SoVote

Context: House Hansard - 280 - Feb/12/24

Feb/12/24 12:35:05 p.m.
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Re: Bill C-62

Madam Speaker, it is disappointing to hear someone who practises medicine talk about it in a manner that is disrespectful to the thousands of people who have very difficult decisions to make. An hon. member: It is unbelievable. Mr. Kevin Lamoureux: It is unbelievable. Madam Speaker, at the end of the day, these are not easy decisions, and the member opposite feels these 13,000 were just killed. The government puts in a great deal of effort to get things in a state of readiness, so that we are able to provide the types of services Canadians want and need. I make reference to the 988 suicide crisis line. Some might try to give the impression that because this is just a three-digit number, all we have to do now is say that we are going to have it and click our heels, and then it appears. The idea came up a number of years ago from, I believe, a member of the Conservative Party, who was being very genuine. That does not take away from the fact that other members, associations and stakeholders were also talking about it. As a government, the minister responsible ultimately did the sharing and the networking that were necessary in order to be able to present to the House of Commons a program that ultimately received the funding that was necessary, and worked with the different provinces, territories and stakeholders to turn it into a reality. Today, the 988 number is live. People having suicidal thoughts can feel comfortable knowing there will be someone at the other end of the line when they call 988 who can help them in different languages and understand and appreciate different cultures. I would suggest this is an example of how things come to the government, actions are ultimately taken and then something is put in place. The same principles have applied here. The Supreme Court makes a decision based on the Charter of Rights; the government brings in legislation, which is thoroughly debated and on which amazing consultation and input take place, with hundreds of hours of dialogue; and the legislation is passed by a majority. It is passed by members of all political parties and then ultimately put into place. It is a policy that is then administered and, as I pointed out earlier, there is at times the need for changes. We saw that need. One of them was amplified through the Quebec court. We make the change. We listen to what the Senate said. The issue of mental health is something that was brought to our attention. This legislation, Bill C-62, like the previous one that delayed the implementation, is going to continue that delay. To that end, I believe we will in fact have sound, solid legislation, and hopefully it will not have to be revisited. Time will tell us on that. With those few words, I hope members can appreciate why the need for the programming of the legislation is being put into place and why the legislation is so critically important. Indeed, I would suggest that delaying it for three years is a reflection of what a vast majority of Canadians want and what the different stakeholders are requesting.

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Mr. Michael Cooper (St. Albert—Edmonton, CPC)

Feb/12/24 12:40:48 p.m.
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Re: Bill C-7

Madam Speaker, the decision to expand MAID in the case of mental illness was not a decision of the courts. It was a political decision made by the Liberals. That is evidenced by the fact that the government's initial legislative response, Bill C-7, expressly excluded MAID for mental illness in response to the Truchon decision, which was not an appellate decision, as the member said, but a lower court decision that, yes, the government should have appealed. We have heard from experts the fundamental clinical issues, including the difficulty, if not impossibility, of predicting irremediability as part of the reason why there was a one-year delay. It is part of the reason why now the government is kicking the can down the road with a further three-year delay. What evidence can the member cite that the issue is going to be resolved in three short years?

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Mr. Kevin Lamoureux

Feb/12/24 12:41:48 p.m.
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Madam Speaker, I am sure the member is aware that the request for the extension is something that is coming from different jurisdictions. There are medical professions and provinces, for example, that have made the very clear indication that they are just not quite ready yet. They believe there should be more of an extension and a bit more time because there is training that needs to be involved and possible accreditation. I do not know all the complexities of it, but I do know that there is a genuine request for additional time, so the people who need to have the level of expertise would be properly in place so the best interests of Canadians are put first.

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Mr. Luc Thériault (Montcalm, BQ)

Feb/12/24 12:42:41 p.m.
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Re: Bill C-14

Madam Speaker, when it comes to MAID, this government is not exactly a shining example of proactivity. After the Carter decision, it took a long time for the government to table a half-decent bill. Bill C‑14 was pretty worthless. It was a poor imitation of the Quebec legislation and was far from addressing the crux of the Carter decision. That being said, the issue of proactivity is still relevant. Regarding MAID for people with mental health conditions, a three-year delay was unnecessary; one year would have been enough. The government has been aware of that for a year, since it is basing its decision to kick it down the road on the consensus recommendations of the Special Joint Committee on Medical Assistance in Dying. Why has the government not done anything on advance requests for the past year? Why is it dragging its feet? Why is it not basing its decision to go ahead with this on the joint committee's key recommendation?

