Federal Health Minister Jane Philpott is voicing concerns over a Senate amendment to Bill C-14, the government’s medically assisted dying bill, that changes who is eligible for the process.

Last night the Senate voted to remove a contentious phrase from the bill, changing the bill so it widens access to patients who are not terminally ill. It was an amendment the House had already shot down.

Philpott expressed concern with the amendment passed last night and, once again, said the government’s version strikes a reasonable, balanced approach.

“I am personally concerned at the lack of safeguards and the extraction of the particular phrase in the amendment that was made last night – raises concerns among vulnerable persons, in particular people facing mental illness,” she told reporters Thursday before question period.

“The removal of the requirement for eligibility for natural death being ‘reasonably foreseeable’ means that people with mental illness as a sole cause of their reason for seeking medical assistance in dying would potentially be eligible.”

Philpott said she and Justice Minister Jody Wilson-Raybould would not make any comments on how flexible the government will be on Senate amendments, and would “consider them all in due time and respond appropriately.” But then added they “stand by the cohesiveness, the integrity of the piece of legislation we put forward.”

Wilson-Raybould said the Senate’s amendment was “substantive” and said the Liberal government’s version of the bill was the “best approach for our country at this time.”

Conservative Interim Leader Rona Ambrose Thursday morning said it’s frustrating that the Senate has significantly amended the bill by widening access to the service — something the House of Commons already voted down.

“I think it’s a reflection of a larger problem because we have the courts making laws in this country and now we have an unelected Senate changing the laws of an elected house.”

“We found a pretty good balance, even though I voted against it. But I think the chamber did its job.”

Conservative Senator David Tkachuk, who voted against Wednesday night’s amendment, thinks third reading will be done next week, but he suspects the Commons won’t accept such a “huge amendment” that removes the term “reasonably foreseeable.”

“They’re not going to accept the one we did last night, that’s for sure. They’ll send it back and we’ll have to decide.”

He said it’s not the Senate’s place to make such a dramatic change and blamed Prime Minister Justin Trudeau’s move to kick Liberal Senators out of caucus.

“If there had been Liberal Senators in there, we wouldn’t be in this mess,” he said. “Someone has to run the place. Someone has to do business. As much as I dislike the Liberals, they won the majority. They won the country. They should be in charge of the place, but they’re obviously not.”

Liberal Senator Mobina Jaffer said the government’s bill needed to be amended to widen eligibility because the original version isn’t constitutional, and thinks the Commons will ultimately be cooperative with the Senate.

“I have great faith because the justice minister has said, and so has the minister of health, that they will look at our amendments. And there is a great will in the Senate to have a bill.”

Meanwhile, the Senate voted down another amendment Thursday put forward by Conservative Senator Claude Carignan which would introduce a judicial review process in seeking an assisted death for those not at the end of their life. Senators voted 37-32 — with four abstentions — shooting down the second amendment proposed in the Chamber at third reading.

It would have meant that non-terminally ill patients seeking the service would have to first go to two doctors along with an independent psychiatrist to confirm they have the ability to provide informed consent and informed about palliative care options, and also seek judicial approval.

Liberal Senator Serge Joyal, who had sponsored the changes widening eligibility, said Carignan’s amendment would have be a complement to his, and won his support.

“I have always stated that if we are recognizing that some vulnerable people might have access to [medical assistance in dying] in particular circumstances, then we have to be mindful that there will be safeguards the vulnerable would be protected.”

Senator Cowan also voted for it, although said he didn’t think it was necessary but respected concerns over having enough safeguards in that area.

Senator Jaffer, who voted against, cited a lack of availability of legal aid for immigrant women in her province of B.C., and issued an emotional plea for other Senators to vote it down.

“If we pass this amendment, everything we worked for is gone.”

Conservative Senator Vern White, who also voted against including judicial review, said it would have further bogged down the courts.

“I think it made it arduous in this country, where we don’t have Superior Court access everywhere in the country easily, for sure.”

“I think yesterday probably brought us closer to the Supreme Court decision, so I was OK with that,” he said.

Although he said he wouldn’t be surprised if other Senators put forward amendment aimed at adding safeguards to the process.