44th Parl. 1st Sess.
February 13, 2024 10:00AM
Madam Speaker, my hon. colleague is mixing up the timelines here. He keeps referring to eight years; in fact, the essence of the bill we are talking about happened three years ago.
Now, if the member wants to talk about someone suffering from stage 4 cancer and just taking some painkillers, I will let him defend himself. However, on what Bill C-62 is doing, we are dealing with a March 17 deadline. This morning, the Conservatives voted against time management of the bill. However, he must understand that we only have two sitting weeks to get the bill to the Governor General's desk.
Why did Conservatives vote against that when we are dealing with a hard deadline, understanding that the law will change if we do not get the bill passed?
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- Feb/13/24 6:55:29 p.m.
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Madam Speaker, in terms of legislative timing, the government missed an opportunity to actually resolve this issue when it voted against the private member's bill from my colleague, the member for Abbotsford. Conservatives put forward a bill in the fall that would fix this problem and forever put a stake in this terrible idea of euthanasia for those with mental health challenges.
Now, we want the bill before us, which would extend the timeline, to pass so that when we have a Conservative government, we can actually permanently fix this problem. However, it is up to the government to allocate more days for debate; I would suggest that they do so, so more members can speak and so we can get it done before the deadline.
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- Feb/13/24 6:56:11 p.m.
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Madam Speaker, the number of Canadians ending their lives through medical assistance in dying is accelerating at a rate that outpaces that in any other country. Canada's most recent annual report on medical assistance in dying, which I will call MAID from this point forward, shows that MAID deaths are actually up by 30% from just one year ago. This is not just a one-time occasion or occurrence. Rather, this is actually a trend. Year over year, we are seeing a rapid increase.
The matter at hand today, in the most literal sense, is a matter of life and death. Around the world, people are watching Canada and the debate taking place in this House. They are doing so with an overwhelming belief that what the current government is considering is, in fact, reckless. That is extending medical assistance in dying to those with a mental illness. This topic deserves our utmost attention today in this place and, my hope would be, beyond.
Last spring, the Liberals created legislation that would grant MAID to those struggling with a mental illness, starting on March 17, which is only a few weeks away. Thanks to the rallying cry of medical experts, those who struggle with a mental illness and concerned Canadians from far and wide, along with Conservative members of Parliament, the government has been forced into a position where they have actually had to hit the pause button. This is not permanent; it is only temporary, lasting for three years. We will then see this legislation back before the House, with the current government desiring to offer medical assistance in dying to those who struggle with a mental illness.
When considering whether a mental disorder is irremediable, Parliament has heard from clinicians, who stated that it is only predictable 50% of the time. In other words, 50% of the time, clinicians are able to say that the individual will not recover from the mental illness. The other 50% of the time, they actually get it wrong. It is not the same as a brain tumour, for example, that can be seen on a scan, where there is evidence that can be judged and physical circumstances that can be known. Mental illness does not operate that way. While doctors might be correct 50% of the time, this means that, with regard to a prognosis, they are also wrong 50% of the time. To be very frank, the toss of a coin feels like a rather sad, wrong way to make a life or death decision. That is really what we are talking about: the toss of a coin, where 50% of the time, they get heads, and 50% of the time, they get tails. That is how this decision would be made if we were to move forward with medical assistance in dying for those who have a mental illness. This is absolutely wrong. That Parliament would even consider it is deeply troubling.
Of course, we know that this has nothing to do with whether our physicians and our psychiatrists are functioning in an adequate manner. It has everything to do with the fact that mental illnesses are incredibly complex and difficult to understand.
It is important, as we engage in this debate, to consider what medical experts are saying. We heard from Physicians Together with Vulnerable Canadians, which reported, “Given that there is no medical evidence to reliably predict which patients with a mental illness will not get better, MAID for mental illness will end the lives of patients who would have recovered.”
The Canadian Centre for Suicide Prevention echoed this, reporting, “There is no consensus on the meaning of irremediability for any mental disorder.” Dr. Gaind, chief of psychiatry at Sunnybrook Hospital, raised the alarm; he said, we “cannot predict irremediability when it comes to mental illness”.
Dr. Zivot agreed, saying, “mental illness lacks a strict definition and therefore, by lack of definition, can never be grievous and irremediable”. He went on to say that “if MAID becomes a treatment option within mental health care, the bond of trust and the pledge between doctor and patient is destroyed”.
