44th Parl. 1st Sess.
February 13, 2023 11:00AM
Mr. Speaker, I thank the hon. member for his work on this file.
What is different now, two years later, is that we have done a great deal of work. The expert committee, led by Dr. Mona Gupta, thinks we are ready to move forward with the protocol it has developed, as do a number of professionals and professional bodies across Canada, but there is not unanimity. That is why we are proposing a one-year extension so we, along with medical professionals and Canadians, can internalize what the next step will be.
Let me point out that we all have a duty as parliamentarians to not participate in exaggeration or misinformation. What this bill would not do would be to allow a person suffering from depression or anxiety to immediately get MAID. This is for a small fraction of individuals who are suffering intolerably from long-standing mental disorders under long-standing care of medical professionals and who want another option. That is what this is about. It is not about people who are contemplating suicide.
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Mr. Speaker, in a debate as sensitive as this, we would expect every parliamentarian in the House of Commons to lend some dignity to this debate and demonstrate a strong sense of responsibility.
Last week, in the middle of question period, on the topic of mental disorders being the sole underlying medical condition, the official leader of the opposition said to the Prime Minister something to the effect that there were people suffering who were destitute, living in poverty and struggling with depression, and that all this government had to offer them was medical assistance in dying.
I would like my colleague to share his thoughts on these types of comments that, in my opinion, will prevent us from having a calm and productive debate not only from a theoretical perspective, but also with respect to the situation with the bill and what it really covers. In short, we are talking here about misinformation.
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Madam Speaker, I do not know how many times I have to rise to say the same thing, but my Conservative colleagues are oversimplifying. That is okay. They are entitled to do that, what with free speech and all. However, among the experts who drafted the expert report and who addressed the issue of mental health care, none of them supports the idea of giving access to medical assistance in dying to someone who is depressed. It is quite the contrary. The expert report includes all the necessary safeguards to exclude those people.
It is true that socio-economic determinants can lead to depression and suicidal ideation, but those people would not be granted medical assistance in dying. I invite my colleagues to read the report because I have noticed that there is a lack of understanding of the safeguards and precautionary principles underlying each of the recommendations. There are 16 very important recommendations in the expert report, and I invite my colleagues to read it.
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Mr. Speaker, I am pleased to rise in the House today to speak on Bill C-39 regarding medical assistance in dying, which proposes to delay for another year the implementation of provisions that would expand the availability of medical assistance in dying to those whose sole underlying condition is mental illness. I think we really need to start looking at how we got to this stage.
It went to the Senate and we had no issues with it, to some degree. Most of Parliament was fine with it. However, when it came back, the Senate had added in a provision with respect to one's mental state.
I started thinking about the many people I have spoken with over the years when I was either a mayor or now as a member of Parliament. When people would phone me, they would usually start the conversation easily by talking about whatever issues they were dealing with. Then they would start talking about themselves. I do not know if it is me, my voice or my appearance, but they would open up to me and start telling me about how they were going through these troubles and the difficulties they were facing. It was not necessarily financial. Sometimes that was the trigger, but most times it was their mental state itself. As they would start talking, I would start getting very worried about people like this who have a mental condition and whether there was somebody there to help them. As they kept talking, sometimes they would break down crying or get angry, and that would change throughout the whole conversation.
However, as I was dealing with them, I would hope that they had some kind of assistance from some medical professional. If they did not, then who would be there to help them? I am worried this is the help they are potentially looking for, but I hope that will never be the case. When I was speaking with these individuals, I would usually try to steer the conversation gently and ask if they had a psychologist or psychiatrist working with them. They would say something like they did, but that person does not know anything, and they would start getting angry again. Then I would start to get worried because I did not want to see them in that state of agitation. I wanted to try to help them as best I could. I am not a psychologist or psychiatrist, so I do not have the expertise, but I would try to at least direct them to where there was help.
Probably one of my biggest concerns with respect to this legislation is the fact that we are relying on our medical professionals more than ever. We all know that there is an extreme shortage of doctors and nurses right across this country, so when we start talking about people having the ability to apply for MAID due to their mental state, how is that going to help them if there are no doctors to assist them?
My next concern is whether we are really there to assist them, to cure them or help them out of that state. That to me is where it seems like we as a society have failed on so many fronts.
