Indigenous leaders from across Canada say they have grave concerns about efforts to expand the availability of assisted suicide, warning it will have a lasting impact on our vulnerable populations.

In a letter entitled Indigenous Peoples Should Not Be Compelled to Provide or Facilitate Medical Assistance in Dying, 15 First Nations representatives and Indigenous health-care workers and leaders asked the government to recognize the value of Aboriginal healing practices and Canadians right not to be compelled to provide or facilitate in the provision of MAiD (medical assistance in dying).

The letter, addressed to senators, federal and provincial politicians, and health-care regulators, calls on the federal government to respect First Nations relationships with their communities and their right to determine how health services are delivered.

Signatories to the letter include Siksika Health Services CEO Tyler White, former Lieutenant Governor of New Brunswick Graydon Nicholas, retired senator Nick Sibbeston of the Northwest Territories, Indigenous health and suicide prevention advisers, and elders.

Bill C-7 goes against many of our cultural values, belief systems, and sacred teachings, said the leaders. The view that MAiD is a dignified end for the terminally ill or those living with disabilities should not be forced on our peoples.

The leaders say the consultation process has been inadequate and has not taken into account the existing health disparities and social inequalities we face compared to non-Indigenous people.

The letter states Indigenous people are vulnerable to discrimination and coercion in the health-care system and, along with all Canadians, deserve protection from unsolicited counsel regarding MAiD.

Given our history with the negative consequences of colonialism and the involuntary imposition of cultural values and ideas, we believe that people should not be compelled to provide or facilitate in the provision of MAiD.

The Indigenous leaders and advocates (supported by the Physicians Alliance Against Euthanasia) are among many groups voicing opposition to Bill C-7, which would eliminate the need for a persons death to be reasonability foreseeable to qualify for euthanasia. The legislation would also eliminate or ease other safeguards such as lowering the number of witnesses needed when someone consents to assisted suicide.

The House of Commons passed Bill C-7 by a two-to-one margin Dec. 10. It is now being debated in the Senate, which is expected to vote on it by Feb. 17.

On Tuesday senators voted to amend Bill C-7 to give the federal government 18 months to expand access to assisted suicide to people suffering solely from mental illnesses. More amendments are expected as debate continues.

The Senates legal and constitutional affairs committee heard from 81 witnesses during five days of hearings. It also received 86 written briefs from health-care professionals, faith groups, and organizations including the Canadian Conference of Catholic Bishops, Canadian Physicians for Life, Cardus, Christian Legal Fellowship, Euthanasia Prevention Coalition, and the Canadian Society of Palliative Care. (All written briefs are available on the Senate website).

Canadas bishops have said the many perspectives shared at the Senate hearings reveal there is no consensus in Canada on expanding assisted suicide despite the governments claim to the contrary in order to justify the passing of Bill C-7.

As the Senate moves toward its final verdict on Bill C-7, some critics think the federal government should not change the existing law, which took effect in 2016, until a full and promised parliamentary review of the legislation is undertaken first.

Colleagues, how did we get to this point, where we are debating an overhaul of our entire regime a few short years after its enactment and before we have even undertaken a parliamentary review? asked Conservative Don Plett, the Opposition leader in the Senate.

We are here because of a lower court decision made by one judge, in one province, and because the government chose not to defend its own legislation.

Pro-life groups are urging Canadians to share their concerns with senators on the legal and constitutional affairs committee.

-With files from Canadian Catholic News

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