Honourable senators, I rise today to take part in the debate at first reading of Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying).

Like many of you, I have given a lot of thought to this bill and to the speeches and the vote that will happen in connection with this bill. I had some doubts, but as I tend to do when I need to make a decision, I tried to put myself in the position of a person who is paralyzed from head to toe or who is terminally ill and experiencing intolerable suffering. I asked myself whether, in that position, I would want to have the freedom to make my own decision. Would I be okay with being at the mercy of another person's decision, beliefs or religion? I realized that I would want to be treated with respect.

I reread Quebec's Act respecting end-of-life care, which was passed before the Carter decision.

Section 2 lists the principles that guide the provision of end-of- life care. Specifically, the first subsection reads as follows:

Respect for end-of-life patients and recognition of their rights and freedoms must inspire every act performed in their regard.

The second subsection goes on to say that:

End-of-life patients must be treated, at all times, with understanding, compassion, courtesy and fairness, and with respect for their dignity, autonomy, needs and safety.

I find these passages to be extremely powerful and inspiring.

Bill C-14 on medical assistance in dying, as its title says, pertains to matters of life and death, two words that are polar opposites, yet inevitably linked to perpetuity.

We rarely debate bills that are so intense and personal in nature. We have never dealt with such a decisive issue, one that forces us to weigh such fundamental Charter rights as the right to life, liberty and security of person.

Who will this bill actually affect? It will affect our families, our brothers and sisters, our loved ones, as well as ourselves, since anyone of us could one day find ourselves in a situation where our suffering is intolerable and we would like to be able to make a choice, to choose where, when and with whom.

Colleagues, we are working under a deadline imposed by the Supreme Court. Many organizations, including the Barreau du Québec, have pointed out what a short period of time this is to study such an important piece of legislation.

In its brief, the Barreau mentioned that it was forced to limit, and I quote:

. . . suggestions for amendments to certain specific sections of the bill.

It was our understanding that other amendments would have been suggested if there had been more time.

We must take the time needed, senators, to conduct a thorough study of this bill and do our work diligently. We must leave no stone unturned and make sure we produce the best possible legislation under the circumstances. This topic may not have been our choice, but we have accepted the responsibility, and with this responsibility comes a fiduciary duty, a duty to take care.

Allow me to begin by saying that, in theory, I agree with Bill C- 14, a bill that is needed to bring stability and certainty to the legal parameters surrounding the application of the Criminal Code. However, after carefully examining this bill and the case law, including Carter, like many of my colleagues, I have some serious legal, constitutional and personal concerns that were brought to light during the pre-study in committee and at the meeting in Committee of the Whole.

I believe that we need to strike a measured and careful balance between the rights of vulnerable people and the rights of people who are suffering. At the same time, we need to ensure that people who are asking for medical assistance in dying are doing so within a very clear and structured protective mechanism that leaves no room for vagueness or uncertainty.

Basically, this bill was to dispel the doubts regarding medical assistance in dying in the application of the Criminal Code. As you know, criminal law requires the use of very specific language because of its influence on individuals' rights and freedoms. Criminal law, by its coercive nature, requires language that is precise, robust, and linked to well-known and specific references.

It is in that context that legal experts warned us about using the expression "reasonably foreseeable death." This is terminology that has no reference, no anchor. The new legislation does not rely on any precedent to require that the natural death be reasonably foreseeable.

This restriction is unacceptable, say its opponents. According to Dying With Dignity Canada, this would add years of severe and unwanted suffering to Canadians like Kay Carter, who suffered intolerably because of a grievous and irremediable medical condition, but who was not terminally ill.

Doctors even warned us about vague terminology with no point of reference. Why draw this line? It is not just a line dividing a group of people who will have the right to medical assistance in dying from those who will not; it is also a line that defines who will enjoy their constitutional right and who will not. It is also the line that will define the boundary between the behaviour of a good, empathetic doctor who provides care and medical assistance in dying, and, on the other side of the line, the doctor who is likely to be criminally charged.

The clarity of this dividing line is fundamental in the bill. The president of the Federation of Medical Regulatory Authorities of Canada, Dr. Grant, from Nova Scotia, said:

This is legal language that is far too vague for physicians. If it remains, physicians will be unable to confidently determine eligibility for some suffering patients.

Even Quebec's health minister, who was a strong supporter of Quebec's end-of-life care regime when he was president of the medical association, was severely critical of this bill. Minister Barrette said:

The most off-putting part is the part about reasonably foreseeable death. That is medically unrealistic. I myself am disinclined to support C-14 because of the reasonably foreseeable natural death provision. It makes no sense. It cannot be enforced.

Senator Joyal quite rightly quoted Minister Barrette's warnings.

