SoVote

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

Feb/13/24 10:08:58 a.m.
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Pursuant to Standing Order 67(1), there will now be a 30-minute question period. I invite hon. members who wish to ask questions to rise or to use the “raise hand” function so the Chair can have some idea of the number of members who wish to participate in this question period. The hon. member for Battlefords—Lloydminster.

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Mrs. Rosemarie Falk (Battlefords—Lloydminster, CPC)

Feb/13/24 10:09:45 a.m.
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Mr. Speaker, here we are once again, seeing the Liberals enforce time allocation. I wonder, through you, why it is that the Liberals are so terrible at managing legislation to put forward the House calendar. At the end of the day, they are the ones deciding what the calendar is and what their priorities are, and it seems like it is at the eleventh hour, every single time. Here we are, once again, with them trying to invoke closure.

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Hon. Arif Virani (Minister of Justice and Attorney General of Canada, Lib.)

Feb/13/24 10:10:21 a.m.
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Mr. Speaker, I thank the member for her contributions, but reject the characterization. We indicated quite openly and publicly that we would not proceed with medical assistance in dying where mental illness is the sole underlying condition until after we had received the study from the joint committee that is made up of members of Parliament and of senators. That joint committee study was tabled in this chamber on January 29. Shortly thereafter, we reviewed that document, prepared legislation and tabled that legislation expeditiously. That legislation is now before this chamber, and we have a statutory deadline to meet prior to March 17 that relates to the sunset clause, thus necessitating the need to move it expeditiously through both this chamber and the upper chamber.

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Mr. Peter Julian (New Westminster—Burnaby, NDP)

Feb/13/24 10:11:11 a.m.
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Mr. Speaker, we do have a date that has been fixed, which is March 17. We have, at this point, only 14 sitting days to get this bill not only through the House of Commons but also through the Senate, as the Minister of Justice said. My concern is the confusion. If this bill has not gone through both Houses, what we would end up with is a situation of utter confusion for something as fundamental as medical assistance in dying. To have that confusion is something that I do not think is acceptable to any Canadian. It is important that we get this right. It is important that we meet the deadline. What I am surprised about is that we do not have a consensus. This is the kind of situation where all parties should get together and facilitate getting this through the House because of the importance of not adding or installing the confusion that would surely result in us not meeting the deadline. My question for my colleague is very simple. Why is there not a consensus around this so that we can move it through the House this week without the use of time allocation?

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Hon. Arif Virani

Feb/13/24 10:12:36 a.m.
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Mr. Speaker, I would say, quite candidly, that I agree with the member's supposition. When we are dealing with a matter of such compelling interest and such consequential interests that are at stake, with respect to a life-and-death situation involving medical assistance in dying, it is important that parliamentarians work in unison. There have been divisions on this issue in the past, and there remain divisions in this chamber with respect to this issue. What we are saying is that we are dealing distinctly with the issue of mental illness as a sole underlying condition. On that piece, we believe the prudent course is to have an extension of time for a following three years. We hope that all parliamentarians would support that and the pressing need to get this piece of legislation through both Houses to royal assent prior to March 17 to avoid the very confusion the member identified.

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Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)

Feb/13/24 10:13:27 a.m.
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Mr. Speaker, when I reflect on this, the whole discussion and debate that has taken place over the last number of years has been fairly extensive. Going back to the Supreme Court of Canada's Carter decision of 2015 and to the amount of committee and House of Commons' time, there has been a great of deal of discussion, justifiably so. It is important to recognize that medical assistance in dying is not necessarily a new issue. It has been well discussed in many different forms, even the issue of mental health well-being. I wonder if the minister could provide his thoughts on the journey taken to bring us to this point today and on why it is so critically important that it pass by the end of this week.

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Hon. Arif Virani

Feb/13/24 10:14:31 a.m.
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Mr. Speaker, I thank the hon. member for his contributions today and every day in this Chamber. The journey has been a detailed one, a responsible one and a prudent one. What we understand, as a government and as parliamentarians, is that mental illness causes suffering, and that suffering is equivalent to physical suffering. We also understand people have decision-making capacity, including those who are mentally ill. We also understand that, as a federal government in a federation where the health care system and the delivery of health care is primarily the jurisdiction of provinces, proceeding in a situation where the provinces have spoken with one voice, saying that provinces and territories are not ready to deliver medical assistance in dying for people who have mental illness as their sole underlying condition, in that context, we have to listen to those provinces and work with those provinces to help them with their readiness. The provinces have spoken uniformly to the Minister of Health and to myself about their lack of readiness and about the fact that more time would be beneficial to ensure that there is better take-up of the curriculum and that supports are in place for those who would assess and provide MAID, and that there is more understanding of how those safeguards would be implemented in the context of an individual who has mental illness as their sole underlying condition. Based on that, we are seeking, through this chamber and through the upper chamber, an extension of three years. That would be a prudent course when the situation is very significant, when the interests are significant and when then consequences are very permanent.

