For Winnipeg Centre Liberal member of Parliament Robert-Falcon Ouellette, the ramifications of the Trudeau government's doctor-assisted dying bill are too final.

"Once we make a decision on this, there will be no going back," Ouellette said on Friday.

On Thursday, new legislation on doctor-assisted death was formally presented in Parliament. It restricts access to the practice to mentally competent adults who have serious and incurable illness, disease or disability.

The bill is expected to go before the House of Commons for a free vote, which means MPs can base their vote on their conscience, not their party.

A recent rash of suicides on Manitoba's Pimicikamak Cree Nation (Cross Lake) and Ontario's Attawapiskat First Nation followed by declared states of emergency in both communities makes the vote a troubling one for Ouellette.

"I'm concerned that we haven't thought out the complete ramifications that a decision like this might have on indigenous communities that seem to be suffering greatly," he said.

"This will be a right that will become entrenched and the impacts on vulnerable groups will become entrenched and it's very hard to stop."

Ouellette said he has not reached a decision about how he will vote on doctor-assisted dying in the House of Commons.

Fighting for survival

Historically, the concept of suicide was unknown to Canada's Indigenous Peoples, according to Ouellette. He described it as counter-intuitive to indigenous culture.

"You were out there in the natural world, you were fighting for survival each and every day," he said.

"When I go to my Sun Dance ceremonies, when I go to meet with the elders and we are in our lodges, I have my Sun Dance Chief, David Blacksmith, who said, 'We must fight the spirit of suicide. We must work each and every day to defeat it.' That, to me, is important."

Studying different people who could access doctor-assisted dying is the next step, Ouellette said.

"I don't think we've consulted with everyone and the impacts this might have."