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Decentralized Democracy

House Hansard - 281

44th Parl. 1st Sess.
February 13, 2024 10:00AM
  • Feb/13/24 12:48:28 p.m.
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Madam Speaker, I really appreciate that question because it goes to the core of the reason we are moving this bill forward. If we do not get this bill through the House and if we do not get this bill through the other place, this law will take effect on March 17. That, then, triggers a situation where we have multiple jurisdictions that have made it very clear that they are not ready to proceed, but it will be the law of the land. A scenario could be created in which there is, I will not use the word “chaos”, but a situation which would be unsettled and inconsistent across the country. We cannot have that happen. When we are dealing with an issue that is so significant and so serious and that has permanent implications, we have to make sure that we are ready and that we have it right. That is why we have to get this bill passed.
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  • Feb/13/24 12:49:22 p.m.
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Madam Speaker, there is wisdom in life, in our decisions, but fear should never dictate our actions. I do not want use the word “chaos”, but I think we need to recognize all the work that has been done on this file. Today's bill adds a three-year delay to the inevitable question that arises when mental health comes into play. It seems to me that re-establishing the Special Joint Committee on Medical Assistance in Dying and giving it an extra year to do a more in-depth study might have been a better solution. This is just going to postpone suffering. Psychological suffering exists. Some people who have it talk about cancer of the mind. That is also a reality. That said, it is 2024. Much progress has been made, such as being able to make an advance request for MAID for certain illnesses. Why has the progress made at the special joint committee not been moving forward? Can my colleague tell us why—
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  • Feb/13/24 12:50:44 p.m.
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The hon. parliamentary secretary.
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  • Feb/13/24 12:50:46 p.m.
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Madam Speaker, on the member's first point, she is right. Fear should never dictate and reason should, particularly when we are dealing with issues of such importance. This bill is not about delay; it is about getting it right. This issue is so important. If we do not have the system in place and the structural integrity to make sure that it is ready to go, we are not doing our jobs as parliamentarians. It is as simple as that. I sat on the special committee on both occasions. The work it has done has put us in a position where we can deal with this in a reasonable, rational and timely way. It was the committee that recommended, last year, that the special committee be put together again this year, which is again recommended. We do not want to be put in a position 12 months from now of having the same discussion and again being rushed. Postponing this for three years is rational and reasonable, but it does not mean the discussion does not continue in the interim.
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Madam Speaker, I appreciate the opportunity to speak to this. Having been in this place for all the debates we have had, I have been trying to figure out the best way to explain to Canadians, if there is an argument here, why it is not between Liberals and Conservatives, or between Greens and NDP and Conservatives and the Bloc. It has actually been, from the very beginning, a struggle for Parliament to actually deal with an issue we have been kicking down the road for too long. I mentioned earlier in debate, as the member for Saanich—Gulf Islands, the quiet and extraordinary courage of a single woman, Sue Rodriguez, who took her irremediable medical condition of suffering all the way to the Supreme Court of Canada and was denied the opportunity for what is generally called death with dignity. She had the procedure illegally. Those who were with her at the time would have been subject to criminal penalty as well, including my friend Svend Robinson, who at the time was member of Parliament in a different party from a different place. It was a very fraught time, and the issue of medical assistance in dying kept coming back to me from constituents who were heartbroken that their parents or loved ones had to go through suffering. Quite often people would say to me they would not let a family pet go through this kind of suffering so why do we allow our moms and our dads to go through this when there is no prospect they are going to recover. This finally went back to the Supreme Court of Canada for a different decision that came out of the Carter case. The Carter case, back in 2015, said that refusing to allow someone the legal option to seek medical assistance from their doctor in a situation where their illness is terminal is really a violation of section 7 charter rights. I only mention this because that was also with a deadline. We have to take action on this; we cannot just leave the matter. The Supreme Court of Canada has said that this provision of the Criminal Code is actually a charter violation. That means one cannot let it just sit there anymore. It would take too much time, and my colleagues will be relieved to know I will not go through this chapter and verse, but it is a tough, tough issue for parliamentarians. At the time, as we started