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Mr. Peter Julian

Feb/13/24 10:15:59 a.m.
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Mr. Speaker, on a point of order, I apologize. I misspoke. I said 14, but there are actually only nine sitting days, including today, before the deadline.

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The Deputy Speaker

Feb/13/24 10:16:08 a.m.
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I thank the hon. member for the clarification.

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Clarification

Ms. Elizabeth May (Saanich—Gulf Islands, GP)

Feb/13/24 10:16:13 a.m.
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Re: Bill C-14

Mr. Speaker, I thank hon. Minister of Justice for sharing these comments with other members of the cabinet, particularly the Minister of Health. This is perhaps the most difficult issue any of us will ever deal with as members of Parliament. Strangely enough, I will just add that, had she been alive when I was a member of Parliament, Sue Rodriguez, who went all the way to the Supreme Court of Canada for the right to die with dignity, would have been my constituent. She lived in North Saanich. There is tremendous public support in my area for medical assistance in dying being available to Canadians. However, I have to say, when it came to Bill C-14 and extending it to where mental illness was the only underlying cause, I voted for that bill only because there was a time delay, and we should be ready before it comes into effect. I support what the Minister of Justice just said. We know the provinces have spoken with one voice. I am very concerned that access to treatments for mental health are still not available and might push people toward seeking MAID because they cannot get access to something like psilocybin that could deal with their underlying causes. I very much object to using time allocation. I do not think I have ever voted for time allocation in this place, but now I must because the court deadline is approaching; March 17 is soon. We need to make sure that we do not leave Canadians in this awful gap where we do not have anything in place, as a Parliament, to deal with the current crisis. I offer those comments just to say that I will be voting differently from the way I typically have, but I still vigorously object to time allocation being used routinely.

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Hon. Arif Virani

Feb/13/24 10:17:59 a.m.
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Mr. Speaker, I thank the hon. member for Saanich—Gulf Islands for her contributions today and every day in the chamber. She outlines exactly the balance that we are trying to craft, and have tried to craft since 2016, in response to the Carter decision. Those are basically two different ideas: promoting the dignity and the autonomy of an individual in this country, and ensuring that we are protecting vulnerable people with adequate safeguards so they are not victimized. In this context, the safeguards and the protection are critical in the context of those who are mentally ill. That has been guiding theme here. In addition to the provinces and territories that have spoken up about the lack of system readiness, we have also heard from the Canadian Mental Health Association and from the Centre for Addiction and Mental Health that they are also not ready and concur with the provinces' and territories' assessments. With respect to the last point raised by the member for Saanich—Gulf Islands, she talked about mental health supports. This is critical now more than ever, particularly coming out of the COVID pandemic. What I would say to her is that when we reached a deal about one year ago to provide a record number of dollars in support of the Canadian health care system, we outlined certain parameters for that support. One of the pillars of that support was to support mental health and the mental health needs of Canadians. That is a fundamental priority for us and will remain so.

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Mr. Rhéal Éloi Fortin (Rivière-du-Nord, BQ)

Feb/13/24 10:19:23 a.m.
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Mr. Speaker, I think that the issue before us is an important one, and I recognize the work that my colleague, the Minister of Justice, has done on this file. That being said, with all due respect, I have to say that we already deliberated on this issue several years ago and that we determined that March 17 would be the date on which this would come into force. Quebec has worked on this and it is prepared to administer the medical assistance in dying that we are talking about. It would be easy for the government to simply adopt the amendment proposed by my colleague from Montcalm, which, we are going to vote on later today, I believe. This amendment would enable the provinces that are ready to administer the treatment to do so. Take section 720 of the Criminal Code, for example. It provides a similar process for drug treatment. It stipulates that provinces are allowed to administer a provincially approved treatment even if it is not otherwise authorized by the Criminal Code. A similar system could be set up for MAID. It is true that some provinces are not ready yet. That will likely always be the case. I am fairly certain that in three years, five years or ten years, some provinces will still not be ready. However, we cannot allow that to paralyze Parliament. Some provinces are ready, and we can set up a process that will allow those provinces to administer MAID. I invite my colleague and his entire government to support the amendment proposed by my colleague from Montcalm to allow provinces that are ready, like Quebec, to proceed with the administration of MAID.

