SoVote

Oct/5/23 6:25:16 p.m.
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Re: Bill C-314

Mr. Speaker, I would first like to pay my respects to my colleague, whose personal accounts were very moving. Our hearts go out to Anton's family. As we know, Bill C-314 amends the Criminal Code to provide that a mental disorder is not a grievous and irremediable medical condition for which a person could receive medical assistance in dying. The Bloc Québécois supports access to medical assistance in dying when a mental disorder is the sole underlying medical condition. We agree with the expert panel that the safeguards currently in place in the Criminal Code are sufficient. We think the exclusion should be maintained for one more year in order to give health care professionals a chance to develop standards of practice for cases of medical assistance in dying related to mental illness and to become familiar with those standards. I would remind the House that the Bloc Québécois's position on medical assistance in dying has always been to uphold the consensus in Quebec, which came about following five years of consultations, specifically that medical assistance in dying is a right. Everyone has the right to die with dignity, of their own free will and with as little suffering as possible. The Bloc Québécois is of the opinion that it is wrong to draw false analogies between the different problems in society and the specific issue of access to medical assistance in dying when a mental disorder is the sole underlying medical condition. We are of the opinion that it is possible to defend the right to self-determination, which is what medical assistance in dying is, while contributing to improving our health care systems, especially our mental health services. On that note, the Bloc Québécois would remind the House that the government has not substantially increased health transfers. That is affecting the system. I would like remind the House that, in this debate, it is not a matter of offering people euthanasia as an answer to society's ills, contrary to what the Conservatives are saying. It is frankly irresponsible to suggest that the government's actions are causing people to become depressed and that the government's solution is to offer them medical assistance in dying. It is also important to remember that the Conservative leader spread disinformation by failing to mention the context, when he stated in his communications that the government decriminalized dangerous drugs. The context is that Ottawa authorized a three-year pilot project in British Columbia to decriminalize the possession of small quantities of drugs. It is a pilot project based on practices used in Portugal with the explicit goal of curbing the overdose epidemic that is happening in British Columbia. The hope is that this pilot project will set a course to help Canadians and Quebeckers with addictions. What is more, it is misleading to say that the governments will be providing medical assistance in dying in less than a year. That suggests that people will have their request for medical assistance in dying approved in less than a year, when that is not at all the case. As the experts on the Special Joint Committee on Medical Assistance in Dying pointed out, it will take at least a decade, maybe several decades, before a person can get medical assistance in dying for a mental disorder. It will have to be established that decades of therapy using multiple approaches have done nothing to treat the patient's mental health condition. In short, that is the complete opposite of what is being said by the Conservative leader, who is suggesting that a temporary depression is sufficient grounds to access medical assistance in dying. In the Truchon and Gladu ruling, the courts had determined that the criteria were too restrictive, hence the evolution of this legislation. At the end of a press conference, a journalist asked the Conservative leader if he was prepared to use the notwithstanding clause to block access to medical assistance in dying. The Conservative leader skilfully dodged the question by mentioning that it is not currently before the courts. The Bloc Québécois is curious to hear what his colleagues think of this. It should also be noted that the expert panel did not recommend deferring the exclusion measure. This is a request by professional associations. Although the expert report is entitled “Final Report of the Expert Panel on MAiD and Mental Illness”, the experts recommend changing the terminology to “mental disorder” because “mental illness” does not have a standardized definition. The panel finds that its recommendations on safeguards, protocols and directives should apply to all clinical situations in which several or all of these important concerns are present, namely incurability, irreversibility and capacity. The expert panel considers that the safeguards currently included in the Criminal Code are adequate for cases of medical assistance in dying when a mental disorder is the sole underlying medical condition. As my colleague from Repentigny said earlier, the panel made 19 recommendations to proceed with requests for medical assistance in dying when a mental disorder is the sole underlying medical condition. They fall into five broad categories: the development of practice standards for medical assistance in dying; the interpretation of the term “grievous and irremediable medical condition”; vulnerabilities; the assessment process; and implementation. Briefly, the panel recommends that practice standards be developed and shared with professional associations so they can adapt and adopt them. It should be noted that the government set up a task group to address this and that these practice standards were published in early 2023. When it comes to interpreting the expression “grievous and irremediable medical condition”, the criteria of incurability, irreversibility and enduring and intolerable suffering, which are currently contained in the Criminal Code, must be duly established. They must be appropriately interpreted in applications for MAID when a mental disorder is the sole underlying medical condition. Although the expert panel acknowledges that it is impossible to establish fixed rules surrounding treatments, their duration, number and variations, they must nonetheless be part of the considerations for accessing medical assistance in dying. Simply put, for someone to have access to MAID when a mental disorder is the sole underlying medical condition, that person must have a significant history of treatments and therapies. With regard to vulnerability, this involves ensuring that applicants have access to sufficient resources—housing, pain management, community support—so that their choice to access medical assistance in dying is not based on an adverse social circumstances. Again, the Bloc Québécois reiterates that increasing health transfers and funding the construction of social housing must be permanent priorities for the federal government. As for the recommendations regarding the assessment process, the key recommendation is that the Criminal Code requirement, in this case consulting a specialist, involve a psychiatrist. Finally, the recommendations for implementation can be broken down into three areas: consultation with stakeholders, training, and data collection for monitoring purposes. As my hon. colleague and friend, the Bloc Québécois member for Repentigny, explained, this is a serious subject. We must set partisanship aside and work with the expert panels.