When I was talking to a grade 10 class during COVID in 2021, the students asked what I thought the number one issue in Canada was going to be when we came out of COVID. I said that was very easy because the number one issue was going to be the mental state of Canadians. It was surprising that the class all responded with, “Really?” I asked them what they thought it was going to be and they said that it was the economy. I said that was not something we really had to worry about and that once people started getting out again and businesses started opening up that, yes, it may be slow at the start, but eventually we would get back to some sense of normal again, but that the mental state of Canadians was something that was going to be with us for years. That was just during COVID.
Unfortunately, before COVID, the mental state of Canadians was suffering. That is something the current government has yet to help with. It promised in the last election that it was going to put more money toward the mental state of Canadians and assist with more doctors, medications and facilities to help those people. However, as we debate here today, it seems that it is easier for the government to offer medical assistance in dying instead of assisting them in achieving the mental state they so deserve.
I have spoken to many people, and they have asked what this MAID legislation is about. Why are so many people concerned about it? I said it is not so much about MAID. It is more about the addition of someone with a mental illness, without a foreseeable death, to actually apply for MAID. People have given me looks, asking what I mean by that. I have said that someone who has a mental illness, depending on what mental illness they have, may or may not qualify for MAID. I would still get people asking why there would not be a doctor, psychologist or somebody there to help them, as opposed to offering them MAID. I replied that that was a very good point and that it is one of the reasons I am speaking out against this legislation.
With moving Bill C-39 forward to extend it for another year, Canadians also need to understand some of the legislation that we are putting forward in the House and how it is not necessarily helping all Canadians. I am not going to bring up someone who has ALS or another disease. That is their right, and that is absolutely fine. To me, they are in charge of their faculties. However, when someone has a mental illness, my biggest concern is whether they are mentally capable of making these decisions.
I know someone will talk to me later and say there will be two psychiatrists evaluating them. Everyone knows that people, when they have a mental condition, have different states of mind where they may seem better at one time, and then they may seem worse or go into a depression, whatever the case may be. Is someone truly getting a fair assessment of the condition someone is dealing with at the time? To me, it is very cold and heartless that people can say, yes, we think someone is acceptable for medically assisted dying, as opposed to really diving into the areas as to how we can help them.
Over the years, there are people who have reached out to me and it is heartbreaking. I do not know if many other MPs have had to deal with something like this, but it is a very sad state. When we start getting into all the funding, or lack of funding, to deal with a mental state. Before COVID, it was estimated that about one-third of all Canadians had had some form of mental condition at one time or another. I cannot imagine what it has grown to after COVID. Are we at 40% or 45%? I do not know the numbers, but we can see how we are escalating the mental stability of Canadians.
Is the government reaching out to them, trying to make their lives any better? I do not believe so. That is one of the reasons I am so happy that we are able to take another year to look at what we can do to either refine or change this legislation, or actually start dealing with the problem itself. We need to deal with the mental state of Canadians and get the people the help they so rightly deserve.
For people to keep living on with a mental condition, they do not get better until they get help. Without the doctors, nurses or facilities out there, there is no way Canadians are going to see a better society. When we start looking at the mental state of Canadians, there are other areas that we can possibly improve upon, such as our criminal system, because a lot of people are addicted to drugs or whatever else, but we need to start dealing with that as best as possible.
I wanted to focus more on what we can do to assist people with their mental state, as opposed to offering them MAID. We need to start getting into the real cause of the problems and the real situation on why they got to this state. If we can accomplish that, we can build a far superior society than the one we have today. As parliamentarians, our number one goal is to make Canada a much better place to live, as opposed to the alternative being proposed tonight.
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Mr. Speaker, right before Parliament resumed following the Christmas break, countless Canadians participated in Bell Let's Talk Day. They took the opportunity to talk about mental health, raise awareness, share stories and remind each other that it is good to offer or ask for help whenever it is needed. There are many members of Parliament from all parties who have joined this effort, and it is only fair to assume that they have done so because they sincerely wish to help people.
