The Trudeau government is insisting that medical assistance in dying should only be available to Canadians near death, showing no inclination to accept a Senate amendment to expand the right to those suffering from non-terminal conditions.
Justice Minister Jody Wilson-Raybould says the Senate amendment upsets the delicate balance the government has struck in Bill C-14 between respecting personal autonomy and protecting the vulnerable.
The amendment, passed late Wednesday, knocks out the central pillar underpinning the government's proposed new law as assisted dying.
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It deletes the requirement that only those whose natural death is "reasonably foreseeable" should be eligible to seek medical help to end their lives. And it replaces the bill's restrictive eligibility standard with the more permissive criteria set out in last year's landmark Supreme Court ruling, which struck down the ban on medically assisted dying.
"The amendment that was passed last night is a significant one," Wilson-Raybould said Thursday.
"It will broaden the regime of medical assistance in dying in this country and we have sought to ensure that we, at every step, find the right balance that is required for such a turn in direction."
Health Minister Jane Philpott said she's personally concerned the amendment would mean people suffering strictly from mental illnesses would be eligible for assisted dying — a group specifically excluded in Bill C-14.
"We stand by the cohesiveness, the integrity of the piece of legislation that we put forward, that strikes that balance that we believe is necessary, that has had broad public support, that has been supported in a vote in the House of Commons," Philpott said.
C-14 would allow assisted dying only for consenting adults "in an advance stage of irreversible decline' from a serious and "incurable" disease, illness or disability and for whom a natural death is "reasonably foreseeable."
That's more restrictive than the Supreme Court's directive that medical assistance in dying should be available to clearly consenting, competent adults with "grievous and irremediable" medical conditions that are causing enduring suffering that they find intolerable.
The ministers did not explicitly say the government will formally reject the amendment, which is just the first of many the Senate is expected to pass. It's up to the House of Commons to determine whether to accept or reject amendments from the upper house.
But their continued defence of the bill and their dismissal of any substantive changes sets up the potential for a deadlock between the two houses of Parliament.
The two ministers were careful not to criticize appointed senators for voting to make a significant change to a bill approved by the elected House of Commons. But Conservative Sen. David Tkachuk said Prime Minister Justin Trudeau is reaping what he sowed when he kicked senators out of the Liberal caucus and set up a process for appointing non-partisan, independent senators in a bid to return the Senate to its intended role as an independent chamber of sober second thought.
"If there'd been Liberal senators in there, we wouldn't be in this mess," said Tkachuk, who voted against the amendment.
"Much as I dislike the Liberals, they won the majority ... They should be in charge of the place but they're obviously not."
'Unelected Senate changing the laws'
Interim Conservative leader Rona Ambrose said the apparent collision course between the two chambers is a sign of a bigger problem.
"We have the courts making laws in this country and now we have an unelected Senate changing the laws of an elected House," Ambrose told a news conference Thursday.
"There's even a larger debate here, which I think is upsetting a lot of my constituents and a lot of people across the country."
But independent Liberal Sen. Serge Joyal, who proposed the amendment, said the Supreme Court ruling on Senate reform made it clear that "the Senate has a responsibility to, first, review the legislation and to intervene when the rights of Canadian citizens are at stake."
New Democrat MP Ruth Ellen Brosseau said the ruling Liberals are "in a mess entirely of their own making." Had the government accepted NDP proposals to drop the near-death proviso before rushing the bill through the Commons, the Senate wouldn't have had to take it upon itself to amend the legislation, the NDP argued.
Joyal's amendment was intended to ensure that the legislation complies with the top court's ruling on assisted dying and with the charter of rights. And it was to go hand-in-hand with another amendment proposed Thursday by Conservative Senate leader Claude Carignan, which would have required a judge and a psychiatrist to sign off on applications for assisted dying by those who are not terminally ill.
Indeed, it's not clear that Joyal's amendment would have passed without the assurance that Carignan's would impose greater safeguards.
However, Carignan's amendment was ultimately defeated by a vote of 37-32, with four abstentions. Numerous senators, as well as some right-to-die advocates, blasted the proposal for undoing the effect of Joyal's amendment and imposing barriers to assisted dying for those who can't afford to pay the legal costs involved or for those in rural and remote communities where there are few psychiatrists.
"If we pass this amendment, everything we worked for is gone," said independent Liberal Sen. Mobina Jaffer, who was almost in tears as she described the impact of Carignan's proposal on impoverished immigrant women.
The Senate is expected to continue debating the bill and voting on other amendments into next week.