Bill C-7 - Medical Assistance in Dying - Second Reading
Honourable senators, I rise today to join debate on Bill C-7, which would make amendments to the medical assistance in dying legislation. My remarks come after discussions with groups on both sides of this debate: ones that are in favour of this legislation, as well as those who have voiced concerns with the processes and procedures by which this legislation came to fruition. While I was initially inclined to support the passage of this bill, information about the consultation period, or lack thereof — with Indigenous stakeholders and service providers, especially those from the disability community — has caused me great concern. My role as a senator of Cree descent is to bring those voices to the floor.
Colleagues, issues surrounding consultation are not new, but remain an ongoing issue that every government seems unwilling or unable to accommodate and rectify. Until consultation is done in a fulsome and responsible way, we run the risk of continuing to trample on the rights, not only of Canada’s Indigenous population but also our non-Indigenous population. We also have the reality of emotional and psychological harm to the disability community who fear that this bill could result in lost lives. How did we get here, once again?
Honourable senators, one conversation I have had on this important bill was with Dr. Sara Goulet, a health care professional who flies into remote, Northern First Nations communities to provide health care to citizens. Dr. Goulet is also the Clinical Lead, Ongomiizwin Health Services, and Associate Dean of Admissions at the Max Rady College of Medicine, University of Manitoba. Dr. Goulet attended a round-table discussion on medical assistance in dying on February 3, 2020, which was hosted by Justice Minister David Lametti and Parliamentary Secretary Arif Virani. This session was to focus on Indigenous people’s perspectives on what would later become Bill C-7.
The meeting on February 3 was attended by roughly 10 participants and was the only discussion that I am aware of that took place with Indigenous peoples or stakeholders through the legislative process surrounding Bill C-7. This, colleagues, is of great concern to me. One round-table discussion with a handful of participants is not adequate consultation, nor does it even constitute what can responsibly be deemed as fulsome.
As Dr. Goulet herself had indicated to me:
The theme of the meeting and what each invitee spoke about on the call was the need for appropriate consultation [and] that the group on the call could not provide the right advice, nor represent the perspective of all Indigenous peoples in Canada.
We now know it was expressly indicated to those government officials present at the meeting that those participants did not feel that they were able to provide the appropriate advice and information that was being sought from them. The participants also highlighted that they could not speak for any other Indigenous group, organization or peoples. This should have been a clear signal to the government that this round table would not come close to meeting the threshold required to satisfy the minimum expectations of responsible consultation.
Colleagues, another issue that Dr. Goulet had mentioned was that she was the only physician on the call. She had indicated that the participants wanted to do a broad consultation on this subject in a variety of First Nations communities to start to get an idea of the impact the current law is having on them and their citizens. This was clearly not accommodated. The insight that Dr. Goulet impressed upon me is that:
Many Indigenous peoples are not aware of MAID as an option. In particular those living in more remote communities would not have even had the opportunity to hear about the law.
Honourable senators, as I have been advised, there were also huge concerns raised by the participants of this meeting around the limited access for Indigenous people to obtain culturally safe and effective health care in Canada. This experience is compounded by the limited access to food, clean water, safe housing and education that supports cultural practices and resilience. The participants present wondered how health care professionals could be satisfied that all other options for treatment, or relevant services, had been offered to the patient before choosing to end their life.
I will quote Dr. Goulet again:
Bottom line is that not enough is known and not enough consultation has been done to make good decisions around MAID policies as related to their impact on Indigenous peoples in Canada.
This is a very big statement to make, colleagues, and one I hope everyone takes to heart.
Dr. Goulet has also generously indicated her interest to help with, in her words, “an actual consultation process around this topic,” which would ideally include other health care professionals and Indigenous community stakeholders interested in discussing what is a critical, life-determining topic.
Honourable senators, I have also had the opportunity to speak with Mr. Neil Belanger, Executive Director of the British Columbia Aboriginal Network on Disability Society, or BCANDS for short. Mr. Belanger was one of the other participants at the aforementioned round-table discussion held in February of this year, along with Dr. Goulet. In his own words, he stated:
There has been zero consultation with Indigenous peoples on this Bill in any tangible way — one meeting that I am aware of, of which I was at, but was not well attended by Indigenous groups, and the disability component was on no one’s radar except [BCANDS].
Colleagues, considering the sustained and ongoing calls we have heard from disability advocates voicing their concerns about this bill, it is alarming to hear from Mr. Belanger that the issues we are hearing now — and which he had initially flagged to government officials back in February — were not being adequately considered.
Through our deliberations, I find that Mr. Belanger has put it best when he said:
This alone should be enough to stop the proposed changes. If we are true to UNDRIP, self-determination and reconciliation, if this is pushed through without [the Indigenous disability community’s] voices, it gives a clear message about Canada’s commitment to these processes.
. . . We cannot in good faith or conscience make any recommendation that would exclude Indigenous peoples living with disabilities from this process and in doing so expose them to even further risk in a health system where their safety is already shown to be precarious. This Bill needs to go to the Supreme Court and Indigenous peoples living with disabilities and non-Indigenous peoples living with disability have got to be involved in this process.
Honourable senators, why place the extra responsibility on the disability community and Indigenous peoples to support a bill that puts them at greater personal risk, essentially saying, “We ask that you support this bill, despite the fact that it will inevitably result in your continued suffering”? Why place them in a position where they feel the Supreme Court of Canada is their only safety mechanism — an option that they can ill afford?
We have heard during debate that it is unacceptable for as much as one person to continue to live in pain needlessly. I would also argue that it is unacceptable for as much as one person to be coerced into receiving MAID as an option by an unethical and unconcerned health care professional.
Colleagues, Indigenous peoples in Canada already have a form of medical assistance in dying thanks to the systemic racism that exists in our health care system. We need look no further than the alleged professionals who were supposed to be providing care to Brian Sinclair and Joyce Echaquan. The issue of systemic racism is a fundamental and largely unacknowledged issue with this legislation. Is this lack of consideration and its potentially lethal consequences really a risk we want to take?
Colleagues, it is astounding to me that in this chamber of sober second thought we are expected to rush through our study on a bill that has the potential to do immeasurable harm to the disability community and to Indigenous peoples in Canada. This bill, particularly through track 2 and the provision of MAID for those people whose death is not reasonably foreseeable, is simply too precarious for these marginalized and vulnerable groups. This is a serious law that needs serious consideration, not just a rubber stamp. It is for these many reasons that a bill of this critical nature, which has been identified as having serious and fundamental flaws, as articulated by various groups, is one that I am hesitant to support. Thank you.