Those who live with a mental illness need hope, not death. They need us to believe in them when they are unable to believe in themselves.
It is incumbent upon us, as a society, to extend hope, to offer support and to give treatment, not death. When we consider extending medical assistance in dying to those who are suffering from mental illness, many Canadians are left extremely vulnerable. When an offer of death is extended to those who are struggling, we communicate a message that there is really no hope and no opportunity for recovery; we communicate that the best relief would be to exit this life. That lacks compassion. It is deeply troubling.
Laurel Walker has been very public about her story. She talks about her darkest days of living with a mental illness, about suicide being an ideation of hers, day after day. Then she talks about the fact that she had this glimmer of hope that somehow kept her alive. She warned Parliament that, if we were to go in this direction of legalizing medical assistance in dying for those who have a mental illness, we would be robbing them of that hope and sending this grave message that, really, death is their only option.
Dr. Sareen offered the same warning and shared that making MAID available for mental disorders would undermine suicide prevention efforts and lead to unnecessary deaths. He said:
When a society makes MAID available, the population believes it is a way to end suffering. In other jurisdictions that have had MAID available for mental disorders, not only are there deaths due to MAID, but there are also deaths related to non-MAID suicides.
In other words, we see an increase not only in medical assistance in dying rates but also in suicide in general. There is this lack of hope and this message conveyed by society that there is no future.
As Canadians, we can do better. I dare say we must do better. We cannot give up on people such as Laurel, who are fighting for their very lives. These folks are in desperate need of hope and help. They want treatment, not death.
Those struggling with their mental health deserve that element of support. Rather than looking to facilitate the deaths of fellow Canadians who are suffering, we must focus on how we can better provide the needed treatment. In an article, psychiatrist John Maher is quoted as expressing that “Mental illness is treatable, and death is not treatment.”
We know that the problem is rarely only mental illness. It is often within the larger context of social challenges as well, whether this is not having basic necessities, such as housing, or a social structural support that is not available to these folks. Again, we have a responsibility as a society to make sure that those things are available to these individuals. Death is not the answer.
To my fellow colleagues in this place, I would make the following plea: Let us not just simply push the temporary pause button, as if to say their life is worth something now but, in a few years, it may no longer be. It is as if to say that the flip of a coin might not be acceptable now, but maybe we will flip a coin in three years; that might be okay. Rather, let us commit to permanently valuing those who live with a mental illness, and let us make sure that they are forever offered the adequate health care supports that are needed. Death is not that.
Christie Pollock submitted testimony calling for great caution. She is a 30-year-old who has her own struggle. She talks about the hope that she is now able to offer, because she runs a support group. Then she talks about the fact that, if medical assistance in dying had been offered to her, she might not be here. She goes on to say that, sure, she has her struggles, and she is not healed, but she has found a mix of therapy and medication that is getting her through. Her days are filled with hope. It is not just hope for herself; she is also able to offer hope to others.
Madam Speaker and members of this House, this is where we should wish to land, where the people of this place offer hope to Canadians, not death.
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- Feb/13/24 7:06:09 p.m.
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Madam Speaker, I am not in too much disagreement with a lot of what the member had to say.
As a long-time doctor, I certainly know that one ought to be cautious, and I think our government has been pretty cautious. We first put a one-year pause on this; now we have a three-year pause. I hate to get political in this political place, but the reality is that one of the reasons we should hesitate to implement MAID for mental illness is a lack of mental health services. Our government has been fighting to increase those services.
Will the Conservative Party make the same commitment to providing adequate mental services for Canadians?
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- Feb/13/24 7:06:52 p.m.
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Madam Speaker, I would ask the hon. member to point to the supports his government has offered to those with mental illness. What we heard in this place, in Parliament, from witness after witness is that the supports are inadequate. People desperately need more support.
On this side of the House, I think of my hon. colleague, whose name I am not allowed to use, and his tremendous effort in advocating for support for those who live with a mental illness and his tremendous effort with bringing in a three-digit suicide line to help prevent suicide, and of course we know that is most often associated with a mental illness.
Not only are we going to make tremendous efforts when we are in government, but the reality is that we do not wait. We are already making a meaningful difference for Canadians.
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- Feb/13/24 7:07:54 p.m.
