44th Parl. 1st Sess.
February 13, 2023 11:00AM
Mr. Speaker, today we are seeing an admission of a process that was far too rushed. Just two years ago, the Minister of Justice appeared at a justice committee one morning and said that there was not a consensus on how to move forward with expanding medical assistance in dying to those whose sole underlying condition is mental illness. However, later that day, after the Senate had amended the legislation to include mental illness, the minister suddenly said in the House that he was confident there was a consensus. The minister's own charter analysis of Bill C-7 said that those whose underlying condition is mental illness needed to be protected.
Therefore, we see evidence now that 70% of Canadians are opposed to this expansion. We know that many Liberal members are voicing their concerns. Will the minister consider delaying this expansion indefinitely, so that those who are suffering with mental illness, such as our veterans with PTSD, are protected?
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Mr. Speaker, I thank the hon. member for his work on the special committee, and we look forward to the recommendations of the special committee. One of the reasons to have a delay is precisely to take what that special committee might recommend better into account.
Mental illness is an illness, and I strongly support initiatives to better resource the encadrement, the support we are giving to people suffering from mental illness. It is something that our government has recognized.
We put $5 billion into the system a number of years ago. However, when we did that for mental illness, we found that we could not guarantee that the provinces would actually spent that money on mental illness. In the current set of negotiations between the Minister of Health and his counterparts, as well as the Prime Minister and his counterparts, we are trying to build some accountability into that system, but we definitely do agree with the need to invest in greater mental health resources, particularly in this case. We want people to be able to live a dignified life with the supports they need to accomplish that.
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Mr. Speaker, we passed the law in 2019. Part of the parliamentary process was the interactions between the House and the Senate. We came to a compromise at the end of that process with the Senate to include mental illness as a sole criterion with a two-year delay.
We felt at the time that this could be done in two years. COVID intervened and an election intervened, but we do feel that a great deal of work has been done, in particular, by the expert committee. However, in order for everyone to internalize those recommendations, and for faculties of medicine, provincial and territorial bodies, and expert groups to build out the didactic materials, we need another year, but this is only a year extension. Of course, this would also give us time to look at what the special committee reports on this particular area, as well as evaluate other suggestions it makes.
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Mr. Speaker, the message it is sending to persons who are struggling with mental illness is that their life is not important and that we are going to offer them death instead of help and support.
The member raises the issue of veterans who are offered MAID completely inappropriately and, frankly, in contravention of the Criminal Code. The Minister of Veterans Affairs, when he came to the veterans affairs committee, said that it had happened once or twice and that he had undertaken a thorough review. We now know that is not true and that it has happened multiple times. It speaks more broadly to how the government has mishandled MAID in so many different ways.
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Mr. Speaker, I would like to begin by providing some background on Bill C-39, which is not rocket science, when it comes down to it. Then I would like to talk about the philosophical foundation for dying with dignity, as well as the context and whether or not medical assistance in dying should be extended to patients whose sole underlying medical condition is a mental disorder. I would also like to talk about mental illness generally in our societies and the experts' report before finally concluding my speech.
The context is rather simple. This is not about rehashing the entire debate. We are studying Bill C-39, which simply defers the provision in Bill C-7 that would have ended the two-year exclusion for mental disorders on March 17, 2023.
Following consultations, the government has decided to extend this exclusion clause for one year, which means that on March 17, 2024, mental disorders, or rather individuals whose sole underlying medical condition is a mental disorder, would be eligible for MAID, subject to the conditions, limits, guidelines, standards of practice, safeguards and precautionary principles outlined in the expert report.
Before voting, I invite all parliamentarians in the House to read the report of the expert panel. It contains precautionary principles that do not lend credence to last week's comments by, for example, the leader of the official opposition. It really puts into perspective the ideology underlying the comments by my colleague from St. Albert—Edmonton. Let me dive right into this matter.
Why is there such a delay? The reason is that we believe things should be done properly by the medical world. When a mental disorder is the sole basis for a request for MAID, how prepared are those working in this field across the country to ensure that MAID is adequately and safely delivered in light of the safeguards?