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The Deputy Speaker

Oct/5/23 6:33:15 p.m.
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The hon. member for Abbotsford for his right of reply.

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Hon. Ed Fast (Abbotsford, CPC)

Oct/5/23 6:33:25 p.m.
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Re: Bill C-7 Bill C-314

Mr. Speaker, medical assistance in dying will soon be expanded to include those with mental illness, including depression. My bill, Bill C-314, would reverse this terrible decision. My bill is very narrow and would not repeal the other provisions of Canada's medical assistance in dying laws. There is no national consensus on expanding MAID to include mental disorders, none. The most recent Angus Reid poll found that a very small number of Canadians actually favour expanding assisted suicide to the mentally ill, somewhere around 28%. The mental health community has raised significant concerns. A recent letter to government from the heads of seven Canadian psychiatry schools implored decision-makers to hold off on expanding assisted suicide to the mentally ill. Similarly, the Canadian Psychiatric Association does not support the expansion of MAID due to the many ethical and clinical concerns that have not been resolved. They argue that mental illness is often highly treatable and that patients should be provided with the treatment they need to manage their symptoms and lead fulfilling lives. Stakeholders have deplored the lack of social and economic supports for persons with mental illness and how this can lead people to consider MAID. They have pointed to the fact that the federal government has not fulfilled its promise to deliver dedicated mental health and palliative care funding to the provinces, leaving Canadians without access to the support that would lead them to choose life rather than death. Many others have joined the chorus. They note that the issues of suicidal ideation, irremediability and competency have not been resolved, ensuring that Canadians will needlessly die because we have rushed ahead with expanding MAID. At greatest risk are those suffering from depression, veterans suffering from PTSD, the opioid addicted on our streets, our indigenous communities and those seeking to escape a life of poverty. The government has even signalled its openness to allowing children to access assisted suicide, presumably without their parents' consent. Last year, in my home town of Abbotsford, Donna Duncan was swiftly approved for assisted suicide after failing to receive proper treatment for chronic mental health issues. Her assisted death happened so quickly and so totally blindsided her daughters, Alicia and Christie, that they referred the case to the RCMP. Is this the dystopian world we are leaving behind? Has anyone consulted with our first nations? Meaghan Walker-Williams of the Cowichan Tribe recently wrote in the National Post: As a Sixties Scoop survivor, my lifelong personal journey back to my community of Cowichan has also been marked by the painful consequences of policies that didn’t respect or understand Indigenous cultures. Another policy, blind to my culture, may soon join them: assisted suicide for mental illness. She concludes by saying, “it's crucial that the narrative remains firmly rooted in upholding the sanctity of life—a cornerstone of Coast Salish teachings.” I note that the government originally excluded the mentally ill from its MAID regime and went to great lengths to explain why that was necessary. It was only after the unelected Senate included the mentally ill in Bill C-7 that the government suddenly enthusiastically embraced the idea. The question is this: Should Canadians be able to trust their government to act in a way that values the life of every Canadian, or do we give up on the most vulnerable among us? Someday, all of us will have to give an account. A famous world leader by the name of Moses once challenged his own people with a choice and a promise: “I have set before you life and death, blessing and curse. Therefore choose life, that you and your offspring may live”. I want my descendants to live, to prosper, to thrive, and I want the same for our mentally ill, our Indigenous peoples and indeed all Canadians. It is time to end this experiment. With so much uncertainty, surely we should err on the side of life, not death. I respectfully ask members to support Bill C-314.

