44th Parl. 1st Sess.
February 13, 2024 10:00AM
Mr. Speaker, it is with a sense of profound responsibility and pride that I address the House today regarding the government's proposed bill, Bill C-62, aimed at extending the temporary suspension of eligibility for medical assistance in dying, MAID, for individuals suffering exclusively from mental illness, for an additional three years. This discussion is not just about policy but about the very essence of compassion, dignity and the complexity of human suffering.
The concept of MAID resonates deeply within the Canadian societal fabric, touching upon the core values of autonomy and the right to end intolerable suffering. In Richmond Hill, as in communities across our nation, I have engaged with constituents, health care professionals and advocacy groups. These conversations have revealed a spectrum of beliefs and underscored the critical importance of adopting this issue with sensitivity, respect and an unwavering commitment to the well-being of all Canadians.
Since MAID was introduced, our office organized three community council meetings to deeply engage on this topic. We also partnered with the Canadian Mental Health Association, among many other professional associations, to enhance the dialogue with our constituents. Following the special joint committee's report, we convened our latest community council to gather our constituents' views and insights. Their response was clear and united in support of the delay. This active involvement with our community underlines the importance of careful reflection and thorough examination in addressing this issue.
The proposed extension under Bill C-62 is not merely a procedural delay. It is a crucial break that would let us look more closely into how mental illnesses and the final choice to end a life interact with each other. Mental health issues are complex and different for everyone, making it hard to fit them into our usual ideas about illness that leads to death. We need to look at each situation individually, taking the person's pain seriously while making sure there are strong protections in place to prevent hasty choices.
Our government acknowledges the importance of the data and reporting in relation to MAID, so much so that the original 2016 legislation obligated the Minister of Health to collect and report annually on MAID assessment and delivery. The formal monitoring system is important to inform our understanding of who applies for MAID in Canada, the medical conditions prompting requests, and trends in MAID activity since the 2016 legislation. As such, we have been working in collaboration with the provinces and territories and with health care professionals to establish a robust monitoring system. It is important to emphasize that this is a significant collaborative commitment.
As members know, on March 17, 2021, revised federal legislation was passed, expanding MAID eligibility to persons whose natural death is not reasonably foreseeable, providing they meet the remaining eligibility criteria.
Since the passing of the new legislation, the vast majority of MAID deaths, that is 96.5%, involved individuals whose death was reasonably foreseeable. Of course, two-thirds had a cancer diagnosis. In 2022, just 3.5% of total MAID deaths, which is 463 deaths, were attributed to individuals whose death was not reasonably foreseeable, representing less than 0.2% of all deaths in Canada. Of those 463 deaths, nearly 50% reported that the main underlying medical condition was neurological, such as ALS or Parkinson’s disease, while the remaining cases involved a variety of other complex conditions, including multiple comorbidities, cardiovascular disease, organ failure and respiratory illnesses.
Although the current sample is small, 2022 data also shows that where death was not reasonably foreseeable, 64% of individuals were approved for MAID, compared to 83% of individuals in cases where death was foreseeable. Each MAID request where the person’s natural death is not reasonably foreseeable is complex and unique, and early indications show that approvals for MAID in this stream are much lower than when the person’s death is reasonably foreseeable.
The decision-making process for MAID, especially in the context of mental illness, is fraught with complexity. It necessitates a meticulous evaluation of the individual's condition, an exploration of all viable treatment options and a profound understanding of the person's lived experience. This process is not undertaken lightly. It is grounded in empathy, clinical expertise and a rigorous adherence to ethical standards.
I also previously engaged in discussions on this matter in 2016 and again in February 2023. Today marks my third address to the House on this subject, which holds personal significance for me and, undoubtedly, affects numerous households in Richmond Hill and beyond.
I wish to highlight the government's consistent commitment to thorough and collaborative investigation, in concert with provincial, territorial and societal stakeholders, to ensure that MAID is administered with rigorous safeguards to protect the vulnerable while respecting the rights and dignities of applicants.
In pursuit of these objectives, the government enacted Bill C-39 last year, extending the moratorium on MAID for those with mental disorders as their sole medical condition until March of this year. This extension was pivotal in facilitating the safe provision of MAID, allowing for the broader dissemination and adoption of essential resources among medical and nursing professionals and ensuring the readiness of our health care infrastructure.
Moreover, this period provided the government with a crucial window to review the conclusive report by the Special Joint Committee on Medical Assistance in Dying. The one-year extension has proven invaluable, enabling the special joint committee to conduct a review in October 2023 concerning Canada's preparedness to accommodate MAID requests for mental disorders.
