Wednesday, June 15, 2016
The Honourable George J. Furey, Speaker
On the Order:
Resuming debate on the motion of the Honourable Senator Baker, P.C., seconded by the Honourable Senator Harder, P.C., for the third reading of Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), as amended.
Hon. Mobina S. B. Jaffer: Honourable senators, before I speak on Bill C-14, I want to thank the three leaders in the Senate: Senator Cowan, Senator Carignan and Senator Harder.
Senator Cowan, my leader in the Senate, you have truly been a role model. You have worked tirelessly for us and especially on this bill. You have worked hard and with compassion for Canadians. Thank you.
I also want to thank Michel Patrice, Michel Bédard and the legal team for all your hard work. I know even on Sunday, while I was asking both of you questions, you were available. Thank you.
I want to thank Jocelyn Downe and Josh Paterson for working with me to help me understand the consequences of this bill.
As a British Columbian, I would like to thank the British Columbia Civil Liberties Association for their great work on this issue. You have heard the cries of the most vulnerable in our society.
Honourable senators, I will be supporting this bill with its amendments.
Honourable senators, we need to ask ourselves: why did we pass Senator Joyal’s amendment and fix this bill? It was because of our duty to protect people who are suffering from such excruciating and unbearable pain.
Honourable senators, at second reading I opened my heart and said to you that for me, as a practising Muslim, this bill was very, very difficult, but I as a legislator have to go beyond my personal feelings.
So I ask that we not forget, amid all of this very interesting and useful debate, what this issue is all about. It is about helping people with grievous and irremediable conditions escape enduring and intolerable suffering, to escape being trapped in torture, whether those people are near to death or not.
This bill is about people who suffer from grievous and irremediable conditions, including diseases that are disabling. This condition causes enduring suffering that is intolerable to the individual.
Honourable senators, “irremediable” does not require the patient to undertake treatments that are not acceptable to the individual. For example, I have spoken in this place about Elayne Shapray who was suffering intolerably on account of advanced secondary progressive multiple sclerosis. Under Bill C-14, as proposed to us by the other place, she would have been forced to starve herself to the verge of death in order to make herself eligible.
Carter didn’t come into effect quickly enough for Suzette Lewis, another woman from Vancouver. She had multiple sclerosis for 20 years and her condition was not terminal. Her death was not reasonably foreseeable.
She decided to starve herself to death this past October at the age of 65. In the words of her daughter, Rachel Ricketts, a corporate lawyer, she was bedridden and subject to excruciating physical and emotional pain and was a prisoner in her own body. This suffering and total loss of quality of life consumed her entire person. Because assistance in dying was a crime, she could not be open with many people in her family. She was, in her daughter’s words, condemned to whispers, but her conviction on the matter never wavered.
Her daughter, whom she did tell about her wishes, was researching and considering flying to obtain drugs from veterinarians in Mexico or from drug dealers here.
As the mother suffered, her daughter, desperate to help her mother, had to go through this awful experience of considering criminal, back-alley dangerous ways to assist her mother.
Rather than choose an option that would place her daughter at risk of imprisonment and jeopardize her legal career, Suzette Lewis chose the only option that could protect her family while allowing her to escape suffering — suicide by starvation. Ms. Lewis starved and dehydrated herself until she died. For 14 unbearable days, her daughter Rachel had to sit and watch as her mother wasted away. Rachel described it as an “atrocious” and “barbarous” death.
The absolute prohibition on assistance in dying for those whose deaths aren’t reasonably foreseeable — people like Suzette Lewis — has been eliminated by the Senate. We have together as senators stood up and said that situations like what happened to Suzette Lewis — having to starve herself to death when she had been granted by the Supreme Court the right to a humane and peaceful end — will not be allowed to occur.
Ms. Lewis is not the only person; there are many other people as well. We have stood up and decided that people like Ms. Lewis, who were granted the right to choose by the Supreme Court, should have the right to choose respected by Parliament.
We have spent much time talking about those who would be excluded from the bill had the Senate not eliminated the absolute prohibition on assistance in dying for those not near to death, but they are not the only people we helped with the amendment we passed last week. The requirement in Bill C-14 that the person’s condition be incurable, instead of irremediable by any treatment acceptable to the patient — as set out by the Supreme Court — clearly do not mean the same thing.
