44th Parl. 1st Sess.
February 13, 2023 11:00AM
Madam Speaker, in the opening part of his speech, my colleague said that he would be voting in favour of extending the deadline by another year. Is he optimistic that in that one year the government will be able to develop regulations, safeguards and guidelines to assist the medical profession in the responsible application of medical assistance in dying?
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Madam Speaker, there is something very broken in Canada today. I could talk about inflation being at 40-year highs. I could talk about interest rate hikes in the last 12 months that are doubling the average mortgage payments and making residential rental rates out of reach for many workers in Canadian cities that need workers. I could talk about the housing affordability crisis and I could talk about crime. We have talked about these things.
We are now learning in recent polls that two-thirds of Canadians feel that Canada is in fact broken. One of the pillars of our society they feel is broken is our health care system. Canadians used to be proud of our universal, world-class, leading-edge health care system. Now people wait for hours for emergency care and months for specialist appointments.
This does not line up with the view that we as Canadians have of ourselves as a prosperous nation. There is indeed something broken, and nowhere is this more evident than in our mental health care arena.
We are in the midst of a serious opioid crisis right across this country, and certainly in British Columbia, my home province. Decriminalization, safe supply and anti-stigma campaigns have had, at best, very little positive effect. At worst, they have contributed to the skyrocketing number of opioid deaths in the last eight years. Clearly, what the government has been doing has not been working.
It is in this environment that we are now, as parliamentarians, talking about whether MAID, medical assistance in dying, should be made available to those whose only underlying health condition is a mental illness. Indeed, there is something broken.
There was a time when those suffering a mental illness got the help they needed. I want to note an editorial that ran in last weekend's Vancouver Sun by editorial writer Douglas Todd. He writes often but not often about himself or his family. This is a very personal story.
When Mr. Todd was a young man, his father Harold, a World War II vet, was diagnosed with schizophrenia. He spent many stable years in metro Vancouver's Riverview Hospital, where he received three meals a day, where he was kept safe and where nurses administered and monitored his medications. He was stable. Riverview was not perfect but it kept Harold off the streets.
Harold died 23 years ago, according to the story, right around the time that the provincial government started taking the view that hospitals and boarding houses for the mentally ill were inhumane and paternalistic, and that patients with mental illness should not be out of sight, out of mind, but should be allowed to live in a community. These facilities have been largely wound down and replaced with nothing, which has led to disaster.
The younger Todd noted that last year alone, 2,272 British Columbia residents died of toxic street drugs. He says this: “If my dad had not had stable housing, he would have been vulnerable to such a fate.” That is where mental health is in Canada in 2023.
That brings me now to the question of recovery and the incurability of mental health issues. A number of my colleagues have spoken about that.
A member of my community shared with me a chilling story of how her daughter struggled with her mental health years ago. Through a proverbial turn of events, she happened upon a hospital during a serious bout of suicidality. My constituent is confident that if her daughter had been offered MAID in the hospital that day, she would have agreed to it. Instead, she found hope for a better tomorrow and access to real support. She has now recovered and is living a full life as a wife, mother and member of our community.
This question of possible recovery is one that experts disagree on. What constitutes irremediability for mental illness? When is a mental illness incurable and how do we discern that? Our special joint parliamentary committee on MAID looked into these very troubling questions. One witness shared that he likely would have chosen MAID in his darkest days but now has a rich life with successful medication and therapy.
Dr. Vrakas gave the opinion that for people struggling with mental illness, offering MAID to them is a “clear signal of disengagement from mental illness”.
Dr. Sareen from the Association of Chairs of Psychiatry said in December 2022 to the committee that, “We're in the middle of an opioid epidemic. And we're in the middle of a mental health pandemic. Post-COVID, wait times for access to treatment are the highest ever.”
We cannot pretend that patients have a free choice between MAID and treatment when treatment is simply not accessible.
However, no consensus has been reached about such pivotal questions as: can this person be cured? There is a huge risk in assuming that they cannot. The reality is, providing MAID to a person suffering from mental illness is an irreversible reaction to a condition that we do not know is incurable.
Dr. Maher summed this up perfectly in his testimony to the committee when said, “The rallying cry is autonomy at all costs, but the inescapable cost is people dying who would get better. What number of mistaken guesses is acceptable to you?”
Dr. Mishara added that he has personally known countless people who have “convincingly explained that they wanted to die to end their suffering and are now thankful to be alive. If you proceed to allow MAID for persons with a mental illness, how many people who would later have been happy to be alive are you willing to allow to die?”
There are, of course, experts on the other side of the debate who assure us that we can discern between people who apply for MAID and people who suffer from suicidal ideation; experts who believe that, when a person is depressed and can see no brighter future, we should not try to change their mind by offering care, medication and therapy.
However, I am confident that this lack of consensus alone should be enough to definitively say no, that expanding MAID to those whose only underlying condition is mental health is not a responsible public policy choice. Instead, let us fix our health care system. Let us see this government deliver on its forgotten promise to fund mental health. Let us open or reopen our assisted living homes for people suffering from mental illness. Let us take care of our mentally ill people. Let us give hope for a better tomorrow and the support needed to live through today.
The very narrow question that we are addressing today is whether we will vote in favour of a bill that would extend the deadline. The government has a two-year deadline. That time has come and gone. I think March 17 is the deadline, which will soon be upon us. Do we give ourselves another year to develop the guidelines, regulations and safeguards to make sure that MAID for mentally ill patients is administered in as responsible a manner as possible?
To be honest, I am torn on this. I voted against MAID in the first place, but like my colleague, I will be voting in favour of this, because I am optimistic that we can at least come up with regulations that will put safeguards in place to manage this very troubling public policy question.
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Madam Speaker, yes indeed I would completely support the government doing whatever is necessary to make sure that indigenous people, and indeed all Canadians, receive the mental health care that they need.
I gave the example of Mr. Todd's father, which I think is just a great example of where Canada used to do this much better, but for some ideological reason, we have abandoned that. It is a disaster.
I am very sensitive to the fact that indigenous people are disproportionately represented in the Downtown Eastside of Vancouver. People suffering with their mental health need to have the care that is necessary for them to recover. Additionally, I have worked with the Kwantlen First Nation community in my riding to help them develop culturally sensitive seniors housing, seniors care, because I recognize that is absolutely necessary.
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Madam Speaker, indeed Canadians are disappointed the government has failed to deliver on its promise to fund mental health to the extent that it is necessary, and they are doubly disappointed now the government is now talking about expanding medical assistance in dying for mentally ill people. They need help; they do not need assistance in dying.
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Madam Speaker, what is not the solution is to allow mentally ill people to live in tent cities or in squalor in some of the single-room occupancy hotels in the Downtown Eastside. This is terrible. The government is funding those homes, but it is inadequate. It is just slightly better than living in a tent. I completely agree that—
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Mr. Speaker, I wonder what the member's thoughts are on what is going to happen in the next year. We have had two years to develop guidelines, regulations and safeguards around MAID for those suffering a mental illness, and yet we have not developed a consensus at all. What we did was hear conflicting evidence and conflicting opinions at committee. Is the member confident that in the next 12 months we will actually come to a consensus, or are we going to be here a year from now seeking another extension?
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