On January 29, 2024, the committee tabled its third report, which outlined recommendations regarding Canada's readiness for the safe execution of MAID under these circumstances. Following the committee's recommendations, the government, via Bill C-62, seeks to extend the pause on MAID for those with only a mental disorder until March 17, 2027. This aims to give our health care system enough time to prepare for MAID under these conditions.
We have held detailed talks with health care experts and the public, which showed a clear need for more time to maintain the integrity of this process. This time would also help in creating and sharing specialized training for health care workers, developing detailed policies and encouraging discussions on this important matter. The goal is to create a system that acknowledges mental illness complexities, protects those at risk, respects individual rights and dignity, as well as the Constitution, and ensures the proper safeguards.
In conclusion, we know that the MAID regime has provided relief from suffering for thousands of Canadians so far, the vast majority of whom are already at the end of life, and that individuals living with intolerable suffering will continue to explore MAID as an option in the future.
We have made a commitment to transparency and accountability across all levels of government to support public confidence in the MAID regime. I am also confident that we are honouring that commitment by providing Canadians with accurate and reliable information on MAID as it continues to evolve in this country.
As I stand before you, Mr. Speaker, acknowledging the profound impact of this issue on myself, the constituents of Richmond Hill and countless other Canadians, I am confident that this bill would facilitate the careful and considered approach required to address this sensitive matter appropriately.
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- Feb/13/24 4:29:57 p.m.
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Mr. Speaker, through you, I would like to thank my colleague across, not only for the work he has done as part of the special committee, but also for the point of view he is raising.
We have to remember that, at that time, we were looking at the bill from a constitutional aspect as well, so when we looked at it we addressed many issues. We put the policies, the procedures, the constitutional concept of it and the rights of Canadians into perspective. I believe that was the right decision to make.
However, since then we have had the opportunity to look at the next phase, which is the implementation and the rollout of that. As we started to address working with the provinces and the professionals, we realized there was a lot more opportunity for collaboration as far as readiness and safeguards are concerned, and that we needed more time. We were hoping that one year would give us that, but once again it became clear that we needed more time. Therefore, the extension we are talking about is finding that fine balance between making sure that all Canadians can exercise their constitutional right and making sure we have the safeguards in place to ensure that no missteps are taken.
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- Feb/13/24 4:31:51 p.m.
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Mr. Speaker, let me address the last part first. I have had the honour and privilege of representing Richmond Hill over the last three terms and am counting on people and my hard work to be able to be re-elected so that I can come back here to continue representing them. Let us leave it at that.
What is key is that the issue of irremediability is a very complex issue, and it takes time to understand each case. We need to make sure all the safeguards are put into place to ensure that we do not cause any undue risk and harm.
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- Feb/13/24 4:33:34 p.m.
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Mr. Speaker, I have had the pleasure of working with my colleague on a number of committees, and I thank her for her point of view.
The point is that it is those complexities that have necessitated, now that we are at the point of rolling out this legislation, that we really take a step back and look at the spectrum of diseases and the challenges that exist to be able to ensure that the right safeguards are in place. Yes, all of those need to be taken into account.
I am hoping that, over the next three years, working in collaboration with the provinces and with professionals, as well as with those with lived experience, we will be able to answer some of those key questions.
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Mr. Speaker, I am pleased to rise once again in the House to speak to Bill C-273, an act to amend the Criminal Code. Introduced by my colleague, the member for New Westminster—Burnaby, the bill proposes to repeal section 43 of the Criminal Code.
It is an undeniable fact that all children have the right to be protected from violence and abuse. As adults are, children are protected from a range of general criminal offences, including assault.
I am a member of the Standing Committee on Health, where we study how to best support the physical, mental and emotional well-being of children across Canada. A big part of that goal is fostering healthy, safe environments in which children learn, evolve and grow.
I have also heard from parents in my riding of Richmond Hill about their concerns for their children’s safety, not only at school but also on their way to and from school. I have had one parent personally reach out to my office to ask for assistance in securing the safety of his daughter because of the ongoing harassment she faced at school. Cases such as these serve as crucial reminders for us to take action on enhancing the protection of children in our communities, in our education system and across Canada. This starts with making the necessary amendments to our current legal provisions on this matter.
Bill C-273 delves into deeply sensitive matters, including parental authority, children's rights, the government's appropriate involvement and delineating between acceptable parental discipline and instances of child abuse. I would like to start by outlining section 43 of the Criminal Code, which the bill addresses, and a few of the important perspectives we have heard on it.