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Hon. Arif Virani

Feb/13/24 10:20:59 a.m.
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Mr. Speaker, I would like to give a two-part answer to that question. First, the Province of Quebec itself has said that it is not prepared to provide medical assistance in dying to people whose only medical condition is a mental disorder. Second, my colleague mentioned advance requests. That is another issue. I have tremendous respect for the crucial work that has already been done in Quebec on advance requests. However, Canada has only one Criminal Code, and there is a very good reason for that. Canadians deserve to have consistent standards and clarity about what is criminal and what is not criminal across the country. There is no quick way to safely allow an exception for Quebec on this issue at this time. The conversation does not end here, though. We are committed to working with Quebec to determine the next step. We have taken a cautious approach to medical assistance in dying from day one back in 2016. We will continue to proceed with caution on this issue for the whole country.

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Mr. Glen Motz (Medicine Hat—Cardston—Warner, CPC)

Feb/13/24 10:22:24 a.m.
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Mr. Speaker, I too am very concerned about closure on such an important matter. My opinion is that by allowing assisted death on the basis of mental illness alone, we might inadvertently close the door on potential recoveries and the possibility of life returning with dignity and purpose. Furthermore, enabling medical assistance in dying for mental health conditions could imply that some lives are less worth living and that some forms of suffering are less deserving of the full measure of our medical and social resources. This could lead to a slippery slope where the right to die may, under subtle social pressures, become a duty to die, particularly among the marginalized or the less privileged members of our society. For those reasons and many others, we need to be very, very careful. Having closure on such a critically important issue, to me, says to those who might be considering this that they are less worthy. That is the farthest thing from the truth. We should be able to debate this. I do not know what took the government so long to bring the debate, given that, as my friend from the NDP said, there are nine days left. What took the government so long to bring it forward in the first place for proper debate?

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Hon. Arif Virani

Feb/13/24 10:23:46 a.m.
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Mr. Speaker, I respect the member opposite, but I am going to take issue with some of the submissions he just made. It is precisely because of the contentious nature of what is at issue that we are ensuring, using every tool that we have, that the bill becomes law prior to March 17 and the expiration. If the bill does not become law by March 17, we would have the confusion that was mentioned by the member for New Westminster—Burnaby, a situation where people may be able to avail themselves of MAID where the context is mental illness as the sole underlying condition. We do not believe the system is ready, because we have heard that, to a person, from every health minister in every province and territory. We have heard it from the health care practitioners, the nurses, the MAID assessors and the MAID providers. A curriculum has been designed, but take-up of the curriculum is not where it needs to be. The safeguards are not in place. The oversight mechanisms are not in place. It is precisely because of the unpredictable nature of some people's mental illnesses that we need to ensure that we are working prudently and safely before we propose an expansion of the regime to persons for whom mental illness is the sole underlying condition.

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Mr. Luc Thériault (Montcalm, BQ)

Feb/13/24 10:24:58 a.m.
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Mr. Speaker, the minister's answer to the question posed by my colleague from Rivière-du-Nord is inadequate. Yes, in 2021, Quebec ruled on the issue before the report of the expert panel on mental illness was published. However, the minister had a year to implement the most widely held recommendation of the special joint committee on medical assistance in dying concerning advance requests. Even a Conservative member from Quebec voted for it. Why did he not introduce a bill aimed at enacting this provision, knowing full well, unless he is unaware, that Quebec was going to legislate accordingly? As for the report, we are talking about a year and he wants three years, but that is another story. He cannot possibly tell us that he did not have the time to implement the special joint committee's main recommendation. Now it is a double standard. He accepted the special joint committee's recommendation about mental illness and made it into a bill, yet he is doing nothing about advance requests, which Canadians from coast to coast agree on. Will the minister commit, if he does not support my amendment, to tabling a bill on advance requests as soon as possible?