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Madam Speaker, I would like to take this opportunity to thank you for ruling the amendment in order.
The Bloc Québécois used this wording in order to recognize the fact that Quebec is a leader in this area, as proven by the unanimous motion recently adopted by the National Assembly. With this amendment, the Bloc Québécois wants to be able to move things along in Quebec.
Does my colleague care about the will of Quebec, whose values are quite different from those defended by the Conservatives?
Consequently, if the Conservative Party takes power within three years—which, according to the polls, is not impossible—do they intend to scrap the bill at the end of those three years?
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- Feb/13/24 7:08:45 p.m.
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Madam Speaker, as Conservatives, our desire is to be on the side of vulnerable Canadians and to be their greatest advocate. Our desire is to listen to the pleas of those who came before the House. That is our job. We have been elected to represent our constituents to the best of our ability, so when it came to hearing testimony on medical assistance in dying being extended to those with a mental illness, we leaned in, listened and did the hard work.
Furthermore, we went out and listened to Canadians beyond this place, sitting down with them in our constituency offices and meeting with them during town hall meetings. Our leader also went on tour across the country, leaning in and hearing the concerns of Canadians, and this came up as one that Canadians do not want. They do not want medical assistance in dying to be extended to those who have a mental illness. Instead, they want to see greater support for those who struggle. They want to see a better medical system put in place. They want to see better health care provisions put in place. They want to see greater support from society as a whole.
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- Feb/13/24 7:10:00 p.m.
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Uqaqtittiji, I appreciate very much the passion the member shared in her intervention.
I wonder if the member could share with us what she thinks would happen after March 17 if we do not meet this deadline, this really important deadline, which we need to avoid so we can make sure what she has been talking about is protected. Could she explain to us what she thinks would happen with the March 17 deadline if we were not able to meet it without the amendments being made?
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- Feb/13/24 7:10:39 p.m.
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Madam Speaker, I cannot help but point out the obvious. She is a member of the NDP, which is currently in a coalition with the Liberal government, so in part, it is actually her doing that we are here in this place having this discussion at the eleventh hour.
I would encourage her to perhaps work with her party to act differently and to actually act on behalf of Canadians. That said, she is going to have to enter into a conversation with her coalition government to ask it what is going to happen on March 17.
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- Feb/13/24 7:11:22 p.m.
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Madam Speaker, at the outset, I would like to say that I am splitting my time with my hon. colleague from Calgary Rocky Ridge.
This is a weighty issue. Over the course of this debate, I have listened intently to all of our colleagues. I am brought back to when we debated this as new members of Parliament in 2016. I said, at that time, that this is perhaps one of the most important pieces of legislation that our generation would be debating and discussing. I also said, at that time, that there is nothing that prepares someone, as a new member of Parliament, to debate and make choices about that piece of legislation.
I consulted so many of my constituents, as well as friends of mine in the faith community. I consulted my pastor. I was conflicted as to how I was going to vote. I said at that time, too, that it was troubling for me because we were in the eleventh hour on such an important piece of legislation, and here we are again at the eleventh hour on a piece of legislation that is, quite frankly, literally life and death.
I want to make something clear. In the time since MAID became law, I have sat with families who have had loved ones who have chosen MAID. Our family very recently had a loved one who chose MAID, and we are currently dealing with all of the emotions that go along with that. It has been a tough few months for our family, but I now have a greater understanding, I believe, of the complexities of this issue. I do understand both sides of the argument better than I did in 2016.
Nevertheless, I firmly believe that expanding MAID to the mentally ill is giving up on people who could be saved. I have spent my eight and a half years of being elected fighting for those who do not have a voice, fighting for mental health awareness, passing bills with respect to post-traumatic stress disorder, and fighting for us, as a nation, to adopt the simple three-digit suicide hotline 988. I have to ask why.
Why did I fight so hard if all we are going to do is pass a piece of legislation so somebody who is struggling with a mental illness or mental health issues can choose medically assisted death or suicide? It is deeply troubling for me to see how far we have fallen to where we can perpetuate one's addiction, but we cannot get them into recovery. We have fallen so far to where we are saying it is okay if someone is struggling, as we will offer assistance in death if they are struggling with a mental illness. We are giving up on people.