The bill before us specifically addresses section 43 of the Criminal Code, which provides a defence to a criminal charge of assault in situations where parents, guardians or teachers use corporal punishment with the intent of educating or correcting a child. This means that parents can use mild physical force, such as spanking or light hitting, to discipline a child in their care. Section 43 also applies to allow parents to use physical control to restrain or remove a child in appropriate circumstances. The same provision also applies to situations where a parent or a teacher uses reasonable physical force to restrain or expel a child from a classroom when appropriate.
We know that Canadians hold a wide range of opinions regarding what should be deemed a suitable degree of physical discipline when parenting or teaching a child. These differing perspectives have sparked discussions regarding which behaviours reach a level of harm necessitating prohibition, all while recognizing that parental choices are deeply personal. I appreciate the chance offered by Bill C-273 to reflect on these significant questions.
Our government supports Bill C-273 and its crucial goal of safeguarding children from violence and abuse. Nonetheless, we have received feedback from parents, particularly those from overpoliced communities, and educators. They have expressed apprehension that they may face criminalization for reasonable actions, such as minor instances of physical intervention that do not result in harm.
It is worth noting that section 43 has been a component of the Criminal Code since 1892, remaining largely untouched. Its origins flow from the parental duty to protect and educate children. The defence typically applies in relation to assault charges, because assault is broadly defined in the Criminal Code as the non-consensual application of force. This definition captures non-consensual touching or even threats against another person, regardless of their age or whether physical harm or injury occurs.
Section 43 was enacted by Parliament to prevent the criminalization of specific behaviours by teachers, parents and caregivers. However, its current application is not designed to safeguard against abusive or harmful behaviour.
The Supreme Court of Canada, in its 2004 decision Canadian Foundation for Children, Youth and the Law v. Canada, found that section 43 is consistent with sections 7, 12 and 15 of the Canadian Charter of Rights and Freedoms, and clarified that the defence applies only to parents who impose minor corporal punishment of a transitory or trifling nature. The court also set certain parameters on the defence. For example, the defence applies only where the child is aged two to 12 and is capable of learning from the situation. No object may be used when applying force. The child’s head must not be slapped. There can be no physical harm or reasonable prospect of harm, and the adult must not be acting out of frustration or anger.
The court has restricted the scope of the defence, particularly concerning educators, who are constrained to employing judicious physical intervention solely for the purpose of upholding discipline or enforcing school regulations, such as relocating a student from a classroom or ensuring adherence to instructions. The court underscored that corporal punishment administered by teachers is unequivocally prohibited. In the aftermath of the Supreme Court of Canada's ruling nearly two decades ago, advancing research and insights into the adverse effects linked to the physical disciplining of children have led to heightened calls for the reform or repeal of section 43.
The government is steadfast in its dedication to realizing all recommendations outlined in the 2015 final report of the Truth and Reconciliation Commission of Canada. The repeal of section 43 would constitute another stride toward fulfilling this commitment, aligning with call to action 6. This particular call is substantiated by documented instances of pervasive corporal punishment and child mistreatment by personnel within the residential school system, as highlighted in the commission's final report: “The failure to develop, implement, and monitor effective discipline sent an unspoken message that there were no real limits on what could be done to Aboriginal children within the walls of a residential school.”
Advocates for the complete repeal of section 43, including numerous civil society entities and the United Nations Committee on the Rights of the Child, contend that the existing criminal legislation fails to afford children equal protection to that which is afforded to adults. Moreover, a growing body of medical and social science studies suggests that corporal punishment adversely impacts children. Such disciplinary measures expose children to the risks of physical harm, abuse, compromised mental well-being, strained parent-child relationships, heightened childhood aggression, anti-social conduct and increased violence and criminal behaviour as adults, thereby perpetuating cycles of violence. More than 650 organizations across Canada have endorsed the stance that physical discipline of children and youth yields no beneficial outcomes, and have called for the same protection from assault for children as that given to adults.
However, the complete repeal of section 43 raises concerns in some sectors. For instance, various religious groups, legal scholars and teacher representation bodies, including the Canadian Teachers' Federation, have expressed reservations regarding the complete repeal of section 43. They contend that a complete repeal could expose teachers and parents to potential criminal charges for minor and inconsequential physical interactions with children such as intervening in sibling disputes or relocating a student from a classroom in the interest of the safety of the other students. In the absence of a legal safeguard for parents, educators and caregivers who apply reasonable physical force to children in their care, the assault provisions may apply. This is due to the broad scope of the assault provisions, encompassing minor instances of force that do not culminate in physical harm. For instance, this could encompass scenarios such as a parent restraining a child to ensure they are properly placed in a car seat.
As I alluded to earlier, it may also have an unintended negative impact on populations that are already proven to be overpoliced and overrepresented in the criminal justice and child welfare systems, including the indigenous and Black communities, as well as members of other racialized groups.
In closing—
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