debating the first iteration of allowing for death with dignity, in Bill C-14, our first Minister of Justice to deal with this was the very honourable Jody Wilson-Raybould. She had to struggle with this. Our Minister of Health at the time, also very honourable, Jane Philpott, was struggling with this. It occurred to me as the debate went on that what we had in Canada on this issue was essentially a professional dispute. The lawyers in Canada wanted to make sure that the charter was respected. The doctors in Canada said they did not want to be asked to figure out what “irremediable” meant and were not exactly ready for that. Therefore, subsequent revisions kept happening because, after all, in our first attempt to get medical assistance in dying right, we did not allow for advance directives. Therefore, we had subsequent court cases where people who had terminal cancer could not access MAID because they decided they better ask for it now, which was maybe months before death would occur naturally and months before a doctor could say, “Okay, you're ready now. Nod.” One had to be able to physically sign; the day of, one had to confirm one's procedure. Again, I better not go back through all of this, but essentially the professional views of doctors pleading with parliamentarians outweighed the lawyers dealing with parliamentarians to say that we were probably still going to have charter violations, but it is better that we listen to the doctors and that they are ready. All of this ended up taking us back to fixing medical assistance in dying again to try to make it more humane, to try to respond to the concerns of Canadians from coast to coast that they wanted to be able to access an advance directive in a situation that fit the MAID template. This brought us to Bill C-7. To some of the comments that were made in this place earlier today, the government and Parliament were under a deadline that was court imposed, not politically imposed, to oblige ourselves, as parliamentarians, to meet what the Supreme Court of Canada said the charter required us to do. We had a very tight timeline, and then the Senate did something I do not think anyone in the House expected. Again, we had a professional dispute going on here. Doctors were saying they were not ready to extend this to people whose sole irremediable condition is mental illness. Public health professionals in addiction and mental health were saying they were not ready. However, with strong pressure and strong professional advice from the psychiatric community, the Senate decided we should extend MAID to those with an underlying condition that is only, and I do not say “only” as if it is a marginal or trivial matter, a crushingly painful and life-ending threat from mental illness. We are walking this fine line. The line is even finer when we start realizing who is more likely to not be able to access mental health supports; they are the marginalized and the poor. Who is more likely to not be able to imagine continuing on in life with a crushing mental illness? It is again the marginalized communities. The disability community spoke with a loud voice saying not to extend MAID as they were worried enough that it was a slippery slope when Bill C-14 first came in, and now Bill C-7. Here we are again with a court-imposed deadline. Let us be clear to Canadians watching today. Certainly, the provinces and many doctors and mental health professionals have spoken with one voice. If we do not act quickly to pass this legislation and if the Senate does not act quickly to get it to royal assent come March 17, then as a matter of reality, we are up against March 17, and medical assistance in dying would become available to people where mental illness is the sole underlying condition. Is it irremediable? We are told by the experts that no one really knows how to answer that question. Yes, some of the psychiatric community says the safeguards are there and if three psychiatrists say that it is irremediable, then that is enough. However, we are all asking where the mental health supports are, particularly for those who are marginalized. Where is the access? This is one that particularly perturbs me. I have had many people come to me from a community that has experience with using psilocybin, conventionally known as magic mushrooms, as a way to alleviate a mental health condition, which might otherwise be irremediable, with remarkable results. We know that Health Canada is currently accelerating trials on psilocybin. It strikes me as beyond a catch-22 that the authorities would say to those people and to their doctors, who think psilocybin could help them, when the alternative is that they are more likely to commit suicide, or if we do not act by March 17, they will have access to legal medical assistance in dying, and it would be too dangerous to let them try psilocybin, but the alternative is death. It seems to me that any medical risks from psilocybin pale in comparison to the irreversible reality of death. How can we let this happen? We cannot. I think we need to discuss another thing in this place, which is societal assistance in living. We know what medical assistance in dying looks like, but what does societal assistance in living look like? It means ending poverty and bringing in a guaranteed livable income for all. It means access to mental health services in this country. It means a compassionate and caring approach that says to every Canadian, whether in the disability community, the indigenous communities or the youth who are struggling with addictions, that we hear them and will not fail them. That means, no matter how members feel about it, we have to pass this legislation expeditiously.