I am disappointed in how we, as a Parliament, have taken the easy way out. Expanding assisted suicide to include people whose sole condition is mental illness will result in the deaths of Canadians who could have gotten better. We have 12 Canadians who die by suicide every day. A further 200 attempt suicide. That is 73,000 Canadians a year who attempt suicide, and those are just the numbers we know of.
What are we saying? My colleagues spoke very passionately about the statistics and the feedback from experts about mental illness and the irremediability of it. It is like a coin flip as to whether somebody can recover from it or not.
In preparing for this debate, I was reminded of a young man long ago who had enough of the abuse and dysfunction he was growing up with. He had lost a brother in a horrific car crash. He wanted to die and attempted suicide, but was found and saved by a loved one. That same gentleman tried it again, but for the bitterness of the metal of the weapon he chose to use, I dare to think what could have happened.
I think about if that young man, so many years ago, was successful in wanting to die by suicide. That young man would not have married his high school sweetheart, had four amazing children and a beautiful granddaughter, and travelled the world so many times to see and experience things that some will only ever be able to experience through the wonders of the Internet. I think about that young man taking a chance in 2014 to run for office. I think about that young man who was elected in 2015 to represent his hometown riding of Cariboo—Prince George and how he would have missed out on all those opportunities.
I think about that every day when we talk about suicide and doing whatever we can to get the message across that we should always choose life, that hope is always possible. Whatever it is that somebody is going through, it may seem so dark, but light is just a short hand away. That young man is me and, for the first time, I am sharing this. I think about that all the time when we do what we do here in the House, when we are fighting for those who do not have a voice. If somebody had not told me that life is worth living and asked to let them help me at that time, there are so many things I would have missed out on.
I appreciate the debate that we have had in the House, but I am saying that today we should be fighting every minute for those who are struggling, to tell them that hope is always possible and life is worth living. I will continue to fight for that as long as I am elected.
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Madam Speaker, the member is a colleague I have always enjoyed working with. I remember one of the very first files I was asked to work on as Parliamentary Secretary to the Minister of Health back in 2017 was his private member's bill, Bill C-211, on post-traumatic stress disorder, so I know it means a great deal to him, and I appreciate his speech.
I voted with our colleague from the other side to completely abandon the idea of opening MAID to people solely affected by mental illness. I have been convinced, through the discussions I have had with psychiatrists from across the country, that we are not ready nor is it desirable to go down that path for various reasons. One of them is that it is hard to say for certain that a mental illness is irremediable, but another aspect that moved me is that, if someone were to have access to that, theoretically, we would need to exhaust all possible treatment options. As we know, in this country, treatment options are sometimes, depending on the regions, hard to access, so I would like to have his comments on that.
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- Feb/13/24 7:22:32 p.m.
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Madam Speaker, my hon. colleague is absolutely right. We do not treat mental illness in parity with physical illness. If I have a broken arm, we can see that injury and will offer all our assistance to it, but if I am struggling with mental illness or mental health challenges, it is an invisible illness and an invisible injury, and we do not do enough as a nation to put those supports in place. That is why I said we are giving up on Canadians when we take the easy way out. We need to put more resources in place so that people can get the help they need when they need it, wherever they need it and for as long as they need it.
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- Feb/13/24 7:23:24 p.m.
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Madam Speaker, I have great deal of compassion for my colleague and want to thank him for so generously sharing his life experience. He says he speaks for those who have no voice, and he is living proof that suicidal ideation is reversible.
I wonder if he could dig a bit deeper and acknowledge that there are people who have no voice, who have yet to find a psychiatric treatment that eases their suffering and who struggle with mental disorders? What solutions does he have for them after 30 years of treatment?
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- Feb/13/24 7:24:15 p.m.
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Madam Speaker, I have sat with many people who have struggled for their lives with mental illness and mental health challenges. The greatest issue many of them have is that they do not have adequate access to help and that they constantly are waiting for help. I think we need to first go down the path of doing everything in our power to remove the barriers for care so that we can help those who feel helpless and we can provide hope in their times of despair. I believe life is always worth fighting for. When somebody is struggling, I will always tell them that life is worth fighting for. We do whatever we can to fight for them.
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- Feb/13/24 7:25:21 p.m.