While we heard from the Minister of Justice in this place that the meaning is the same, I have been convinced by the testimony we have heard that the words “incurable” and “irremediable” are different.
To change the word and to eliminate the qualifying language of not requiring the person to undergo treatments that are not acceptable to them clearly means something different on the face of the language. It was very important that we changed the word “incurable” back to the Supreme Court’s terminology, because the result would otherwise be that people are trapped in suffering.
In the Carter case itself, there was evidence before the court of a patient with a condition that is potentially curable but only by treatment that she finds unacceptable.
Honourable senators, at committee we heard from Josh Paterson, Executive Director of the B.C. Civil Liberties Association, who very graphically — and I won’t go into all the details that he did — described to us the plight of Leslie Laforest. She had Stage IIIC anal cancer. She had undergone multiple surgeries and three rounds of radiation therapy in an attempt to cure her cancer. Her doctors said a fourth round of radiation and chemotherapy would give a chance of survival, a chance to be cured of the tumours, but with no guarantee of success.
Leslie testified by affidavit that she found the side effects of the therapies and the drugs needed to control her pain to be intolerable. She was told that the radiation and chemotherapy will wipe out her red and white blood cells to dangerous levels, leaving her susceptible to infections, moulds and severe fatigue. Her doctor advised her that radiation is likely to severely burn her skin, including burning of her private parts and bladder; this cannot be avoided, as she would be irradiated through her pelvis. She was told that if she survives, she may end up with permanent scarring of her bowel, resulting in diarrhea and incontinence.
Mr. Paterson went on and on in describing what would happen to her if she took the treatment. Yes, honourable senators, this treatment could have saved her life, but it is not certain and will result in a potentially significantly diminished quality of life.
Leslie told her doctor that she does not want to go through another round of radiation therapy but, rather, wishes to end her life in peace, through medical assistance in dying rather than continuing to endure the intolerable suffering until she dies, painfully, as a result of her cancer. Her oncologist says that her death from the cancer will be a death in agony, regardless of pain medications. Her legs will swell to gross proportion as poisons and toxins accumulate in her system. The tumour will grow to explosive proportions, blocking off the bowel, which will begin to contort and twist under pressure. She has been told that she will ooze mucous, blood and fecal matter out of every orifice, and that no amount of drugs will deal with the breakthrough pain.
Leslie would not have access to medical assistance in dying under the original wording of Bill C-14, because her doctors made clear to her that there was still a chance of cure. Honourable senators, Leslie’s condition, according to her doctors, is not incurable.
Honourable senators, I want to first of all thank Senator Joyal for his leadership on this bill and on this amendment. I again want to thank Senator Carignan and Senator Cowan for their leadership on this as well.
As those who were in committee with me know and also heard from me in the chamber, I am absolutely obsessed with the word “incurable” in the bill. I have spoken to so many people and to so many doctors about this word. I was very graphic about what happened to Leslie, not because I am looking to be dramatic or graphic about it, but I want people to understand what we have done; and if we do not stick by this, there will be a lot of Leslies we will hurt.
To access medical assistance in dying under the original provisions, you would have either been forced to undergo painful treatments and fail those treatments until you become incurable, or continue to endure intolerable suffering until the point at which treatments would no longer have a chance of being effective; and while waiting, you could die a tortuous death. Under the Carter decision, people like Leslie will have a right to avoid this terrible death.
Honourable senators, it is simply cruel — in our great country, with all kinds of assistance in medicine — to have people suffer. With the amendment, we have given people like Leslie, and others, assistance in dying.
Honourable senators, I want to conclude by echoing the words of Dr. Forbes and Dr. Blackmer at committee, where they said that they and their colleagues will provide the service out of compassion in caring for their patients.
We have made these amendments to the bill, and we have heard a lot of constitutional arguments. Yes, that is part of it, but there is always a foundation on which we fight for constitutional rights. Honourable senators, here we are fighting for the right of people to die with compassion, to die with dignity. In our great country, we hear that innocent people will be killed. I don’t know about you, senators, but I have great faith in our doctors. I haven’t met a doctor who is keen to hurt a patient. However, I have met many doctors, as have you, who want to treat their patients with compassion.
Honourable senators, I say to all of you that, yes, we’ve had the foundation of the Constitution to guide us, but each one of us also has compassion, and we have heard from Canadians.