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  • Feb/13/24 1:01:04 p.m.
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Madam Speaker, as we are debating this measure today, a huge scandal is unfolding. We learned from the Auditor General yesterday that there is evidence of corruption and wasteful spending. That is why we are announcing that we want the RCMP to expand its investigation in order to find the truth and shed light on the possibility of criminal activity in the arrive scam scandal. I have letters to that effect. I am asking the RCMP to expand its investigation into the arrive scam affair, and I am tabling this letter—
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  • Feb/13/24 1:01:49 p.m.
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I thought the hon. member was rising on questions and comments, but his intervention does not relate to the debate.
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  • Feb/13/24 1:02:07 p.m.
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Madam Speaker, I am rising on a point of order. The arrive scam scandal has exploded into public consciousness after the Auditor General revealed evidence that senior government officials got gifts, such as fancy whiskies, in order to give out contracts. I would like to table in the House of Commons a letter to the RCMP commissioner asking for the investigation into arrive scam to be expanded.
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  • Feb/13/24 1:02:38 p.m.
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Is there consent? Some hon. members: Nay. The Assistant Deputy Speaker (Mrs. Carol Hughes): Questions and comments, the hon. member for Châteauguay—Lacolle.
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  • Feb/13/24 1:02:54 p.m.
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Madam Speaker, I have a question for the hon. member for Saanich—Gulf Islands
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  • Feb/13/24 1:03:05 p.m.
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Order. I cannot hear what the hon. member is saying. If members want to have conversations, I would ask them to please take them out into the lobby or outside the chamber. The hon. member for Châteauguay—Lacolle.
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  • Feb/13/24 1:03:20 p.m.
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Madam Speaker, I greatly appreciated the comments, just as I have all the discussions in this debate today. Going back to 2015, I too sat on the first joint committee to study medical assistance in dying. It was a difficult time for me as a new member. As a practising Catholic, I was profoundly touched by the issue, but I was able to understand, through expert testimony, that it is important for people to have choices. I would ask my hon. colleague, since I know she is also a person of faith, to talk about that. Even though we may personally have very strong values, is this not something on which Canadians deserve to have a choice?
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  • Feb/13/24 1:04:18 p.m.
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Madam Speaker, I must say, I was very disappointed that the hon. leader of the official opposition was not rising to ask me a question. It would have been a first, and I was so looking forward to my response to him. The hon. member for Châteauguay—Lacolle has asked me a very important question. I am a person of faith. I struggled with this. My constituents convinced me. I spent a lot of time talking to people in Saanich—Gulf Islands, who begged me to support legalizing, removing criminal sanctions for, medical assistance in dying. My view is very personal and a matter of conscience; I do not expect others to agree with me, when they passionately and firmly believe otherwise. I believe all life is sacred, of course. I believe that taking a life, including one's own life, is also a profound matter of deep moral conflict. However, I have no doubt at all that the Christian impulse to compassion is not to allow people to suffer needlessly. Medical science is now allowing us to extend our lives beyond what my grandparents and their peer groups would have experienced. As we extend our—
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  • Feb/13/24 1:05:35 p.m.
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I have to allow for other questions and comments; I am sure the hon. member can continue to elaborate. The hon. member for Montcalm.
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  • Feb/13/24 1:05:42 p.m.