More providers and seasoned assessors will be needed. I should note that the experts did say that assessing whether a person with a mental disorder has the capacity to choose MAID is something they are already doing. Often a person may have cancer and also suffer from a mental disorder. It is not the sole underlying medical condition, and they still need to establish the person's capacity to decide for themselves. Again, in response to the oversimplification by my colleague from St. Albert—Edmonton, first a person needs to want MAID, and then they need to meet the criteria.
As far as mental disorders are concerned, to meet the criteria, this is not going to happen overnight or anytime soon. It is going to take decades before anyone can have access. It is going to take time for the whole range of necessary treatments and possible therapies to be tested without the condition that the person demonstrate that they cannot bear any more and that their pain cannot be relieved. That is a long way from people living in poverty, who are depressed and who might have access to medical assistance in dying. We are far from it.
That being said, what are we talking about? When we talk about medical assistance in dying, I know that everyone in the House wants to do the right thing. Everyone has the best of intentions and wants to look after the best interests of patients and people who are suffering. However, being compassionate does not square with undermining human dignity. Human dignity is grounded in the capacity for self-determination.
Those are the philosophical premises. The law grants any individual with a biomedical condition the right to self-determination. Nothing can be done without the patient's free and informed consent. To that end, the role of the state is not to decide what that patient, who is the one suffering, needs. Rather, the state must ensure the conditions needed for them to exercise free will, so that patients can make a free and informed decision.
Historically, it was difficult to fight medical paternalism. At one time, people who had reached the terminal phase of an incurable disease did not have the right to die. The right to die was acquired, and it was called palliative care. Life was artificially prolonged, and people died from clinical trials or new therapies rather than dying a peaceful death in palliative care. However, palliative care is not a substitute for medical assistance in dying.
I find it strange that my colleague thinks it is unacceptable to grant access to medical assistance in dying to someone whose soul is suffering, and that he even opposes any form of medical assistance in dying, even when people are at the end of their life. He is opposed. At some point, if people are opposed, they need to explain why.
Why does the law recognize people's right to bodily autonomy throughout their lifetime but take it away from them at the most intimate moment of their lives? The government or our neighbour is not the one dying, so on what basis is the government giving itself the authority to decide for us at the most intimate moment of our lives?
These are the ethical and philosophical grounds and principles behind our position. Just because someone has a mental disorder does not mean that they should also be subject to social discrimination and stigma. Even though mental illness is now considered to be an actual illness, mental health is still not on the same footing as physical health. Mental illness results in discrimination and stigma.
Should we be telling people who have to deal with such discrimination and stigma that they will also never be given the right to MAID, even if they have been suffering from a mental illness and have had schizophrenia, for example, for 25 or 30 years? On what grounds are we refusing them that right? That is the basis of the expert panel's report. Do we give that right to someone with a mental disorder who is suffering, who has tried everything, whose problems are far from over and who says that they cannot go on?
There are people out there who have an ache in their soul, and unfortunately, we lose them when they attempt suicide. It is really no better. We absolutely must fight against suicide because it is one decision that cannot be undone.
In the report, the experts set out several precautionary measures. They talk about structural vulnerabilities like poverty. On page 11 of the report, the experts state the following: “In the course of assessing a request for MAiD—regardless of the requester's diagnoses—a clinician must carefully consider whether the person's circumstances are a function of systemic inequality”, and, if so, this should be addressed.
With respect to suicidal ideation, experts offer us another precautionary measure. It is not enough for a person to request MAID to have access to it.
The report states: “In any situation where suicidality is a concern, the clinician must adopt three complementary perspectives: consider a person's capacity to give informed consent or refusal of care, determine whether suicide prevention interventions—including involuntary ones—should be activated, and offer other types of interventions which may be helpful to the person”.
What is this claim about people who are depressed being able to request MAID? Members need to stop talking nonsense. That is not what the expert panel's report says. It says that incurability can be established over the course of several years. The patient must have exhausted all available therapies and treatments. However, that does not include overly aggressive therapy.
What does the member for St. Albert—Edmonton think should happen? When a person with a psychiatric disorder says that they reached their breaking point years ago, should psychiatric science insist that there is a treatment out there and that it is going to find it? That is what I mean by overly aggressive therapy.
