44th Parl. 1st Sess.
February 13, 2024 10:00AM
- Feb/13/24 3:43:30 p.m.
- Watch
Mr. Speaker, I am a bit surprised in how the Conservatives are approaching the debate. They have made it very clear that they do not support the expansion of MAID with regard to mental health. However, it will automatically take effect come March 17, unless this legislation passes. They seem to want to prevent the legislation from passing, especially if we take a look at the vote.
Does the Conservative Party want this legislation to pass and, if so, will they support it?
83 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 3:44:22 p.m.
- Watch
Mr. Speaker, we are going to take every single opportunity to put on the record in this House that these Liberals have broken what is a long-formed consensus in this country, that MAID, for the sole purpose of mental illness, is a no go. We are going to continue to speak about that so that Canadians know where they stand.
I know that they have brought legislation forward, but it is not our responsibility to clean up the mess that has made us stand here at the eleventh hour because they screwed up their schedule and their legislation.
99 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 3:45:09 p.m.
- Watch
Mr. Speaker, medical assistance in dying and mental health are obviously not simple issues. What is surprising, however, is that some people experience intolerable suffering. An expert report found that these people are not eligible. For example, people who are suicidal are not eligible if they are newly diagnosed and being monitored but refuse treatment and their requests are based on systemic vulnerabilities. Help and support are available to these people. Just because someone requests medical assistance in dying does not mean that they will receive it.
The Conservatives' conception of medical assistance in dying is flawed. There are people suffering right now who need their support.
107 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 3:46:00 p.m.
- Watch
Mr. Speaker, I think it is clear from the evidence of those who have raised concerns about this issue that there is not enough evidence to say that somebody cannot get better. It is not the job of a parliamentarian to encourage that, to make it a priority in this country or even make it allowed in this country.
We need to make sure that we expand a system in which people can actually get help, and that a utilitarian vision of this world is not the thing that we strive for to make sure there is room in the system or that people can just do what they want. We actually have to try with people. We have to try and help them recover and get better. Offering them this tool, I think, is an abdication of our fundamental responsibility as leaders and as parliamentarians.
146 words
- Hear!
- Rabble!
- add
- star_border
- share
Mr. Speaker, I agree with many points my hon. colleague made in her speech. It is why I voted against the Senate amendment to Bill C-7 in the previous Parliament. It is why I voted for the member for Abbotsford's bill, Bill C-314. It is why I agree with the recommendation that came out of the special joint committee.
There is more than enough blame to be assigned to the Liberals, but we are dealing with a March 17 deadline. This is a time the House collectively has to stand up and get this bill through because we also have the Senate to deal with.
Why, with that context upon us right now, did the Conservatives vote the way they did this morning when it is imperative that this bill get passed before March 17?
We do not yet know what is actually going to happen in the Senate. We can only really say for certain what is going to happen in the House, but this is a critically important bill to pass before March 17.
179 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 3:48:00 p.m.
- Watch
Mr. Speaker, we are not going to limit this debate in this House because the Liberals cannot manage their agenda or their legislation, or the fact that they have screwed this up. We are going to continue to have a productive conversation about this and make sure that Canadians know that there are members in this House who want to see this go forward and want to see this go forward quickly.
72 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 3:48:25 p.m.
- Watch
Mr. Speaker, I always consider it an honour to rise in the people's House to speak in regard to matters of great importance and consequence for the nation of Canada. I rise with mixed emotions today as, obviously, many Canadians have been grappling and dealing with this issue and have been considering and discussing the issue for years and months. Even more recently, with the expansion of MAID, which has been happening at an unbelievably rapid rate, more Canadians are growing more concerned. Therefore, today, I hope to add my voice to the calls for absolutely increasing the implementation of safeguards and for putting in place the safeguards necessary to prevent this absolute augmentation in access to MAID by more and more vulnerable Canadians.
Canada has historically been known as a nation of great hope, where the dreams and aspirations of individuals could be fulfilled, for them and their families. We have had a great reputation on the world stage for many years as a peaceful people and a hopeful people, but disturbingly, we are hearing more voices, not only within our own country but also internationally, raising the alarm bells at the direction our nation has taken, especially as it pertains to it becoming more available to more Canadians who are at high risk to be able to access MAID and to make a decision of such finality in times of great vulnerability.
It has been said, and I have said it in the House before, in regard to this debate, that the character of a nation is revealed in how it treats its most vulnerable. Those battling with mental illness and having bouts of anxiety, depression, fear and despair are definitely among our most vulnerable. It would behoove the House and the current government to ensure every safeguard possible is put in place to provide a pathway of hope that would foster and encourage life, even in the midst of uncertainty, in the midst of overwhelming odds and in the midst of some huge obstacles that come across a person's pathway. The last thing we should be doing in the House is expediting and making it easier for more Canadians to access MAID.
It is troubling, not just for many members on this side of the House; we have heard testimony at committee from many reputable organizations whose representatives are speaking out with grave concerns at the direction this country is going. I want to add a few quotes into the record as it relates to this.