As the Barreau du Québec said, the best scenario is when:

. . . doctors have an open relationship with their patients and can discuss all of the care options available to them.

To achieve that trust relationship with patients:

Doctors must be certain that they are not vulnerable or at risk of being charged when they talk about things with their patients.

Doctors cannot provide adequate information if the bill is not clear. The only way they can do so is if they can be absolutely certain that their actions are not criminal.

Bill C-14 fails to satisfy either side in this debate: those who want additional restrictions and those who want fewer. Regardless of anyone's legitimate position on this issue, we have to make sure the law is clear and unambiguous and that it contains clear guidelines for patients, doctors, lawyers and families.

When the Minister of Justice appeared before us in Committee of the Whole yesterday, we heard more questions than answers about the constitutional challenge that will result from this bill. Her answers raised red flags for me and for some of you, I'm sure. She insisted that this bill complies with the Charter and all constitutional obligations.

Nevertheless, clear and factual social data came out of the initial Carter trial. As a result of that data, Carter clearly stated, and I quote:

We conclude that the prohibition on physician-assisted dying is void insofar as it deprives a competent adult of such assistance where . . . the person affected clearly consents to the termination of life; and . . . the person has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.

I would like to interpret the Charter as Senator Sinclair did, but there is a Supreme Court ruling. When a Supreme Court ruling interprets the Charter, then I must rely on that ruling, particularly when it comes from the Supreme Court and is signed unanimously by "The Court."

To understand the scope of the right and protections provided by the Charter, the Supreme Court identified a group of people whose rights were not only violated . . . We cannot say that the mission has been accomplished if the right is guaranteed for only one subgroup of victims, as is the case in this bill. It limits the rights of a whole group of people identified in the Supreme Court decision to only certain types of people in that group.

Amendments were proposed to ensure that Bill C-14 complies with the Constitution. However, the government did not accept those amendments. Many courts in Canada did not accept the government's arguments. The decision of the Alberta Court of Appeal and more recent decisions by the Ontario Superior Court are in direct opposition to Bill C-14. The Alberta Court of Appeal rendered a decision on May 17 in E.F. The judge rejected Canada's argument that Carter applied only to patients who were terminally ill and found that E.F. met the criteria set out in Carter. Canada appealed the decision and lost.

The government did nothing to amend Bill C-14 after this important and ground-breaking decision. In that decision, the motions judge ruled, and I quote:

The Supreme Court in Carter 2015 did not expressly limit the right to dying individuals or those with medical conditions that are terminal, life-threatening, or that reduce one's life expectancy.

Furthermore, the decision clearly stipulates that the terminology in Carter should not be considered, on the whole, and I quote:

The decision itself is clear. No words in it suggest otherwise. If the court had wanted it to be thus, they would have said so clearly and unequivocally. They did not.

The fact that the government refused to accept any amendments is very troubling, and not only in light of the cases in Alberta and Ontario. The government received a pre-study report from the Senate 15 days before it introduced the bill, and yet there were no amendments. It did not follow through on the recommendations from the Standing Senate Committee on Legal and Constitutional Affairs on Bill C-14, nor did the government follow through on the report by the special joint parliamentary committee co-chaired by our colleague Senator Ogilvie.

Honourable senators, in this chamber we have a duty not only to ensure that the rights of minorities are respected and to represent the rights of vulnerable people and people who are suffering, but also to ensure that their constitutional rights are respected.

Limiting eligibility to people who have terminal illnesses will exclude a group of people who meet all the criteria set out, including people who are experiencing intolerable suffering as a result of degenerative diseases like multiple sclerosis, ALS, Parkinson's disease and Huntington's disease, for example.

We've all seen the stories in the media about the people in Quebec who decided to go on a hunger strike in order to be eligible for medical assistance in dying.

Many people, including me, are very concerned about these cases. People all across Canada are expressing concerns. Canadians want a balanced approach. We must be the beacon of hope for all those who are suffering terribly, while also ensuring that there are strict safeguards to protect the vulnerable.

Honourable senators, we must succeed. We must. Let's take the time to examine this bill very closely and to give it the attention that it warrants and that Canadians have the right to expect. That's why we are here, dear colleagues. The chamber of sober second thought plays a very important role in the process and in studies. The debates and speeches we have heard so far confirm our purpose. Without the Senate, this flawed bill would have come into force this week.

The government put an end to debate in the other place and rushed this bill through all the legislative steps, even though it knew that the bill was not perfect. The Senate is now called upon to play an important role, namely to ensure that this bill is constitutional, that it protects the vulnerable and that it helps those who are suffering. This is the task at hand. This is the task that Canadians have assigned us. We have a fiduciary obligation to these vulnerable people, and it is up to us to fulfill it.