Overly aggressive treatment may exist for all types of illness. Who gets to decide when it is too much? The Supreme Court and the Superior Court of Quebec have told us that it is up to the patient to decide. That is important, because the member for St. Albert—Edmonton keeps saying that we are cutting lives short, ending lives prematurely.
In reality, the opposite is true. Everyone wants to live as long as possible. People who are on what we call the second track, whose natural death is not reasonably foreseeable, want to live as long as possible. What they do not want is to be denied help when they reach their breaking point. If we do not give them access to MAID, they will find their own way to avoid ending up in that situation, because it is currently illegal for them, and they will end their lives prematurely. They will commit suicide.
The ruling that some contend should have been appealed to the Supreme Court states that there is an infringement on the right to life. The Conservatives' position infringes on the right to life because it forces people to end their lives prematurely rather than waiting for the moment of death, which sometimes is in one or two years. As proof, there is the case of Ms. Gladu. She did not go ahead with MAID, but she was relieved to know that she had that option. She did not commit suicide; she died naturally.
However, if her suffering became intolerable, she knew that she could access MAID because our compassionate and empathetic society would take care of her and ensure that she had a peaceful and dignified death. This meant that she could have the death that she did. Many people say that they choose to end their lives because they are not certain that they will be taken care of.
Is there anything more devastating than a suicide? That is a societal failure. We cannot be complacent about suicide attempts, about people feeling suicidal. In the health care system, mental illness, which is an illness like any other, absolutely must have all the necessary resources.
I just want to say a few words about the governments' ability to pay for the health care needs of the patients I am talking about, given the feds' post-pandemic offer. Governments have to deliver care to these people with irreversible illnesses, but they will not be getting money to do so. Over the next 10 years, they will barely be able to cover indexing on chronically insufficient funding. The federal government's share will go up from 22% to 24%. I hope government members are not too proud of that, especially considering that, during the third wave, people told us the system was in critical condition. The pandemic had destabilized it to the point that it would take 10 years to recover from the pandemic's side effects on patients without COVID. Right in the middle of the third wave, the Prime Minister said it would all be dealt with after the pandemic. We were told an agreement was imminent. I figured that they would come close to the $28 billion everyone expected, that they would give the governments of Quebec and the provinces the predictable funding they needed to rebuild their systems, take care of people over the next 10 years and finally recover from the pandemic.
I have heard the Conservatives say they will honour that small percentage. Of all the G7 countries, Canada still has the best borrowing capacity. If debt is unavoidable, what better justification for it than taking care of our people and restoring and rebuilding our health care systems?
I hear people say that individuals who have had an incurable mental disorder for years should not be given access to MAID on account of structural vulnerabilities. According to the expert report, however, two independent psychiatrists would have to be consulted. Not only would two independent psychiatrists be required, but we also have to consider recommendation 16. So far, I have been talking about recommendation 10, but my colleagues should hold on to their hats, because recommendation 16 states that, unlike for other kinds of MAID, when mental disorders are involved, there would be something called “prospective” oversight. This is different from retrospective oversight, as required by Quebec's commission on end-of-life care, which requires a justification every time MAID takes place. No, this does not happen after, but rather before, in real time.
This prospective oversight needs to be established in each jurisdiction, which is precisely what the delay will be used for. This additional safeguard needs to be established in controversial cases. According to the expert report, when an individual's capacity cannot be properly assessed, MAID is not provided, period. It is not complicated. There will be no slippery slope.
If there is a slippery slope, there is the Criminal Code, the courts, the police. Evil people do not belong in the health care system. They would be fired. If they do harm, they can be taken to court. To my knowledge, the provisions allow action to be taken.
My esteemed colleague seems to assume that everyone in health care is necessarily evil, which is absurd. The slippery slope is based solely on health care workers having evil intentions. However, to work in that field, people have to demonstrate skills proving the opposite. Consequently, all the precautionary measures and principles in this report are sufficient, in my opinion.
What needs to be done now is to ensure that people get training. Not all Quebec psychiatrists have read the report. If they listen to interviews given by the member for St. Albert—Edmonton, they will wonder what is happening with their profession.
We must be able to see things realistically and proportionately, provide training, and ensure that we implement a law that will be both accessible and equitable throughout the country. We must avoid situations where an institution that does not want to provide MAID prevents someone from accessing it, if it is their choice and they meet all the criteria.