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The Deputy Speaker

Oct/5/23 6:38:33 p.m.
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The question is on the motion. If a member participating in person wishes that the motion be carried or carried on division, or if a member of a recognized party participating in person wishes to request a recorded division, I would invite them to rise and indicate it to the Chair.

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Hon. Ed Fast

Oct/5/23 6:39:16 p.m.
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Mr. Speaker, I would ask for a recorded division.

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The Deputy Speaker

Oct/5/23 6:39:22 p.m.
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Re: Bill C-314

Pursuant to Standing Order 93, the division stands deferred until Wednesday, October 18, at the expiry of the time provided for Oral Questions.

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Ms. Lori Idlout (Nunavut, NDP)

Oct/5/23 6:39:56 p.m.
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Uqaqtittiji, the cost of flights in Nunavut is astronomical. All 25 communities that I represent are fly-in communities. A flight to Ottawa can cost over $5,000. It costs more to fly within our own country than it does to destinations such as Mexico, London or Nuuk. Most of my constituents cannot choose to take vacations, because it is simply not affordable. There are no other options. Flying is an unfortunate reality of living in Nunavut, yet Nunavut does not have adequate airport infrastructure to ensure that prices are affordable. Nunavummiut have seen increases in fares since the government first approved the Canadian North-First Air merger. I understand these increases were a result of Transport Canada undertakings that made it impossible for Canadian North to maintain sustainable operations. It is difficult and expensive to run an airline in a territory as large and sparsely populated as Nunavut. Imposing onerous conditions on one of Nunavut's only airlines is not the solution. The 25% annual fare increase that Transport Canada has allowed for is also far too high. That is four times the rate of inflation. For a $3,000 flight between Ottawa and Iqaluit, the fare could be raised by $750 this year. When the government announced its new deal with Canadian North last April, they promised to maintain fares and departures while providing a more efficient service. In the last few months, I have received many complaints about the disruptions experienced by my constituents. Gjoa Haven only has one or two flights per week, which can leave families in southern facilities for extended periods of time. For example, if a person from Gjoa Haven has a medical appointment in Yellowknife, that patient will most likely end up in Yellowknife for weeks because of cancelled or overbooked flights. These are patients who, because of the lack of a health care system, are forced to leave their territory to access basic health care services that are available to the rest of Canada. The mayor of Arctic Bay wrote to me, saying they are seeing nine fewer flights per week compared with last year. This is unacceptable for communities that rely on these flights for food, health, education, tourism, infrastructure and economic development. My office is hearing many similar stories from constituents who have been stranded due to cancellations, delays or rescheduled flights. Nunavummiut struggle every day with the excessive cost of living in the North. Not only are they battling the rising costs of food, fuel and housing, but they are also paying thousands of dollars more for essential appointments. According to the federal government release, the deal signed with Canadian North would provide “the access to air services they need, while at the same time ensuring Canadian North remains a viable service provider”. When will the government admit that it will not do so?

