44th Parl. 1st Sess.
February 13, 2023 11:00AM
Mr. Speaker, I would like to inform the House that I will be sharing my time with the member for Thunder Bay—Rainy River.
I am pleased to rise today to speak to the government's proposed Bill C-39, which seeks to extend the exclusion clause for those requesting MAID and whose sole underlying medical condition is mental illness.
I would like to take a few moments to draw our attention to the MAID monitoring regime and what we know about MAID cases to this point.
Canadians hold personal and very strong views on medical assistance in dying. They deserve accurate and reliable information to inform their decisions and their opinions. This is why we are working to ensure that our public communications are clear and comprehensive through our annual reports.
We know that a lack of accessible information opens the door to misinformation about evolving MAID systems. To be clear, while the proposed legislation would not impact the monitoring regime directly, a year's delay could bring the added benefit of more time to collect and the ability to report on important data regarding those complex cases where death is not reasonably foreseeable.
Putting this into perspective and context, our government acknowledges the importance of the data and reporting in relation to MAID, so much so that the original 2016 legislation obligated the minister of health to collect the necessary information and report annually on MAID activity.
This formal monitoring system is important to informing our understanding in three ways: who applies for MAID in Canada, medical conditions prompting requests and trends in MAID cases since the 2016 legislation.
As such, we have been working in collaboration with provinces and territories, as well as other health care partners, to ensure a robust monitoring system. It is important to understand that this is a significant, collaborative commitment.
Let us begin with a glimpse into what we know right now. As of December 31, 2021, there had been a total of 31,664 MAID deaths in Canada. This is the total number of MAID deaths since the law permitting medical assistance in dying passed in 2016.
MAID deaths represent 3.3% of all deaths in Canada as of 2021. This is very much in line with jurisdictions that have MAID regimes similar to Canada's.
The proportion of all deaths attributed to MAID varies across the country, with the highest rates reported in Quebec and British Columbia, and lower rates in the remaining provinces and territories.
Conditions include multiple comorbidities, cardiovascular disease, organ failure and respiratory illnesses.
Although the current sample is small, 2021 data also shows that, where death was not reasonably foreseeable, 50% of individuals were approved for MAID, compared to 81% of cases where death was foreseeable.
Each MAID request where the person's natural death is not reasonably foreseeable is complex and unique, and early indicators show that approvals for MAID in this stream are much lower than when the person's death is reasonably foreseeable, 50% versus 81%.
The assessment process for a person whose natural death is not reasonably foreseeable is often much more challenging due to the nature and complexity associated with medical conditions of this population. These assessments require detailed clinical analysis of each one of the elements of the eligibility criteria, which define a grievous and irremediable medical condition.
Let us spend a little bit of time talking about the human aspect of this data collection.
We should acknowledge that behind every data element in our annual report is, indeed, a human story. Implicated in each case is a group of people, their families, MAID assessors and providers, health care teams, and most importantly, the person making the request for MAID. The data we collect comes from thoughtful and compassionate conversations involving people who are making the most important decision of their lives and the MAID practitioners. The practitioners are responsible for assessing the requester in accordance with the person's wishes and the law. Through these discussions and the recording of information arising from them, we have a robust monitoring and reporting system for MAID in Canada.
MAID practitioners must ensure that every requester is aware of the services available that might relieve their suffering. This includes exploring treatment options, facilitating referrals and following up on the outcomes. When faced with a MAID request where death is not reasonably foreseeable, assessors spend much more time gathering the necessary information about the person and their condition. The process often involves a review of many years of treatments, surgeries and/or medications, as well as consultation with one or more experts in order to exercise due diligence in making a decision regarding eligibility.
New regulations for the monitoring of medical assistance in dying came into force on January 1 of this year. The MAID monitoring system will report on an expanded set of MAID data points that are collected according to these new regulations. The additional information should provide a greater understanding of persons applying for MAID whose natural deaths are not reasonably foreseeable, as well as their associated circumstances.
In conclusion, we are committed to transparency and accountability across all levels of government to ensure public confidence in the MAID regime. We are honouring this commitment by providing Canadians with accurate and reliable information on MAID as it continues to evolve in this country.
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Madam Speaker, let me clarify and reiterate what I said in my intervention. I talked about the total number of MAID-related deaths in 2021 being 10,950, of which 2% related to MAID for individuals whose deaths were not reasonably foreseeable. The numbers the member is quoting might be accurate, but that was not the point I was trying to make. As I also indicated, the total was nearly 30,000 since 2016, when the legislation came into force.
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Madam Speaker, first of all, I do not think that MAID has been abused, especially as it relates to mental health. As I intervened, I lost my father to cancer back in 2016. At that time I wished the MAID option were available to us. Having said that, we have felt in our government that the base of 219 cases is not representative enough of the data that we want. We want to ensure that the safeguards we should have are in place and strengthened. This is the fundamental reason that we are extending the timeline by a year and introducing this bill. If this bill is to protect those individuals who are dealing with mental illness, then they need all the supports to be able to make that decision.
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Madam Speaker, aside from the timeline that we have set to make sure that we have more data to be able to analyze the situation, it is also important to work with the provinces and territories to ensure that they have the processes, guidelines and support system they need. Then they can help those individuals who are in the process of making that decision to receive the support they need to come to the right decision.
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