This is still a dangerous situation. It is happening in Quebec, and the college of physicians warned last week that, in a simple case of MAID for a terminal patient, some doctors did not want to refer the patient to another doctor who was willing to provide it.
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Mr. Speaker, I want to start by saying that before I dove into this subject, read the expert panel's report multiple times and asked endless questions, I was among the unconvinced.
Second, because we cannot cut corners on this issue, the entire community of professionals in mental health care, mental wellness and mental illness needs to be informed and trained. It will require an adequate number of service providers and assessors. It will require guidelines. Each of the regulatory bodies from coast to coast will need to establish standards of practice for their members, so as to ensure safe, effective and adequate implementation.
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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, my colleague from Thunder Bay—Rainy River is well aware of my great respect for him. However, in listening to his speech, I found it riddled with confusion.
I wondered whether he read the expert panel's report on mental illness as the sole underlying medical condition. I believe that our thinking may not be quite so different. I think that his practice has shown him the need to take care in adopting such an approach. However, in reading the report, he will see that there are many precautions in place and very specific guidelines.
Indeed, just because there are not very many mentally ill people experiencing tremendous suffering does not mean we must not move forward. One person experiencing unimaginable and intolerable suffering is, in my opinion, one too many.
I would like to know my colleague's thoughts on this.
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Madam Speaker, I think it would be better for my colleague to choose his words more carefully.
Unless I am mistaken, last week we heard him say in an interview that there was no agreement on the issue of MAID for those with a mental illness. My colleague also went to the trouble of stating that one in two experts did not agree.
I will close by citing the panel he spoke about.
The evolution of many mental disorders, like some other chronic conditions, is difficult to predict for a given individual. There is limited knowledge about the long-term prognosis for many conditions, and it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient.
I will stop there.
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Madam Speaker, I want to thank our hon. colleague from Cariboo—Prince George from the bottom of my heart for the work he has done in this place for people who are suffering from mental illness and who are feeling suicidal ideation, and on the need for the ability to get that 988 number. I know how heartfelt his engagement is on this.
I will also be voting to see Bill C-39 through, but I probably differ from my colleague on the question of at what point do we say there has to be, with proper protocols and rules, access for people to medical assistance in dying. Is the member open to considering at some point, if there were a medical consensus on this, that we should proceed to extend to mental health issues as well?
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Madam Speaker, that is a tough one for me. I would have to actually work with the experts who are out there. Right now, as it sits, I could never support medical assistance in death for those who are struggling with mental illness because I believe recovery is always possible.
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Madam Speaker, it is important to outline what we are talking about here today: Bill C-39. Currently, due to Bill C-7, the Criminal Code explicitly states that, when it comes to MAID, mental illness is not to be considered an illness, disease or disability. However, when Liberals passed Bill C-7 two years ago, it had a sunset clause, and this is an important clarification. That means an important guardrail protecting those with mental illness from being eligible to seek MAID during times of depression or other crisis would expire two years after that bill passed, which means it is set to expire next month.
Now the Liberals, having heard the outcry from across the country, from the medical community and those serving the folks with mental illness, have introduced Bill C-39. This is a last-minute attempt to save face by extending the prohibition on MAID for mental illness for one more year. That is not good enough.
Conservatives have been united in our opposition to expanding the Liberal government’s medical assistance in dying regime to Canadians with the sole underlying condition of mental illness. We do not believe that medical assistance in dying is an acceptable solution to mental illness and psychological suffering. Our health care system should help people find hope when they need to live and not assist in their deaths.
Allowing MAID for people with mental illnesses such as depression blurs the line between suicide assistance and suicide prevention. Experts have been clear that expanding eligibility for medical assistance in dying to Canadians living with mental illness cannot be done safely. It is impossible to determine the irremediability of an individual case of mental illness.
For example, Dr. Sonu Gaind, who is the physician chair of the MAID team at the Humber River Hospital in Toronto, where he is chief of psychiatry, states, “I know that some assessors think they can make those predictions of irremediability in mental illness, and some assessors think they can separate what we consider traditional suicidality from what’s fuelling psychiatric MAID requests. And on both counts they’re wrong. The evidence shows that.”
