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

Mr. Francesco Sorbara (Vaughan—Woodbridge, Lib.)

Feb/13/24 5:05:04 p.m.
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Re: Bill C-62

Mr. Speaker, it is always an honour and a privilege to rise in the House on behalf of the wonderful residents of my riding of Vaughan—Woodbridge and all of the residents in the city of Vaughan. I will be sharing my time with my friend and colleague from the wonderful riding of Kitchener Centre. Before I begin my formal remarks, this is a debate on Bill C-62, medical assistance in dying, which is obviously highly personal to all members in the House. Remarks are being delivered today with much passion, substance and thought. I will add a few words on that front. I have provided my personal beliefs on medical assistance in dying, which I am obviously in favour of. I know many individuals in many families who made tough decisions that were not with regard to mental illness. That gives me great consternation and much thought. I am glad that a pause will be put in place because mental illness is a complex subject. I am not an expert and will not profess to be an expert, but we all know someone who has struggled with mental illness. We all know family members or friends for whom mental illness continues to be an issue. Unfortunately, many folks have taken their lives, and we need to make sure there is a system in place that is robust, where people can get the help and assistance they need to live their full lives, which God has blessed them with. I am convinced that our current MAID system is working well. I would like to take the next ten minutes to explain why Canadians should have confidence in our MAID legislation and its application over the past seven years. I also want to describe some of the activities that will help sustain that confidence when eligibility is expanded in March 2027, as proposed in Bill C-62. When the law authorizing medical assistance in dying was originally passed in 2016, it included a number of mandatory eligibility criteria for anyone requesting MAID. The person must be an adult of at least 18 years of age and capable of making health-related decisions. The request must be voluntary. Their request must be fully informed, and the person must have knowledge of the options available to relieve their suffering. They must have a grievous and irremediable health condition, meaning it cannot be cured, which is defined as follows: They have “a serious and incurable illness, disease or disability; they are in an advanced state of irreversible decline in capability”, and they are experiencing “enduring physical or psychological suffering” that cannot be relieved under conditions that they consider acceptable. In 2016, the law also required that the person's natural death be reasonably foreseeable. In 2019, the Quebec Superior Court ruled that this criterion violated the Charter of Rights and Freedoms. In March 2021, a revised version of the federal law was passed, extending eligibility for MAID to people whose natural death was not reasonably foreseeable as long as they met other eligibility criteria. In addition to these eligibility criteria, the law also sets out many procedural safeguards that a clinician must meet before administering medical assistance in dying. Here are a few of them: Two independent practitioners must provide a written confirmation of the person's eligibility. The person who is requesting medical assistance in dying must be informed that they can change their mind at any time and in any way and that their wishes must be respected. Also, the person must reconfirm their desire to receive medical assistance in dying immediately before receiving it. When a person's natural death is not reasonably foreseeable, a series of enhanced safeguards must be respected. I will talk about some of those critical safeguards. First, at least one of the two MAID assessors must have expertise in the person's medical condition. If they do not have that expertise, they must consult another practitioner who does. Second, the person must be informed of the means available to alleviate their suffering and be offered meaningful consultations. Third, these means must have been discussed, and both MAID assessors must agree that the person has seriously considered these means. Fourth, at least 90 days must pass between the beginning of the eligibility assessment and the day on which MAID is administered. These are legislated safeguards that all practitioners must abide by. We know that MAID practitioners across the country exercise considerable professional judgment in providing this service by keeping patients' interests and wishes at the forefront. Practitioners work hard to ensure that MAID is a last resort. They compile essential information about the person's medical condition, their treatment history and their use of support services. They have the necessary conversations to ensure that their patients are aware of the services available to them that might alleviate their suffering. It is about exploring treatment options, facilitating referrals and following up on the results. If the person who wants to receive MAID consents to involving family members and loved ones, the practitioners will encourage their involvement and include them in the discussions that are part of the overall assessment process. Practitioners are also aware that they do not always have the necessary expertise in the patient's condition to conduct a full assessment. In these situations, they have to consult the relevant experts and other health professionals who have the necessary expertise to make an informed decision. Some provinces or regional health care authorities have put in place MAID care coordination services or case consultation mechanisms that rely on a team or network of doctors, nurses and other professionals, such as social workers and spiritual leaders, to support the assessment process. What does that mean for the future, once we begin allowing MAID requests based on enduring and intolerable suffering resulting solely from mental illness? Are our existing legislative safeguards sufficient? How can we be sure that the same level of care, diligence and consistency in the provision of MAID will be the norm? In 2021, as mandated by the former Bill C-7, an expert panel reviewed the issue and concluded that the existing legal framework for eligibility criteria and safeguards is sufficient, provided MAID assessors apply the existing framework appropriately, with guidance from MAID standards of practice that have been developed as well as specialized training. In the time I have left, I would just like to say that we all rise in this most honoured House on many topics. One of these topics, probably one of the most personal ones that we have risen on in the number of years I have been here, is medical assistance in dying. I look forward to questions from the hon. members in the House, who have been sent here by their constituents. This is an important debate for us to have, and it is an important topic to discuss.

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

Mr. Francesco Sorbara

Feb/13/24 5:16:27 p.m.
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Mr. Speaker, I have had much respect and much time for the hon. member in all of our conversations. I am not a lawyer. On having something referenced to the Supreme Court for a decision, I would have to get back to the learned member for Abbotsford on that front. I would say that it is important for all members in the House to look at the evolving needs of individuals in this country, speak with the pertinent experts and work with the provinces and territories. I have always believed that we should legislate and not defer to the courts. That is my own personal opinion. I believe in that. I think that is the best way to legislate and govern. We should do so by taking decisions in the House, while making sure they are obviously compliant with the Charter of Rights and Freedoms, which I know all members in the House hold dear.

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

Mr. Francesco Sorbara

Feb/13/24 5:18:38 p.m.
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Mr. Speaker, I would like to thank my colleague from Quebec for his question and assure him that this is very important to us. My answer would be yes, of course, as a member of Parliament, I always work in the interests of my constituents, and this is an issue and a law that has been brought forth in the last number of years that people are quite passionate about. I have always grappled with the technical and fine details of the law and the early provisions on a personal level. One term that has been used is “foreseeable death”. Thinking about this must be done with much diligence and judiciousness. I continue to advocate on our side and within our caucus for a law that is robust, that reflects the individual interests of Canadians and that is obviously compliant with the Charter of Rights and Freedoms.

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

Mr. Francesco Sorbara

Feb/13/24 5:20:34 p.m.
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Mr. Speaker, in terms of a timeline of three, five or six years, obviously, a decision was made. As the member identified, we need to work with the provinces and territories as we move forward on this policy. We need to make sure that all provinces, territories, health ministers and individuals working in the various fields are ready for this. We need to make sure that we are ready for this and that it goes through in a manner that is prudent and appropriate.

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