SoVote

Context: House Hansard - 281 - Feb/13/24

Mr. Yasir Naqvi (Parliamentary Secretary to the Minister of Health, Lib.)

Feb/13/24 4:04:07 p.m.
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Re: Bill C-7 Bill C-62

Mr. Speaker, I appreciate being recognized to speak to a very sensitive and emotional issue. Today, I am pleased to be speaking to Bill C-62. This bill proposes extending the temporary exclusion from MAID for people whose sole underlying medical condition is mental illness. We are proposing that the exclusion be extended by three years. To understand why an extension of this exclusion is so important right now, we need to look at how we got to this point in the legislative process. As members know, former Bill C-7 was enacted in response to the Quebec Superior Court Truchon ruling. The ruling found that the original MAID legislation, which required a person's natural death to be reasonably foreseeable, contravened the Charter of Rights and Freedoms. The former Bill C-7 received royal assent and became law on March 17, 2021. This law included a temporary two-year exclusion of eligibility for individuals suffering solely from mental illness, which meant that such persons would become eligible to receive MAID starting March 17, 2023, if they met all other eligibility criteria. The intent of this two-year delay was to allow an expert panel to undertake an independent review and to provide recommendations respecting any protocols, guidance and safeguards that should apply to requests for MAID by persons with a mental illness. I will be sharing my time with the member for Richmond Hill. On May 13, 2022, the “Final Report of the Expert Panel on MAiD and Mental Illness” was tabled in Parliament and released publicly. The expert panel noted that MAID clinicians are already assessing very complex cases and concluded that certain assessment challenges, such as determining incurability or assessing decision-making capacity, are not unique to MAID requests from persons with a mental disorder, nor are they applicable to every requester who has a mental disorder. The expert panel also concluded that the existing MAID eligibility criteria and safeguards in the legislation provide an adequate structure for MAID where a mental disorder is the sole underlying medical condition, as long as they are interpreted and applied appropriately. The expert panel's recommendations provide guidance to support complex MAID assessments. In its final report, the expert panel made 19 recommendations, laying out a broad set of principles that could structure the practice of MAID not only for persons with a mental disorder but also for those with other conditions where concerns may arise related to incurability, irreversibility, decision-making capacity, suicidality and/or the impact of structural vulnerability, regardless of the person's diagnosis. The government supports the insights and general advice emerging from the panel's work. Let me take a few minutes to highlight some of the key achievements. The expert panel report recommended the development of national practice standards on MAID for mental disorders and other complex cases. Practice standards help regulatory bodies evaluate the appropriateness of the clinical decisions of health professionals who assess and provide MAID. They also provide clarity to MAID clinicians regarding their professional obligations. In March 2023, a model practice standard for MAID was released along with a companion document of advice to the profession, which provides a series of questions and answers that elaborate upon specific clinical questions raised by the model standard. That is not all we have done to help prepare a safe approach to providing medical assistance in dying across Canada. We are providing $4.9 million to the Canadian Association of MAiD Assessors and Providers to develop and deliver an accredited, Canadian-made curriculum to support practitioners. This consists of seven training modules that address various topics related to the assessment and provision of MAID, including guidance in how to assess capacity and vulnerability, how to navigate more complex cases and how to assess MAID requests with mental illness as the sole underlying condition. The MAID curriculum was launched in August 2023. Over 1,100 clinicians have registered for it. From when MAID legislation was enacted in 2016 to the end of 2022, over 44,000 Canadians received MAID. The vast majority of these individuals were at the end of their life. In fact, numbers from 2022 show that 96.5% of individuals accessing MAID were terminally ill, and two-thirds had a cancer diagnosis. Many more requested MAID but were ruled ineligible based on the strict eligibility criteria and safeguards, withdrew their requests or died before receiving MAID. This is not unexpected. The government recognizes that public reporting is critical to ensuring transparency and public trust in the legislation. Both the original MAID legislation of 2016 and the amended law passed in 2021 set out obligations for the collection of data and public reporting on important aspects of MAID. As of January 1, 2023, we have expanded our collection of information on MAID. I would like to take this opportunity to highlight the achievements of the provinces and territories, as well as key partners in the system, such as health care professionals, who are working to safely implement MAID within their health care systems. We have come a long way, but we have heard clearly that there is more work to be done. More preparations are required within the provincial and territorial health care systems to support the wraparound activities that may be necessary for the management and assessment of MAID requests where mental illness is the driver. We also know that some Canadians and members of the medical community are concerned about expanding eligibility for MAID to people suffering solely from mental disorders. We will continue the work with the provinces, territories and key health system partners to support the safe implementation and delivery of Canada's framework for MAID, while protecting those who may be vulnerable. The expert panel also recommended consultations with first nations, Inuit and Métis people. We recognize the importance of meaningful engagement and ongoing dialogue with indigenous peoples to support the culturally safe implementation of MAID. Working in partnership with indigenous communities, we have developed an extensive plan for indigenous engagement. Our approach involves both indigenous-led community engagement and federally supported activities, such as an online tool, which has already been launched, and knowledge-exchange round tables, which will be taking place this February to April. We are working closely with indigenous partners to design a process with them at their pace. I recognize that there is a lot of hard work being done in order to show that MAID is accessible to people who need it, with appropriate safeguards in place. However, we need to make sure that we do not rush into that decision. This is why it is really important that we extend the application of this particular bill, as it relates to people with mental disorders, by at least three years; as a result, all provinces and territories can have the appropriate training and assessment tools ready. A year ago, we extended the exclusion period for one year, until this March. As we approach that date, we have heard unanimously from all provinces and territories that their health care systems are at various stages of readiness, and there is more to be done. The decisions we are making about MAID are not easy to make, nor should they be. These are life-and-death decisions and we must get this right. In Bill C‑62, the government has put forward a three-year extension of the exclusion from eligibility for MAID for people suffering solely from mental illness. I urge all members of this House to support Bill C-62.