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Mr. Kevin Lamoureux

Feb/12/24 12:43:40 p.m.
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Madam Speaker, I would disagree with the member with respect to the government dragging its feet. We can go all the way back to the Carter decision of the Supreme Court to find that it was Stephen Harper who chose to do nothing after the decision. Shortly after forming government in late 2015, we initiated legislative draftings so the legislature would be able to deal with the legislation in 2016, where there were thorough discussions and debates, at the different levels of readings, plus standing committees. I have spent a good portion of my comments today amplifying that. On the one hand, some members of the Conservative Party want us to get rid of the mental health component. The Bloc, on the other hand, are saying that we are not moving fast enough. I think the approach that we have taken as a government is on target.

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Mr. Alistair MacGregor (Cowichan—Malahat—Langford, NDP)

Feb/12/24 12:44:46 p.m.
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Re: Bill C-7 Bill C-62 Bill C-39

Madam Speaker, this is obviously a week when the House of Commons as a whole has to step up to the plate because we really only have two sitting weeks left on the parliamentary schedule until the March 17 deadline. That being said, I think it is worth it for us to remember why we are here. We have to go back to Bill C-7 and the Liberal government's 11th hour, inexplicable decision to accept a very consequential Senate amendment to it, which got us into this mess in the first place. The Senate changed the law without having done the proper research and consultations. Ever since, it feels like we have been playing a game of catch-up. That is why Bill C-39 was necessary last year, and why we have found ourselves in the same situation with Bill C-62. Is the parliamentary secretary prepared to accept some responsibility on behalf of his government and issue an apology for setting that arbitrary deadline and getting us into the mess we now find ourselves in?

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Mr. Kevin Lamoureux

Feb/12/24 12:45:48 p.m.
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Re: Bill C-7

Madam Speaker, in the question previous to that of the member, the government was accused of being too slow. Now my New Democratic friend is saying that we were too quick when it came to Bill C-7. In saying that we did not do enough background work, he implied that we were too quick. The Government of Canada, when we look at the broader picture of the Supreme Court decision back in 2015, brought forward very difficult legislation. As has been demonstrated, it was not perfect legislation. Given the very nature of it, one would be naive to think there was never going to be a need to make changes. That is why standing committees were mandated to meet on the legislation. It was because it was the first time we had substantive legislation of this nature.

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Mr. Mike Morrice (Kitchener Centre, GP)

Feb/12/24 12:46:47 p.m.
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Re: Bill C-39

Madam Speaker, it is almost one year to the day that the governing party proposed Bill C-39. I am glad we are once again talking about rushing through legislation to avoid extending medical assistance in dying for mental health. The parliamentary secretary asked a really important question. He asked in his speech if we are doing enough on these social issues. The answer is very clearly no because the government is not rushing through crucial legislation to address the housing crisis. It is not rushing through legislation to address legislated poverty for people with disabilities, and it is pretending its commitment to a $4.5-billion Canada mental health transfer never happened. Why is this the case?

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Mr. Kevin Lamoureux

Feb/12/24 12:47:39 p.m.
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Madam Speaker, I would challenge the member to show me a government in the last 50 or 60 years that has been more progressive on social development than the Prime Minister and this government, whether we are talking about taking seniors and children out of poverty by the hundreds of thousands, or dealing with a wide spectrum of social issues through the child care program and the many senior supports we have put in place, not to mention the substantial enhancements to OAS and increases to the GIS, especially back in 2016 when we first became government. There is a long list. I could talk about the dental care program or the tax break for Canada's middle class. There is a whole list I could go through, but I do not have enough time.

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Mr. Mark Gerretsen (Kingston and the Islands, Lib.)

Feb/12/24 12:48:39 p.m.
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Madam Speaker, the parliamentary secretary can be an animated speaker, quite like myself, but he took the time to be very selective in his words to properly represent his constituents and his view. An hon. member: Oh, oh! Mr. Mark Gerretsen: Madam Speaker, I am already being heckled. What I found— Some hon. members: Oh, oh!

