Third reading of Bill C-7, An Act to amend the Criminal Code (medical assistance in dying) – Sen. Munson

By: The Hon. Jim Munson

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Hon. Jim Munson: Honourable senators, nothing really prepares you for this kind of debate, even the debate that we had a few years ago. I do find this very tough. It’s such a sensitive issue.

I rise today to speak at third reading on Bill C-7. Throughout my research on MAID, like many of you, I sought answers to my questions by reading news articles, reports and hearing heartfelt testimony at the Legal Affairs Committee.

When we first started to discuss expanding the medical assistance in dying regime, the first group to reach out to me was the disability community. Many of the same concerns we heard mentioned by over 90 disability groups, such as safeguards, access to resources and human rights, are at the forefront of my mind with this legislation. For these groups, it is having the right to live in dignity.

However, I also believe in MAID. I have great respect for Nicole Gladu and Jean Truchon, the two disabled Quebecers who brought their cases before the courts in fighting for their right to die with dignity. My heart aches every time I hear of someone making a decision to die with dignity. I firmly believe in physician-assisted death and the many safeguards in place to assist those who choose to die with dignity.

My heart also aches for those in the disability community who believe this bill makes it easier for those who are disabled to choose death over life. There are those in the community on both sides of the debate, and we must be respectful and very sensitive to every view.

On one side, there are the views of former Senator Jim Cowan. Jim is with Dying with Dignity Canada. He says it’s worth reading the words of Justice Baudouin in the Truchon decision. She said:

The vulnerability of a person requesting medical assistance in dying must be assessed exclusively on a case-by-case basis, according to the characteristics of the person and not based on a reference group of so-called “vulnerable persons.” . . . the patient’s ability to understand and to consent is ultimately the decisive factor, in addition to the other legal criteria.

Although imperfect in many ways, the intent of this bill is not to have people with disabilities choose this option. It is to bring a compassionate ending for those who are experiencing intolerable suffering.

I feel it’s important to add my voice, as we look ahead to our vote on the bill, to echo the work we still need to do to improve the lives of persons with disabilities. I have worked all my Senate life fighting for disability rights. I cannot stress enough that the government must do more for those who are disabled to choose life.

This bill is a wake-up call for the federal government to do more in the areas of palliative care and other health supports.

In the Senate’s Legal Affairs Committee, Carla Qualtrough, Minister of Employment, Workforce Development and Disability Inclusion, expressed grave concerns over what she called unprovoked MAID, medical assistance in dying. In her comments, she linked this idea to the case of Roger Foley, a 45-year-old with a neurodegenerative condition that has left him hospitalized, unable to move or care for himself.

Mr. Foley’s testimony as a witness in committee in the other place indicated that he was pressured by hospital staff to seek an assisted death when he asked for home care. Minister Qualtrough echoed this call for increased access to services for persons with disabilities when she said, “. . . I can tell you, he’s not alone.” She mentioned that she hears from people who discovered that a family member with a disability has been offered unprovoked MAID on a regular basis.

This speaks to the underlying systemic discrimination that we must talk about and rectify in this country. It is important to underline that there is a lot of work to do on improving assisted living resources. For example, palliative care and long-term care remain missing from the Canada Health Act.

Do you remember the Social Affairs, Science and Technology Committee report? Witnesses suggested that federal legislation should require mandatory accreditation of long-term care homes, as well as national standards for equal access and consistent quality in long-term care homes across Canada. Canada still spends significantly less of its gross domestic product on long-term care homes than many other countries. There needs to be major change.

So as we catch our breath from having this extremely sensitive debate together, it is vital for us to have as much well-informed data as possible, because it enables us to cast a vote worthy of this chamber; a vote on sober second thought.

That being said, there are a few additional complexities here regarding human rights that are important for me to have on the record. It really means a great deal to the international community to have their concerns on the record as well. This is the view that they have.

The letter sent to the government by three UN Special Rapporteurs represents the voices of three unique thematic groups: the rights of persons with disabilities, the enjoyment of all human rights by older persons, and extreme poverty and human rights.