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Mr. Vance Badawey (Parliamentary Secretary to the Minister of Transport, Lib.)

Oct/5/23 6:43:44 p.m.
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Mr. Speaker, the First Air-Canadian North merger was approved, as was mentioned earlier, in 2019, with terms and conditions around pricing, scheduling and employment, amongst other elements that would be in place until mid-2026. The sudden onset of the pandemic, which drastically changed the air transportation landscape in northern Canada, has had a lasting impact on Canadian North's ability to comply with these conditions while continuing to serve communities, return to profitability and maintain services. Passenger levels in the North remain below 2019 levels and are lower than in other regions throughout the country. The lasting impacts of COVID have required us to vary the original terms and conditions, while at the same time ensuring that important safeguards remain in place for northern Canadians for the remainder of the period subject to obligations. In this context, Transport Canada has negotiated new terms and conditions with Canadian North, which were subsequently approved by the Governor in Council. These conditions are intended to strike a balance in ensuring the airline's continued operations and financial resiliency, while maintaining some conditions to maintain the public interest, such as imposing caps on fare increases and profit margins, as well as ensuring the balance of service. These terms and conditions will be in place for the next three years. Furthermore, the new terms and conditions include an obligation by Canadian North to be subject to assessment by an independent monitor, reporting to the Minister of Transport, and to provide financial and scheduling data to ensure compliance with the new terms and conditions. The Government of Canada shares concerns over air affordability and accessibility in northern Canada, which is why the Government of Canada insisted on maintaining safeguards for Canadians when deciding to vary the terms and conditions. At the same time, we have acted to ensure that Canadians in northern communities continue to receive the air services that they rely on. It is our understanding that the merger related terms and conditions to which Canadian North is subject do not supersede the contractual obligations it has with the territories around medical and duty travel. In this context, Canadian North will need to adhere to the conditions laid out in the agreements it holds with the territories. I will add, and the member does recognize this, that we on the transport committee are working with the member for Yukon to look at these arrangements, as well as other arrangements to, once again, strike that much-needed balance in the northern part of our country.

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Ms. Lori Idlout

Oct/5/23 6:46:59 p.m.
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Uqaqtittiji, I would like to thank the parliamentary secretary for his response. I did have the pleasure of travelling with him when he was part of the indigenous and northern affairs committee, and know that he has direct experience with the challenges of travelling in my region. Another example of what it is like to fly in Nunavut is that one of my constituents was on a routine flight from Iqaluit to Ottawa. This flight was cancelled twice, then re-booked for days later. It would have caused her to miss an important meeting. As a result, she had to take a much more expensive flight with Air Canada through Edmonton. She was told that she was not eligible for compensation and would have to dispute her claim through the Canadian Transportation Agency. She was also advised that this process would take up to 18 months. This is unacceptable. Nunavummiut do not have thousands of dollars and many months to wait for compensation for essential travel. Are these delays what the government had in mind when it introduced the air passenger bill of rights?

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Mr. Vance Badawey

Oct/5/23 6:48:11 p.m.
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Mr. Speaker, the Government of Canada is concerned with ensuring that northern Canadians have access to the air transport they require. COVID-19 placed serious pressure on the ability of Canadian North to continue to provide services to northern Canadians while at the same time avoiding financial losses. To ensure ongoing service in the north, Transport Canada recently reached the agreement I spoke about earlier with Canadian North to vary their merger related terms and conditions. These aim to strike a balance between addressing public interest concerns while maintaining the sustainability of the airline. In conclusion, the Government of Canada, in approving these new terms and conditions, ensured there remained safeguards for Canadians, especially in the north, such that each community will continue to be served and that fare increases would be representative of the new realities of the market and capped to ensure that the balance is maintained.

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The Deputy Speaker

Oct/5/23 6:49:22 p.m.
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The motion that the House do now adjourn is deemed to have been adopted. Accordingly, the House stands adjourned until tomorrow at 10 a.m. pursuant to Standing Order 24(1). (The House adjourned at 6:49 p.m.)

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