Andrew Lawton, Canadian columnist and journalist, wrote a harrowing personal article two years ago, stating:
If Bill C-7 were the law of the land a decade ago, I’d probably be dead....
In 2010, I nearly succeeded in committing suicide. My battle with depression was worsening, and I was losing. Miraculously, I pulled through: I count my lack of success in that attempt as my happiest failure, for which I’m grateful to God’s intervention and a team of dedicated healthcare practitioners.
It’s saddening to think that under different circumstances, these practitioners could have been the ones killing me rather than saving me....
Bill C-7 undermines years of attention and billions of dollars of funding to bolster mental illness treatments and supports, including, ironically, suicide prevention and awareness campaigns and programs.
This bill kills hope and reinforces the flawed belief afflicting those with mental illness, that life is not worth living and that one’s circumstances cannot improve.
Every time I have risen to speak on these bills, that has been my emphasis as well: Life is worth living. Every life has dignity and value. We need to be far better as a nation at communicating that to those who need to hear it the most.
Two years ago my friend Lia shared her story with Canadians. She said, “I was 15 when I first tried to kill myself and I attempted suicide seven times in the years that followed...I’m speaking about my mental health struggles because I’m scared that doctors could soon be able to end the lives of people suffering with mental illness - people like me. To be honest, if medically assisted suicide had been available when I was in university, I would have used it to end my suffering as soon as I could.”
This is Lia's call to parliamentarians: “I don’t need someone to tell me how to die, I need someone to tell me to stay.”
The House should be writing laws that instill the value of life and that there is no question this is what we value. Laws need to encourage people to stay rather than seek to end their lives.
Dr. John Maher is an Ontario psychiatrist and editor-in-chief of the Journal of Ethics in Mental Health. Dr. Maher has highlighted that the wait times for mental health treatment in Ontario programs are up to five years long, and that one of his patients recently told him that he would like assisted suicide because he believed that nobody loved him.
Dr. Maher also rejects assisted suicide as a solution for mental illness by stating the following:
You're assisting someone in the completion of their suicide. The doctor is the sanitized gun...I'm not at all disagreeing that there are people who have an irremediable illness. What I defy you or any other person in the universe to prove to me is that it's this person in front of you.
The suicide prevention community has also pointed out the harsh reality for costs. Shawn Krausert, the executive director of the Canadian Association for Suicide Prevention, testified at committee and said the following:
Ending the life of someone with complex mental health problems is simpler and likely much less expensive than offering outstanding ongoing care. This creates a perverse incentive for the health system to encourage the use of MAID at the expense of providing adequate resources to patients, and that outcome is unacceptable.
Most Canadians do not support expanding MAID to those with mental illness as the only underlying condition. Today, a survey was published in which a mere 30% of Canadians support MAID for those who have a mental illness.
I can assure members that, among my constituents, that number is far lower. The vast majority of my constituents want the federal government to focus on helping people live well and to invest in palliative care and suicide prevention instead of assisted suicide.
Some of the petitions I have tabled here over the years were sent to me by constituents who have recognized that suicide is the leading cause of death for Canadians between the ages of 10 and 19. They are specifically calling on the government to protect Canadians struggling with mental illness by facilitating treatment and recovery, not death.
I agree with my constituents, and the majority of Canadians, that the government should withdraw this bill entirely and table a bill that permanently removes the extension and expansion of assisted suicide for mental illness when it is an underlying condition.
I want to end with some words from my friend Lia. She says:
I want to say right now, to whoever might need to hear this: death doesn’t have to be the answer. It takes work. It takes time. It takes others. And it's complicated. But there is hope...I’m sharing my story because I’m not the only one who has more to live for. There are people in your life who do too. As someone who struggles with mental illness, I don’t need someone to tell me how to die. I need someone to tell me to stay.
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Madam Speaker, no, they have to invest in what gives people hope. There is no research. The experts and the special joint committee have done the research. This is window dressing. This is an arbitrary timeline for something that is dangerous. There is no proof. There is no science. They cannot say with certainty whether somebody with mental illness will or will not get better.