In the different roles of each Special Rapporteur, the purpose of their letter was specifically to address concerns over the removal of a current MAID requirement, where the patient’s natural death is reasonably foreseeable; one of the major concerns with reasonable foreseeability being the act of how it might be applied in practice.

For your consideration, the letter from the UN rapporteur mentions ways this might happen:

In particular, there is a real risk that those without adequate support networks of friends and family, in older age, living in poverty or who may be further marginalized by their racialized indigenous, gender identity or other status, will be more vulnerable being induced to access MAiD.

For the UN rapporteur, this is one of the main concerns in the bill that relates to the human rights of persons with disabilities. We know that marginalization complicates equal accesses to resources. Therefore, we have to get this right.

For me, the most pressing concern that the letter highlights is that these vulnerabilities that could induce access to MAID compound in many areas. Social stigma, such as ableism, is also mentioned as a factor. When intersecting margins collide, the reality of being coerced is very real.

Ultimately, the letter seeks further information from the government in response by requesting an explanation as to how the current bill, configured as it is, does not subtly or indirectly reinforce ableist assumptions, contrary to Article 8, combined with Articles 4 and 5, of the UN convention. It calls for an explanation of measures taken to consult closely with representative organizations of people with disabilities and older persons when developing, adopting and implementing the new national policy on medical assistance in dying. Additionally, it calls for further specification on the extent to which the government considered alternative approaches to wording to avoid impaling or reinforcing ableist and ageist assumptions contrary to these vulnerable positions. This is what we are trying to do right here, right now.

One of the other areas I found very helpful for understanding some of these complexities were the webinars that expressed perspectives outside of committee. One of the webinars, co-hosted by Disability Justice Network of Ontario, or DJNO; Inclusion Canada; the DisAbled Women’s Network of Canada, or DAWN Canada; and Independent Living Canada, focused on those on the margins. Their discussions stuck with me. This webinar hosted on February 1 included the anonymous voice of someone with a disability currently going through the MAID process. The final question asked was this: What supports would you like to see in Canada for persons with disabilities to combat the increased suicidality that makes them more likely to choose MAID? The answer from the anonymous MAID applicant was a simple one: If people can afford their food, medicines, rents and bills, there is no need for assisted suicide, but until rates are raised, even if Bill C-7 were removed, the need for suicide remains.

I want to highlight these concerns; they’re important. I want the government to pay attention to these concerns so they can do something in the upcoming budget soon by initiating programs and protecting the rights of those with disabilities. It is really important.

But as I fight for those with disabilities, I have to respect those whose actions brought the bill to this stage in the first place. The names of Nicole Gladu and Jean Truchon cannot be forgotten in this debate, nor can the name Sue Rodriguez. They are very brave. They had great courage.

For some, Bill C-7 is a road too far; for others, Bill C-7 is a road to liberation from the intolerable pain of living. For me, Bill C-7 does recognize the significant role that social, mental health, disability and community support services play in the full realization of equal rights.

Honourable senators, I listened closely to the words of Senator Chantal Petitclerc and the suffering she endured as a child. It was a very emotional moment here today. It is not easy being a sponsor of a bill. It is a tough road, but I have the highest admiration for Senator Petitclerc as sponsor of Bill C-7. I know in her heart she is trying to find the right balance, and she deserves our respect.

We know that the Accessible Canada Act sets out the guiding principles of Bill C-7, which include that everyone must be treated with dignity; everyone must have meaningful options and be free to make their own choices; and everyone must have the same opportunity to make for themselves the lives that they are able and wish to have, regardless of their disabilities.

Honourable senators, in closing, this is the opportunity that the government needs to truly become a trailblazer in the area of human rights for people with disabilities. Is this the debate that is pointing the way for the government to reinvent its policy agenda and its commitment to the human rights of people with disabilities? I think this is an open invitation to rethink the way that people with disabilities can live, thrive and lead productive lives as Canadians. While I have my worries about the bill, I must, at the end of the day, listen carefully to the voices of Nicole Gladu and Jean Truchon. Theirs is a Charter right and an individual right, and I will vote for the amended bill.

Thank you.

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