There are a couple here from the Society of Canadian Psychiatry. It states, “it is impossible to predict in any legitimate way that mental illness in individual cases is irremediable. A significant number of individuals receiving MAID for sole mental illness would have improved and recovered.”
This is another quote from the Society of Canadian Psychiatry: “Evidence shows that individuals with suicidal ideation symptomatic of mental illness cannot be differentiated or identified as distinct from those seeking MAID for sole mental illness. Suicidal individuals who could benefit from suicide prevention will receive psychiatric MAID instead.” This again is not coming from a partisan perspective. This is coming from the Society of Canadian Psychiatry.
We are fostering a culture that encourages giving up in the face of grave adversity, when Canadians historically have been the types who have faced great challenges, have overcome huge obstacles, have come through adversity, have come out the other side and have become stellar examples of what it is to overcome great challenges in life. I want that to be our continued reputation, not easy access to a decision that has such finality and such a dire consequence.
Another quote from the Society of Canadian Psychiatry says, “the political process leading to the planned expansion of MAID for mental illness has not followed a robust and fulsome process, has not reflected the range of opinions and evidence-based concerns on the issue, and has been selectively guided by expansion activists.”
Those are huge statements of fact. If they are to be considered, they should give direction, and clear direction, to this House, on how we should proceed going from here.
This time I will quote from what would not be known as a far right extreme voice. I am quoting from a Washington Post article that reads, “empowering a mentally ill person to invoke a physician’s aid in ending his or her suffering — by ending life itself — inverts the most basic goal of psychiatry, which is to prevent suicide rather than to facilitate it”.
Dr. Madeline Li, a professor in the department of psychiatry at the University Health Network, told the BBC, “Making death too ready a solution disadvantages the most vulnerable people, and actually lets society off the hook”, and she went on to say, “I don't think death should be society's solution for its own failures”. These are professionals at the top of their professions, speaking to the grave direction that we are heading in as a country, as it relates to medical assistance in dying.
Of those who advocate for the most vulnerable among us here in Canada, the CEO and the executive vice-president for Inclusion Canada said, “MAiD for people with disabilities who are not terminally ill is a discriminatory disaster”.
Again, these are the chief advocates for the most vulnerable among us. We should listen to their voices as we consider this and bring to the House the voices of the many concerned Canadians who have risen up, written my office, made phone calls and contacted colleagues, I am sure, on numerous occasions to say that this is not the direction that they would have ever anticipated Canada to go, and this is not the direction that we should go.
In closing, I am drawn to a story of a gentleman I got to know, a dear friend of mine. I share this story with his permission. Robert McCoy is a gentleman from my riding of Tobique—Mactaquac who had a huge challenge in his life. He is a young man with a young family, who began to lose sight in one of his eyes. It quickly spread to his other eye, and he became completely blind. He did not know how he would provide for his family since he had worked in the woods and was a skidder operator. He was not sure how he could make provisions for his family. It seemed overwhelming. He spoke about this publicly as part of his story. He told me he was so desperate in those times that he seriously considered taking his own life. He even planned it out. He thought maybe if he could somehow step inadvertently in front of a truck or a vehicle, because he was blind, that his family and other people would think it was an accident, and they may be able to at least continue on the insurance and make ends meet. It was a very low point, but he told me that in his desperation, he cried out. Yes, faith was important to him, but he felt like he heard at that moment a very clarion voice inside that said, “You will survive”.
That one moment became enough for him, along with the encouragement of his wife and family, to start over again. A woods worker put himself through learning how to live with blindness, went to university and got a degree. He now has a Master of Sociology and is a professor at St. Thomas University in Fredericton.
I am glad to say that Robert McCoy is doing very well; I spoke to him today. I am glad that during that time he did not have ready access to voices who would encourage him to go down this particular path as a potential solution to his problem. I am glad he chose the pathway of hope, of recovery and of overcoming obstacles. As parliamentarians, we should be doing everything we can to foster a culture of life and hope, rather than a culture of death and despair. I hope we make the right decision at this time.
1378 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 3:58:21 p.m.
- Watch
Mr. Speaker, the member is a great speaker in the House. I certainly enjoyed the story about one of my constituents. That was really great, and I agree. I am an advocate for mental health access. Actually, I did vote against the previous bill as well in the previous Parliament.
I really want to highlight that it is so important to create the clear distinction between suicidal ideation, what happens when someone is dealing with depression and wants to take their life, and medical assistance in dying. It is really important to have that distinction made.
I wonder if the member could comment on that.
105 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 3:58:59 p.m.
- Watch
Mr. Speaker, my colleague is from a neighbouring riding of Fredericton, and it is always good to have good debate and discussion with her.
I want to assure her that the concerns we are hearing are that this pathway is being opened up and people do perceive that when someone is struggling in a season of difficulty, they may want to access, through the avenue of MAID, medical assistance in dying, for the sole purpose of mental illness.