Absolutely, we need to invest. There was $4.5 billion promised by the Liberal government to invest in the Canada mental health transfers. Not one dime has been sent. What are the Liberals saying to people at home who are struggling? They are saying that they care about them, but they are not going to invest in access to treatment. They are going to invest in legislation that allows them to apply for MAID. It is wrong.
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Madam Speaker, I think we are saying the same thing repeatedly here. The experts have weighed in and said that we cannot, with certainty, scientifically predict whether or not someone will or will not recover from a mental illness.
If the member wants to take that risk, and risk playing Russian roulette, I guess that is his answer, but the data is already there, which we have seen repeatedly.
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Madam Speaker, the minister seems to be of the opinion that, if we just let people warm up to the idea, it will somehow become a good idea.
What I am saying is that this is not something that should be offered to Canadians this year, next year or the year after that. Offering medical assistance in dying to someone who is suffering with mental illness is not the right move forward. The member is quite right in saying there are rules within Bill C-7 that certainly do not contemplate this massive expansion, rules that apply to someone who is near death or has a reasonable foreseeability of death. Those rules are not made to apply to someone who is suffering with mental illness.
I would argue that all of us in this place should agree to do better and to fight, hand in hand, for those who are suffering with mental illness.
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Mr. Speaker, far be it from me to provide medical advice to anybody. I warn people back home to not ever take medical advice from a politician; that is not what we do, but I think what we look at in our job is to make sure people have access to housing. Our job is to make sure that, if people are on the streets, they can get mental health supports.
My brother is a subway driver, and he has seen the impacts of the pandemic and mental health crisis in real time in Toronto with the rising violence. We can talk all we want about getting tough on violence, but it is our job as politicians to put in place the supports. For people who are chronically depressed and people with mental illness, our job is to make sure there are places they can receive treatment. Then I think the vast majority of cases of what we are talking about and debating tonight would not be necessary, and it would be reserved for those who are suffering from illnesses, and they have a right to die in dignity.
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Mr. Speaker, it is an honour to rise this evening to speak on Bill C-39. Before I do, I want to let you know I will be splitting my time with the member for Saanich—Gulf Islands.
This legislation might be the simplest one I have had the chance to speak on in the House since being elected, but it is also one of the more serious and emotional ones. Simply put, it would allow for an extension for mental illness to be a condition for eligibility for medical assistance in dying.
I strongly support this delay for several reasons. The first is about concerns I heard about from so many neighbours of mine in Kitchener. In particular, I remember one conversation a group had in their backyard on a colder afternoon just last month. It was between Hannah, Peter and some friends of theirs, and they wanted to share with me specifically some of their serious concerns with medical assistance in dying being expanded further than it already had been.
I really appreciated them sharing their stories, concerns and recommendations. In my view, that was the best of how our democracy is supposed to function, which is for folks like myself who are sitting in legislatures like this one, who have a say in laws like this, to be hearing from neighbours about their concerns. In that conversation and in emails since, it has been almost been universal that folks in my community want to see at least a delay, if not more.
Second, I am supportive because we heard the concerns of experts across the country, such as doctors and health care professionals. On December 1, I really appreciated hearing from the Association of Chairs of Psychiatry in Canada, which includes the heads of the psychiatry departments of all 17 medical schools across the country, as they appealed for the governing party to delay what was then an expected expansion of MAID for those with mental illness.
The third reason I am supportive is because I believe we should spend more time closing the social safety net before we expand medical assistance in dying. I would put it to all colleagues here and ask why it is we are seeing a movement to expand medical assistance in dying much more quickly than we are seeing an expansion to the social safety net. I will give a few examples.
In my community, as colleagues well know as I have shared it many times, the unsheltered population has tripled in the last three years from just over 300 to over 1,000 people living rough. It is clear what is being done when it comes to the affordability of housing is not nearly enough, that we are going in the wrong direction and that more needs to be done.
As well, there are income supports, whether that is a guaranteed livable income for all or as many in this place, myself included, have pushed very hard for, a guaranteed income for those with disabilities across the country. Although we have made progress, and I am glad to see that Bill C-22 was passed in this House and is now in the Senate, the fact is it is yet to be funded. I would strongly encourage the governing party to fund the Canada disability benefit to get on with closing the social safety net with the urgency it deserves.