Every year, after the day comes and goes, it helps us realize that promoting mental health is actually a huge task and it is easier said than done. Over time, there has been some progress with how we approach mental health, but it can sometimes be discouraging to see that we still have to deal with some of the lingering problems or to know how much work there is left for us to do. It puts everything into perspective and shows that the results and decisions we make about an issue are more important than just talking about it.
In that light, Bill C-39, along with the larger issue surrounding it, is a real test for us. It forces us to consider what exactly we mean when we say that we want to promote mental health. Unfortunately, we are looking at a government bill that signals that we are going to take a wrong turn and fail vulnerable people who are suffering with their mental health. In a way, it is good to see Bill C-39 come forward, but it should also be clear that it is not good enough. At the very least, there will be a year before this new change takes effect, but that is nothing but a brief delay of the inevitable instead of reversing a terrible decision.
What is going to happen a year from now? Is the government going to bring another bill like this one forward to delay it another year? Will all the major problems raised by the provinces, professionals, advocacy groups and concerned citizens miraculously get resolved before the year is over? How is that even realistic? Does the government really expect Canadians to believe that?
The timeline is obviously ridiculous. It does not make sense practically and, more importantly, it will not take care of the issue at stake in the first place. There might be different views on assisted suicide for mental illness as the sole condition, but no one on either side of the debate can seriously say that it has been carefully considered in this country, if such a thing were possible. Instead, the whole process has been rushed and incomplete.
If the Liberals truly cared about making the right decision, the new legislation would be quite different. Even on their own terms, they will not be any more ready for the coming change next year than they would be if it was next month. It was only public pressure that made them slow down, but it is not going to stop them entirely. Clearly, they are planning to go ahead with the plan and hoping to get away with it again next spring.
It is highly irresponsible if we take a step back to consider the larger issue. First, I will look at this bill as it has been presented to us. We normally do not have to think too much about the official title of a bill as it comes through Parliament, but in the case of Bill C-39 it does matter, and it might even be fair to say that its name is somewhat misleading. It says that we are amending the Criminal Code related to the medical assistance in dying system, but that is only a technicality. In reality, this bill is not touching the substance of Bill C-7 as it was passed in the last Parliament. All it would do is delay the implementation of Bill C-7 or the aspect of the expansion for one year. That is definitely not a helpful or encouraging response to what Canadians and experts have been telling us since Bill C-7 became law, both inside and outside Parliament.
When Bill C-7 passed in 2021, 91% of Ontario psychiatrists opposed the expansion of euthanasia, but they were ignored. The government has not bothered to listen to critical advice and feedback. Make no mistake, there are ordinary citizens across the country who are horrified when they learn of what is happening here with expanding accessing to MAID for mental illness. I have heard from a lot of people in my own riding who are concerned. They came up to me at hockey rinks. They came up to me at my various town halls that I hosted over the winter break and told me how unimaginable it was for this is to happen in Canada.
There has been the same reaction around the world when people in other countries found out what has happened here in Canada. We stand out compared to other places that offer assisted suicide, and not in a good way. International media coverage shows how Canada's reputation has suffered as a result. It is long past time for the government to get outside of its bubble and hear what Canadians are thinking and feeling. Despite the Minister of Justice trying to claim that our system has strict safeguards, we need to look around and realize that something is not going right.
Canada reported 7,300 deaths in 2020 and 10,000 deaths in 2021. It is interesting that if we compare with another jurisdiction, it gets even more troubling. The state of California started to allow assisted suicide the same year that we did in 2016. The size of its total population is similar to that of Canada, yet it only reported 495 deaths in 2020 and 486 deaths in 2021. The difference in proportion is striking.
People see these numbers and they cannot believe that this government is considering expanding access even further to people with mental illness as a sole condition. They cannot help but wonder if these people are already slipping through the cracks and are caught up in the numbers we have here in Canada.
If we want to understand the background of how we found ourselves in the situation today with Bill C-39, we need to recall what happened with the previous bill. Back then, this Liberal government brought forward a piece of legislation that was a significant expansion from the way MAID was originally set up a few years before. It allowed assisted suicide for conditions where natural death was not reasonably foreseeable.
At the time, we heard overwhelmingly from many advocates, organizations and members from the disability community who were deeply concerned about the government's new direction. They pointed out the flaws and the risks involved for people with disabilities who could find themselves in a vulnerable position, and experience abuse rather than receiving the support and the resources they needed. They also worried about the stigma and the message it could send to the disabled as well as to wider society. It was clear that it would not be unacceptable for anyone, whether they live with a disability or not, to get the impression that these human lives are inferior or not worth living.
