been prescribed. In these cases, there is no safeguard ensuring that the patient's express consent is given at that time.
At 4 p.m., the committee adjourned to the call of the chair.
ATTEST:
Jessica Richardson
Clerk of the Committee