Next is mental health specifically. Just last week we saw a big announcement about health care, and yet absent from that announcement was dedicated mental health funding. It is all the more egregious when in the 2021 campaign the governing party ran that campaign on a commitment for a $4.5-billion Canada mental health transfer.
I hope there is no sleight of hand here, that with this new health care announcement we are not going to continue to see dedicated mental health funding. It is imperative that all parliamentarians in this place continue to apply pressure to ensure the Canada mental health transfer is in budget 2023. When I last asked the parliamentary secretary about it on Wednesday night, I did not get a clear answer, and it should concern all of us to not see dedicated mental health funding.
In fact, it was because of this absence of sufficient supports for affordable housing, income supports and mental health care that I joined the CEO of the Canadian Mental Health Association of Waterloo Wellington to encourage the Minister of Justice to follow through on the delay that had been promised in December of last year. I am glad to see him follow through on that.
With my remaining time before I close, I just want to quickly mention the importance of quality journalism in this country and how it relates to this legislation.
I am glad to hear that all parties are supportive of Bill C-39, but I am not surprised to hear that, because of the work of Althia Raj and the Toronto Star. Specifically, back in November, as other members have shared, Ms. Raj spoke with the Minister of Justice. At the time, he said nothing could be done and that it would be a “challenge in the current Parliament” to delay the expansion of medical assistance in dying.
Ms. Raj then did something very reasonable. She reached out to all of the opposition parties, including the Green Party, and asked them if they would support what is now Bill C-39. Opposition parties responded, and days later, on December 11, Ms. Raj published an article sharing that all opposition parties were supportive. Then the question was put back to the Minister of Justice, and days later, on December 15, it was announced that this legislation would come before this House.
While there are many advocates and many campaigns that lead toward legislation such as this one, I think it is important that we call out and appreciate non-partisan journalists across the country doing important work to help bring to light the agreement that is sometimes there to move forward with important changes like the ones we are discussing, and to call out what might be certain rebuttals that may or may not be justified. In this case, they were not, and I appreciate Ms. Raj, as well as the medical professionals I mentioned earlier, like those from the Association of Chairs of Psychiatry in Canada, for their advocacy, which brought us to this point.
In closing, I applaud the governing party for introducing Bill C-39 and following through on the promise that was made back in December, and for listening to the need to slow down. I have no doubt that other parliamentarians across the country heard concerns similar to the ones I heard from Hannah, Peter and so many others. I also encourage the government to move more quickly on the social supports that are needed in my community and across the country.
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Mr. Speaker, I want to thank my colleague for talking about some opportunities and she also cited broken promises when it came to palliative care. As members know, I was here last Monday and the Monday before and would have been here tonight on Adjournment Proceedings, to drag the government here to talk about mental health, but it was disrupted so I am back.
I asked the minister about mental health just last week. She cited:
Through the proposed bilateral agreements on the shared health priorities, we are working with the provinces and territories to integrate mental health and substance use as a full and equal part of our universal health care system.
However, when it comes to the reality on the ground, the Liberals have still not delivered on their promised mental health transfer of $4.5 billion. Even the agreements that they signed with the provinces today do not assure that.
Does my colleague agree that we need, enshrined in the legislation, parity between mental and physical health to have a proper conversation in this House about expanding medical assistance in dying for those whose sole identified underlying medical condition is a mental illness?
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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, there was a great phrase coined by our interim leader that “unity does not mean uniformity.” The reason that is important is because MAID is a deeply personal issue. We are not here to talk about the merits of MAID in and of itself. What we are here to talk about today is the expansion of mental illness as a sole reason for people to be eligible for medical assistance in dying.
If we look at the results Canadians are seeing, it is quite alarming and astonishing to see the government is willing to proceed with that as a reason for people to access this. Where we are united as a party, and I think where most Canadians, generally speaking, across this entire country are united when it comes to this issue is they want to see people have access to the supports they need for mental health.
I referenced Mr. Landsberg and how for over 20 years he has been advocating for the conversation around mental health and to try to eliminate the stigma that for so many years was assigned to people with mental illness. When we proceed with allowing mental illness to be a sole reason, it sends the wrong message. That is where Canadians want to see us go, which is to make sure we are sending the right messages and giving people hope as they go forward when they are going through their darkest hour.
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