Here we are seemingly caught in a similar position once again. It was shocking when the Liberals accepted the last-minute amendment to include mental health as a condition for assisted suicide. Since then, they have had time and opportunity to reconsider, but they refuse to listen and protect the lives of vulnerable Canadians. If government members do not put a stop to the expansion of MAID for mental health, it will be impossible to take them seriously when they try to talk about a mental health crisis.
I want to take a moment to talk about Michael Landsberg, who spoke very passionately about mental health a number of years ago, and I consider this man to be a pioneer and a trailblazer.
Michael Landsberg was the host of Off the Record on TSN. Mr. Landsberg has a foundation called “#SickNotWeak”. A big part of what he talked about 20 years ago, and what he talks about today once again, is the stigma that people with mental illness quite often face and that people with depression face. When we look at the disability community and what we talked about earlier with the stigma around them, we are seeing that happen again for people with mental illness. I think it is important that we look at the stories of people like Michael Landsberg who has spoken so clearly and passionately around making sure that we do not provide harmful stigma for mental illness. When we look at the statistics that I quoted earlier, there is a real and present danger here if we do not address this properly while we have the opportunity.
Across the country there is a lack of mental health support, especially in rural ridings like mine. It is absolutely shameful to offer death as a solution. While Bill C-39 brings a pause in this expansion, it is inappropriate to use it as a selling tactic with the hope that public opinion will shift to their direction in the meantime.
However, a delay is not enough. We need to exclude mental health as an eligible condition for assisted suicide. This government must stop and review what it has done with the system. If not, it only shows that it is untrustworthy. There has been no sign of meaningful reflection about its previous legislation. Because of this, it has failed to reassure Canadians about further changes. We talked about the safeguards earlier; people are wondering if they even exist.
How can we ignore the veterans who are offered MAID instead of mental health support? How can we proceed when we have seen people in poverty and distress offered it against their will? These types of reports are coming far too often, and we cannot say that we had no warning. The predictions of experts and from many of us here on the official opposition have been proven to be correct so far. If this expansion happens in March 2024, how can anyone possibly pretend that these problems cannot get much worse?
Because the Liberals will not do what is necessary, one of my Conservative colleagues has taken the initiative to introduce a bill that will remove eligibility for mental illness. It would give us another chance to prevent this catastrophe, and I hope my colleagues support it.
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Mr. Speaker, I support the need for additional mental health for Canadians. That is why I am very proud of the fact that we have a $198-billion agreement with the provinces now over the next 10 years, as provinces will determine how best to use that money. There are some qualifiers for that. There is going to be more accountability. There is going to be transparency.
Let us contrast that, as Conservative members stand up and are critical of the government, saying that we are not doing enough on mental health. I think we need to be honest with Canadians in what the Conservative Party is proposing to do on mental health, which is nothing. There is no commitment coming from the Conservative Party to deal with mental health, rural or urban. If there is, I ask the member to please tell me where the announcement is. What is the Conservative Party doing? Give me another half-hour, and I will be more than happy to explain what it is the Liberal Party is doing in support of mental health.
Depression is not going to be used as access to medical assistance in dying. I have more confidence in our medical profession.
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Mr. Speaker, I appreciate the comments from the member opposite because, for the most part, I concur with what the member is saying. In the debate that took place in regard to Bill C-14, if the member looks at Hansard he will see that the issue of palliative care and hospice care was huge. Members on both sides of the House understood how important it was that we have that in our communities, as we did not want to see people using MAID as an escape because of not having that care.
Again, when I reflect on what we are talking about now, more and more members are talking about the issue of mental illness. It is good that we all have a consensus. No one is talking about depression as being something that would allow someone to apply for MAID. If they do apply, the doctors and medical professionals are not going to authorize something of that nature. We are talking about the extreme situations. That is my understanding.
It is good to hear those independent voices on this particular issue and, as much as possible, I would concur. I would just ask the member to continue to expand upon why it is important that we take the party politics out of it, because it is very much a personal issue.
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