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Madam Speaker, I am sure my colleague's intention is not to exploit the pain of people who have been enduring irremediable suffering for decades. However, she is repeating an argument that we have heard often in this debate and that I feel is something completely separate. The issue of access to primary mental health care has nothing to do with the decision we must make on whether to expand medical assistance in dying since, with regard to access to care, these people would not qualify under the criteria and guidelines of the expert report. I do want us to advocate for better care. I wholeheartedly agree with that, but that is another debate. However, there are people who have been receiving care for decades and who are suffering, and the government wants to tell them to keep suffering for three years.
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  • Feb/13/24 1:06:44 p.m.
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Madam Speaker, I believe access to care really is a key issue. I agree that having a continuum of suffering is unacceptable. I am not against MAID eligibility for people who are suffering due to a disease and who have shown that their suffering is real. We must act. However, we do not have to act immediately, on March 17.
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  • Feb/13/24 1:07:32 p.m.
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Madam Speaker, can the member share a bit more around the decision to use time allocation? Why is it important that we get this legislation put through? What are the impacts on people in our communities if we do not?
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  • Feb/13/24 1:07:53 p.m.
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Madam Speaker, it is not an easy choice. I was in this place in the Harper years, when time allocation started to be used on every single bill. In those days, the Liberals were against it, as I was. Things change. Whoever is in power thinks that the tools that were used by the last government, which they used to decry, are okay if they are efficient for getting things done, because might makes right. However, it is and always will be wrong, whether the Conservatives or the Liberals use it. This time, we are up against it. We have no choice. We are responsible grown-ups. We have to get this bill through so that we do not have a default reality that none of us would vote for.
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Madam Speaker, the decisions made in this place have a direct impact on the lives of Canadians. That impact can be no greater than when it is a matter of life or death, and this is exactly the case with this piece of legislation. As members of Parliament, we have a duty to serve in the best interests of Canadians; this duty must extend to the protection of the most vulnerable in society. I should note that I will be splitting my time with the member for Portage—Lisgar. The expansion of medically assisted death to those suffering from mental illness is dangerous and, simply, reckless. It is inevitable that the expansion of MAID to those suffering solely from a mental illness would result in the deaths of Canadians who could have gotten better. This is not to say that those with mental illness should be left alone to suffer. Recovery is possible, and we cannot give up on these individuals and their loved ones. Canadians suffering from mental illness need and deserve support and treatment. They may feel that their situation is hopeless, but the antidote is hope, not death. They deserve government policy and a health care system that are compassionate and responsive to their needs. Where there are gaps or shortfalls in our care system, we should prioritize working alongside our provincial partners to address them. That, not expanding MAID, should be the priority. The Special Joint Committee on Medical Assistance in Dying heard loud and clear from the mental health experts and advocates that the planned expansion of MAID was dangerous. The current Liberal government has already had to introduce eleventh-hour legislation to delay the expansion of MAID by one year from the date that it had arbitrarily set. We find ourselves, ironically, now in the same position as we were in last year. Bill C-62, once again, would only offer a temporary delay in the expansion of MAID to persons suffering from mental illness. The risks and dangers that exist today would continue to exist in three years. However, the Liberal government is intent on its expansion. It is truly frightening to see that the Liberal government wants to continue to expand the access to MAID, despite clear concerns about safeguards of vulnerable people. The Liberals' careless approach was already evident when the Liberal government decided not to appeal the Truchon ruling and, instead, introduced legislation that went much further than the ruling had required. What we have seen repeatedly from the current Liberal government is the willingness to offer MAID to more and more Canadians, without prioritizing supports or treatment. This continues to be the case with those in the end stages of life. Through pain management and psychological, emotional and practical supports, palliative and hospice care provides relief from pain, stress and symptoms of serious illness. Palliative care has proven to improve the quality of life not only for the patient but also for their family. However, access to this is not universal here in Canada. The government's own report on the state of palliative care in Canada, released this past December, confirms that access to palliative care is indeed not universal. We do not have the necessary