We have to close that door. Obviously, I am glad our position is to make sure that door is closed completely and with finality, so that that access point is no longer available. Without those safeguards in place, I am afraid that more Canadians would choose that route as an avenue of coping with such devastating circumstances in their lives.
I will conclude with this point. I want to give honour to a colleague in the House, the member for Cariboo—Prince George, who fought very hard to get 988 established, to bring in a suicide crisis hotline in this country. To tell of the need for this kind of hope to be offered to Canadians, right now, the stats are upwards of 1,500 contacts a day, of people utilizing and calling or texting 988. That tells us there is a cry for hope in Canada. People want options, and the last option they should ever be given is to access MAID.
242 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 4:00:31 p.m.
- Watch
Mr. Speaker, I sympathize with my colleague’s story about one of his constituents. However, using specific cases to try to advance ideological views is not how we move forward in a debate. Since this morning, I have been hearing the Conservatives talk about medical assistance in dying as if the process were like renting a movie on Netflix. This is not how it works.
Legislators are expected to stand back a bit and place the public good before their personal ideology. I know people who have sought medical assistance in dying. It is a medical procedure like many others that must be weighed. I would advise my colleague to place the common good before his ideological interests. Perhaps we would all grow if we worked this way.
129 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 4:01:35 p.m.
- Watch
Mr. Speaker, I thank the hon. member for sharing his thoughts. However, I will take exception to where he is taking that thought.
We cannot expect any parliamentarian who enters the House to separate what informs their decision-making process and the values they hold dear when it comes to debates in the House. If this is indeed the people's House, the House of Commons that represents the voices of the common people, no voice, world view, value set or concept should be dismissed out of hand. They should be welcomed and embraced. We should have wholesome discussions on these matters, especially a matter pertaining to life and death. No, I will not separate my values nor my world view from that discussion. They help inform the discussion.
129 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 4:02:31 p.m.
- Watch
Mr. Speaker, in his speech, the member for Tobique—Mactaquac evoked the disability community, along with his concerns for their well-being when it comes to expanding medical assistance in dying for mental health.
The House could be pressing the Liberal government to actually address the legislated poverty that people with disabilities are facing. We could all be pressing to fund the Canada disability benefit. If the member claims to be concerned about the lives of people with disabilities, as I am sure he truthfully is, is he going to, and how will he, continue to press the government to fund the Canada disability benefit and end legislated poverty for people with disabilities?
114 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 4:03:14 p.m.
- Watch
Mr. Speaker, I quoted the CEO, Krista Carr of Inclusion Canada. They are raising alarm bells on this matter and this issue at this point. If we do not get this right, we will never get to the other access points.
It is absolutely critical that what we do in the House is the most fundamental basic thing, which is to make sure they have access to recovery and to hope. If we do not start there, we will never get to the other very important issues that need to be discussed and debated. Let us start with the fact that they need to make sure we are doing everything, as the people's representatives, to ensure their access to hope and to life.
124 words
- Hear!
- Rabble!
- add
- star_border
- share
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.
1264 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 4:14:04 p.m.
- Watch
Mr. Speaker, I would begin by reminding my colleague across the way that the provinces and territories sent a letter to the then minister of justice asking for an indefinite pause on MAID for the mentally ill, not just a three-year extension. I would also remind him that the large majority of Canadians oppose the expansion of MAID to the mentally ill. Similarly, a large number of mental health professionals across our country oppose the expansion.
Given all those circumstances, why does the member support a three-year extension rather than an indefinite pause on this policy?
98 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 4:14:55 p.m.
- Watch
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.
175 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 4:16:03 p.m.
- Watch
Mr. Speaker, I would like to thank my colleague for his speech, and especially the bits in French.
However, I am still amazed to learn that during the course of this debate, which is not that old, the Special Joint Committee on Medical Assistance in Dying agreed on recommendations. These recommendations are found in the Bloc Québécois amendment we are debating today. I believe this amendment is very simple. It mentions that the bill “take into account provincial medical assistance in dying frameworks for advance requests from persons who have an illness that could deprive them of the capacity to consent to care”. I think this is just common sense.
Can we not vote on this amendment first and then make some progress so that people who need it can have access to medical assistance in dying in a free and informed manner?
149 words
- Hear!
- Rabble!
- add
- star_border
- share
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.
118 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 4:17:58 p.m.
- Watch
Mr. Speaker, as the parliamentary secretary well knows, we really only have two sitting weeks left for this bill to reach the Governor General's desk. We are already pretty much halfway through one of those two. I think that the House of Commons is going to do its duty and pass the bill this week, but there are reports in the media of senators openly defying the intent of this bill and threatening to block it.
What steps is the government taking to ensure that the Senate does not thwart the will of the democratically elected House and that it makes sure the bill reaches the Governor General's desk in time?
113 words
- Hear!
- Rabble!
- add
- star_border
- share
- Feb/13/24 4:18:40 p.m.
- Watch
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.
112 words
- Hear!
- Rabble!
- add
- star_border
- share