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The Assistant Deputy Speaker (Mrs. Carol Hughes)

Feb/12/24 12:49:04 p.m.
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Order. Hon. members know that, if they have not been recognized and do not have the floor, then they need to wait until the time for questions and comments or their turn for debate, which will come shortly. The hon. deputy government House leader.

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Mr. Mark Gerretsen

Feb/12/24 12:49:19 p.m.
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Madam Speaker, what I found most shocking was that, when the parliamentary secretary was trying to deliver his remarks, the member for Cumberland—Colchester immediately started heckling and yelling at him. It reminded me of when the member for Cumberland—Colchester, on October 25 at the health committee, said, “Don't worry, Canadians, because when you're addicted to these opioids that this Liberal-NDP coalition is giving you for free in its crazed experiment, what are they going to do? They're going to kill you.” Now Conservatives are clapping for his comments on that. I am wondering if— Some hon. members: Oh, oh!

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The Assistant Deputy Speaker (Mrs. Carol Hughes)

Feb/12/24 12:49:55 p.m.
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Order. If members want to participate in the debate, they need to wait until the appropriate time. The hon. deputy government House leader.

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Mr. Mark Gerretsen

Feb/12/24 12:50:05 p.m.
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Madam Speaker, I am wondering if the parliamentary secretary could provide his comments on whether he thinks that people who make comments like that should even be participating in a debate like this.

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Mr. Kevin Lamoureux

Feb/12/24 12:50:21 p.m.
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Madam Speaker, it is disappointing in that this is such a serious issue. A member of the Conservative Party is being disrespectful to Canadians, as a whole, by taking the issue so lightly and making light of a decision that is so difficult. The member feels it is okay to say that well over 10,000 people were killed. How insensitive can a person be? These are decisions of the greatest difficulty, and the way the member has behaved is disrespectful.

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The Assistant Deputy Speaker (Mrs. Carol Hughes)

Feb/12/24 12:51:06 p.m.
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I know this is a piece of legislation that many are passionate about. There are differing points of view, and I would hope that each side will be able to respect each other, whether they agree with what is being said or not. Resuming debate, the hon. member for Cumberland—Colchester.

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Mr. Stephen Ellis (Cumberland—Colchester, CPC)

Feb/12/24 12:51:26 p.m.
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Madam Speaker, I would like to seek the House's unanimous consent to split my time with the member for Peterborough—Kawartha.

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The Assistant Deputy Speaker (Mrs. Carol Hughes)

Feb/12/24 12:51:36 p.m.
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Does the hon. member have unanimous consent to split his time? Some hon. members: Agreed.