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Context: House Hansard - 281 - Feb/13/24

Mr. Yasir Naqvi

Feb/13/24 4:14:55 p.m.
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Mr. Speaker, I thank the member opposite for his remarks and question. I want to remind the member that, back in 2016, when the first MAID legislation came, I was serving at the provincial level. In fact, I was the attorney general for the Province of Ontario. I had the opportunity to work closely with the federal government, along with the provincial minister of health at that time, on the appropriate and proper implementation of the MAID legislation that was passed by this House. This was hard work that required a lot of appropriate training, curriculum, readiness and safeguards to ensure that MAID was practised in the province according to the law. That is the path forward as we look at people with mental disorders. We need to make sure that provinces and territories are ready, as they are asking for time. We are confident that, if we provide an extension for three years, they will have the appropriate tools, curriculum and training necessary in order to deliver this service in the most appropriate manner.

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Context: House Hansard - 281 - Feb/13/24

Mr. Yasir Naqvi

Feb/13/24 4:16:57 p.m.
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Re: Bill C-62

Mr. Speaker, I thank my colleague for his question. Partnership with provinces, including Quebec, is extremely important in order for the legislation around MAID to be applied properly. As we know, delivery of health care is a provincial responsibility. It is really important that our provinces have all the tools and the time necessary to administer MAID in an appropriate manner. That is why the work that is happening around setting of curriculum, training and the tools that regulatory bodies need to ensure that the training and curriculum is being met, as well as that the safeguards are being complied with, is important. This is also why the three-year extension under Bill C-62 is absolutely necessary.

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Context: House Hansard - 281 - Feb/13/24

Mr. Yasir Naqvi

Feb/13/24 4:18:40 p.m.
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Mr. Speaker, I want to thank the member opposite for his question and the members of this House for the hard work they are doing to ensure that this particular piece of legislation passes through this place as quickly as possible, so it can get to the Senate and become law by March 17. I am confident that the Senate will fulfill its responsibility appropriately and will pass this legislation. I know the minister, along with the Attorney General, will be speaking to the senators and answering their questions. I hope this will satisfy them in terms of the validity of the bill and the need to pass it by March 17.

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