safeguards in place to protect vulnerable Canadians when access to MAID is more universal than access to palliative care is. When Canadians suffering from serious illness do not have access to appropriate care, they can be left feeling hopeless. Personal autonomy is not increased when a person feels as though they have no other choice. When the current Liberal government removed the “reasonably foreseeable death” clause from the MAID framework, it opened up to persons with disabilities who are not close to death. Disability advocates raised alarm bells with this decision, and the news stories that have emerged in recent years have underscored the risks and the danger in that decision. Reports showing that poverty, not pain, is driving Canadians with disabilities to consider assisted death are truly heartbreaking. For persons with disabilities, the pressures of the cost of living crisis are compounded. Their basic living costs are generally much more significant. As the prices go up on everything, their costs are even greater. It is unacceptable that there are persons with disabilities turning to MAID because of their cost of living situation. This NDP-Liberal government's inflationary spending and taxes are fuelling the affordability crisis in this country, and what is even more shameful is that, despite the pain and suffering it is causing Canadians, there has been no course correction for this costly coalition. It has continued to mismanage tax dollars. It is intent on quadrupling the carbon tax, which is increasing the cost of just about everything. Let us not forget that not a single disability payment has gone out to those who want it and have been asking for it. Bill C-22 was sped through the parliamentary process, but those who are desperate for financial assistance are still waiting. The affordability crisis is continuing to surge across the country, and it is further putting persons with disabilities in a vulnerable position. Medically assisted death should not be more readily available to persons with disabilities than the supports and accommodations they need to live a full, healthy and dignified life. Repeated reports that Canadians are being offered medically assisted death without first requesting it is also very alarming. It suggests that safeguards have not been put in place to ensure that vulnerable people are not being pressured or coerced into seeking medically assisted death. No person should feel that the health care system, the infrastructure that is meant to provide care and support, sees no value in their lives. There are serious concerns with the existing MAID framework and the framework's ability to protect the most vulnerable in our communities. These are concerns that are not being addressed by the Liberal government and that ultimately should be the priority of the government on an issue such as medically assisted death. When the risks and concerns that exist with the current framework are already proven to be warranted, we should certainly heed the clear warnings against its expansion. Experts have said that it is impossible to predict in any legitimate way that mental illness is irremediable. This means that individuals suffering solely from mental illness can recover and can improve. Their mental health state is not destitute nor without hope. If medical assistance in dying is offered to persons suffering solely from mental illness, it is inevitable that vulnerable Canadians will die who could have gotten better. Experts have also made it clear that it is difficult for clinicians to distinguish between a rational MAID request and one motivated by suicidal thoughts. Persons with mental illness are already disproportionately affected by suicide and suicidal ideation. To extend access to medically assisted death to this group of individuals contradicts and undermines suicide prevention efforts. Every single person's life has value and purpose. It is not acceptable to have government policies in place that devalue the life of a person, and the Liberal government's intention to expand access to MAID fails individuals suffering from mental illness in this country. Whether it happens in March of this year or in three years, the expansion of MAID will still be dangerous and reckless. The delayed expansion of MAID will ultimately still fail vulnerable Canadians. Bill C-62 does not go far enough to protect those suffering with mental illness. The Prime Minister must immediately and permanently halt the expansion of medical assistance in dying to persons with mental illness. We cannot give up on an individual who is suffering. They deserve support and treatment, not death. Common-sense Conservatives know that recovery is possible for persons suffering from mental illness. We do not support policies that abandon people when they are in their most vulnerable state. Death is not a treatment for suffering. We will stand with them and their loved ones. Above all else, when we consider medically assisted death, we must be gripped by a resolve to protect the most vulnerable because, in matters of life and death, there is simply no room for error.
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  • Feb/13/24 1:18:40 p.m.
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Madam Speaker, I listened to my colleague's speech, and I realized there was a lot of personal input and a lot of regard for the vulnerable. Does she not agree, as I had to come to accept that, regardless of my personal feelings, beliefs, values or the choices I would make for myself, and given the safeguards that were put in place with successive legislation, Canadians are deserving of having that choice for themselves?
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