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Mr. Stephen Ellis

Feb/12/24 12:51:50 p.m.
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Madam Speaker, today, it is interesting to follow the member across the aisle when we are speaking about a matter of grave importance. I find it absolutely fascinating, in a very strange sense, that the member opposite would suggest that somehow MAID has saved lives, when, indeed, 13,200 Canadians have died because of MAID. On top of that, we know that is a 30% increase year over year. We also know that in California, which has a similar population, if I have my statistics correct, about 450 people died because of MAID. MAID for mental illness presents a serious difficulty for all Canadians, and thankfully, Conservatives on this side of the House are ready to stand up for those who have mental illness and who have suffered with it for a very long time. We know clearly, from the DSM-5, that there are many conditions that, if Canadians were aware were classified as a mental illness, they would find this legislation even more appalling than they do now. We know that over half of Canadians reject this terrible idea of MAID for mental illness. When Canadians think of mental illness, they think of things such as depression, schizophrenia and bipolar illness, all of which are chronic medical conditions with available treatment. However, we also know the reckless government and this reckless expansion of MAID is causing some of the major difficulties. In the DSM-5, what would also be classified as a mental illness would be things such as substance use disorder and autism, both of which are chronic illnesses. I believe Canadians specifically would find it appalling for the reckless government and its reckless agenda to suggest that Canadians who are suffering from a substance use disorder or Canadians with autism are never going to get better, and that they should be subjected to the MAID regime. When we begin to look at and understand the difficulties associated with the reckless, costly coalition's expansion of MAID, we also know that the 17 chairs of the departments of psychiatry from Canada's universities have spoken out specifically against this expansion of MAID. There are two things that are very important. Let us start with, perhaps, suicidality, which the member across did mention. I guess the question then remains how an experienced, or even inexperienced, primary care physician or nurse practitioner would be able to determine the difference between suicidality and a demand for MAID. The member across is right. I did practise as a family physician for more than 25 years. Practising in an emergency-room setting on a Saturday night when somebody comes in and is suicidal is probably one of the most stressful things someone can possibly deal with. I think every one of my physician colleagues across this country would admit to that. We are incredibly well trained, and we have incredible protocols for dealing with trauma, strokes and heart attacks, but when somebody comes in with suicidal ideation, it is incredibly personal. It is situational. It is related to medication. It is related to family. It is related to every single difficult relationship they have in their lives. If there is a physician out there who suggests that, when they go home after a shift Saturday night that ends Sunday morning where they told someone who was suicidal that they are okay to go home, and they know that person is fine, but they do not worry about that decision, I would challenge them on that. That, for me personally as a physician, was something that created significant distress and angst, and it should. What we are talking about is somebody's life and their decision to end it or not. We have a regime put forward by the reckless and costly coalition to have people with mental illness receive medical assistance in dying, to be put to death by the state. That is the suicide part of it, which, again, can be with respect to an acute or a more chronic condition. However, it is the irremediable aspect of the mental illness that creates significant difficulties for the reckless and radical expansion of the MAID regime. What does the word “irremediable” mean? It means, in basic terms, that the condition cannot be fixed, that the treatment that has been rendered is all the treatment available and that the condition is going to either continue the way it is or get worse in the future. Who is going to decide that? There is a Canadian Association of MAiD Assessors and Providers. The group is staffed by family physicians and nurse practitioners, despite the opposite thought of many Canadians who would think it would be psychiatrists who would be determining whether a condition is not fixable and chronic and that all of the possible treatment out there has been rendered. That is not the truth; at the current time, the decision would be rendered by two different care providers who are either primary care providers or nurse practitioners. That is incredibly important because we know that even the diagnosis of a mental illness is based on probabilities: Has someone had a particular set of symptoms for a certain amount of time over a certain amount period of time? It is not like high blood pressure, which a doctor can check and then have a concrete, objective answer. It is not like diabetes, where a person's blood work is done and they have a concrete answer that, yes, the numbers are elevated and the person does have diabetes and can be told what will be done to help them with it. Mental illness is very, very different, and Canadians need to know that; if they do already know it, they need to remember it. The other important thing is the terrible job that the costly NDP-Liberal coalition has done with respect to access to health care in general but more specifically to mental health care. We know that across this country, half of Canadians are extremely unhappy with their ability to access mental health care, and we also know that the waiting time for adults to access a psychiatrist in most parts of this country is about a year. This means very clearly that primary care physicians and nurse practitioners are providing the majority of mental health care for Canadians, deciding which treatments are working and which are not, when to increase medications, when to add on, etc. Very sadly, it is clear that for Canadians under 18, the wait time for mental health care access to a psychiatrist in Canada is more than two and a half years. The system is atrocious. The Prime Minister stood up and promised 7,500 doctors, nurses and nurse practitioners to Canadians. How many have we seen? I dare say it has been almost zero. The terrible situation with respect to access to care is most acute when people are seeking mental health care. Of course, from this side of the House, we do not want the legislation to proceed, but we see a government in panic mode that has no plan and no clear idea of what it is going to do, wants to do, or should do on behalf of Canadians. Here we are. Multiple times at the 11th hour, senior elected government officials across the aisle have said, “We have to rush this through; we have to get it done on behalf of Canadians.” What they fail to remind Canadians of is that it is the government's fault that we have arrived at this situation in the first place. The government members did not appeal the right decisions, allowed decisions to be added on in the Senate, and did not make a decision when they should have, on behalf of Canadians. Therefore, I would implore the House to understand clearly that MAID for mental illness is not the correct path to go down.

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Mr. Marcus Powlowski (Thunder Bay—Rainy River, Lib.)

Feb/12/24 1:01:59 p.m.
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Madam Speaker, the member opposite from Nova Scotia is a fellow doctor. The legislation would put a hold on implementing MAID for mental illness. A year before the legislation would come into effect, the committee would have to be re-formed to reconsider the matter and call the experts again. Do you think that in two years' time there is going to be any more of a consensus on the issue than there is at the moment?

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