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Hon. Arif Virani

Feb/13/24 10:26:27 a.m.
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Mr. Speaker, I appreciate my colleague's remarks and his hard work on the special joint committee. I have several points to raise. The first one is that the bill addresses mental illness as the sole condition. The act requires that we deal with the issue before March 17, 2024. I have a lot of respect for my colleague across the aisle. He mentioned that Canadians from coast to coast agree on the issue of advance requests. Although Quebec has expressed its willingness, I do not believe that all Canadians agree; that is the second point. Obviously, if we want to extend medical assistance in dying to advance requests, we need to do so responsibly and with caution, as we did with all of the other issues, in other words, with all of the health experts, namely health ministers, psychiatrists, doctors and nurses. We need to proceed with caution, making sure to respect individual rights. We also need to strike a balance between individual rights and the protection of vulnerable persons. That is how we have been doing things since 2016, and that is how we will continue in the future. Once again, it is important to note that the Criminal Code applies to the entire country. It is important to have clear information for all Canadians, so that everyone understands their rights and the criminal rules that apply across Canada. Criminal law must be consistent from one province to another. That said, political discussions with Quebec are ongoing because this conversation needs to be had. However, we need to proceed carefully, cautiously and prudently.

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Mr. Randall Garrison (Esquimalt—Saanich—Sooke, NDP)

Feb/13/24 10:28:41 a.m.
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Re: Bill C-314

Mr. Speaker, in the previous Parliament, I was the NDP's representative on the medical assistance in dying committee. I do support medical assistance in dying, but it was the most difficult issue I have ever dealt with, and I agree with my colleague from Saanich—Gulf Islands that it was probably the most difficult issue most of us have ever dealt with in the House. For that reason, I agree with the minister that we have to proceed very cautiously and very deliberately in any expansion to medical assistance in dying. Today I would rather be talking about removing mental illness as the sole underlying condition, but Parliament dealt with that question with the private member's bill from the member for Abbotsford, Bill C-314, so we cannot do that today. We are placed in the awkward position where the Senate added the provision to the original medical assistance in dying legislation, which I think was very ill-advised. However, we have no choice at this point, I believe, but to support the closure motion to try to get this done so we can prevent the provision from coming into force, when we know clearly we are not ready and when we know some of us have very clear moral reservations about the expansion.

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Hon. Arif Virani

Feb/13/24 10:30:44 a.m.
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Mr. Speaker, I want to thank the member for Esquimalt—Saanich—Sooke for his contributions today and every day, particularly on the justice committee and on the joint mixed committee. I agree with him that this is probably the most challenging and personal issue that any of us has touched, particularly for those who were elected in the class of 2015, who have been dealing with this for the last eight years. Because what is at issue is so significant, because the consequences are so permanent by definition, it is critical to get it right and to proceed in a prudent manner. Some of those things are outlined in the charter statement we have tabled in the House. It talks about the screening for decision-making capacity being particularly difficult in the context because of the symptoms of the person's condition or because their life experiences can impact their ability to understand and appreciate the decision they are about to make. Further, feelings of hopelessness and wishing to die are common symptoms of some mental illnesses, which can make it difficult for even an experienced practitioner to distinguish between a wish to die that is fully autonomous and considered, and something that is a symptom of one's personal illness. Also, the course of a mental illness over time is very much less predictable than that of a physical illness. Last, and importantly, we do not have a record of evidence that has been built up in this country with respect to how the practice would unfold. Ensuring that we build up that record of evidence and that we build up the important curriculum and the uptake of that curriculum for the assessors and providers is critical. For these and many other reasons, we are adopting a position that we would proceed responsibility, cautiously and prudently in three years' time with the initiative, but also reconvene the joint committee on which the member has sat so it can assess system readiness about two years from now, prior to the three-year deadline's coming to the fore.

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Mr. Richard Bragdon (Tobique—Mactaquac, CPC)

Feb/13/24 10:32:40 a.m.
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Mr. Speaker, it has been said that the character of a nation is revealed in how it treats its most vulnerable. I cannot think of a higher obligation for the House that houses the representatives of the people to take up than this very discussion. It is a matter of debate that should not be rushed. It should not be shut down and should not be in any way pushed through in expeditious fashion. We should take all of the time required to make sure we get it right, because we are literally dealing with matters of life and death. The sensitivity surrounding the issue cannot be overstated. The impact on families that are going to be and are being affected by the issue cannot be overstated. I would ask the minister to reconsider the direction he has taken with this and allow Canadians to have their voices expressed, for their concerns and desires for proper safeguards to be fully expressed in the House during the debate for as long as it takes to get it right. Would the minister care to comment on that?

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