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Madam Speaker, I want to thank my colleague from Cariboo—Prince George for his excellent work in bringing the 988 number, which is now finally implemented and seeing great use. I want to thank my colleague for always being a passionate advocate, not only for his constituents, and for always doing the right thing. I can say that I am going to rest easier tonight knowing that there is somebody who is never going to give up on me. I really do appreciate that from my colleague, and I want to thank him for joining me. We will never give up on those who feel like giving up.
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- Feb/13/24 7:26:05 p.m.
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Madam Speaker, that is my motto. It is “never give up”. In our darkest days and our darkest moments it is easy to find a permanent solution to a temporary problem, and that is suicide. I believe with every fibre in my body that life is worth fighting for. We just have to be able to have those moments of clarity. Sometimes it is hard to find those moments of clarity. Sometimes it is hard to see the light through the trees, but it is there. I am living proof of it.
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Madam Speaker, it is quite difficult to follow the incredible words we just heard from the member for Cariboo—Prince George. Nevertheless, I am going to give it a try.
I am here tonight of course to speak to Bill C-62 and the self-inflicted debacle that has been unfolding in Parliament since it passed its radical expansion of legal medical assistance in dying to include persons for whom the sole underlying health condition is mental illness.
I will remind members of the House and my constituents that I supported and still support the principles of the 2016 bill, which was a necessary response to a 2015 Supreme Court ruling that struck down the blanket prohibition against MAID. That bill was not perfect, but it was a reasonable response to the Supreme Court's decision and was certainly better than the free-for-all on MAID that would have surely followed had there been no law.
It is my view that people who are suffering intolerably from a terminal disease without any hope of recovery or any prospect for improvement and are spiralling into a certain death as a result of illness or disease ought to be able to seek medical assistance in dying as long as they are not coerced, have received an option of proper palliative care, are not proactively offered MAID as an alternative to treatment, and most importantly, as long as the patient is a mentally competent adult.
Part of the criteria laid out in the original 2016 law was the reasonable foreseeability of death of the applicant. This clause was a problem from the start. It was challenged in court and struck down by the Quebec Superior Court. The Truchon case presented the Liberals with a decision point. The decisions the government has made since then have all been wrong.
The first thing the Liberals could have done, but did not, was defend their own existing law and appeal the Truchon decision to the Supreme Court. If they believed that their 2016 law was charter compliant, like they claimed it was during the debate in 2016, they should have stepped up and defended it. Not doing so was their first mistake.
The second mistake was that the then minister of justice was so eager to expand the law, they used the Truchon case as an opportunity to open up and expand access to medical assistance in dying and tabled Bill C-7 in the fall of 2020. That was their second mistake.
As I said before, I support MAID for competent adults who are grievously and irremediably ill and suffering cruelly from intolerable pain and anguish in the late stages of a terminal illness. I have consistently said there are important conditions for my support for legal access to MAID: the availability of quality palliative care as an option; the existence of robust safeguards for the vulnerable, especially minors, the disabled and the mentally ill; conscience protection for practitioners who oppose MAID; and any expansion of the availability of eligibility for MAID be well thought out, carefully considered and not rushed.
For these reasons, I voted to send Bill C-7 to committee, but voted against it at third reading because it failed on at least two, maybe three of my four conditions for support. I concluded that access to palliative care is not adequate in Canada. I have also become alarmed by the cracks in what should be the protections for vulnerable Canadians, as we have experienced in my own family. It was my view, even before the Senate amendment, that Bill C-7 was flawed and unworthy of support.
Then the House made a terrible decision when it passed the amendment that came back from the Senate. It was rightly opposed by all of my Conservative colleagues, who knew then that medical professionals cannot, with the certainty required for what is literally a life-and-death decision, determine irremediability of a patient in a case of mental illness. Conservatives opposed it, but it was passed nevertheless, and this expansion, which was not necessary to conform to any court decision, was to come into effect last year. The government had to introduce emergency legislation this time last year to give the medical system more time for this extraordinary change. That was the next mistake it made.
The Liberals could have used that opportunity to deal with this once and for all and simply strike this portion of what was then Bill C-7. However, they did not do it and here we are, another year later, and this country is no more ready for this expansion than it was this time last year. Here we are again in an eleventh-hour panic to kick this further down the road until after the next election; the next mistake.
Now, the Liberals could have tabled a bill that would have removed this from the bill that passed in 2021, but they have chosen not to and so said that the next government will have to deal this. However, the good news is that a Conservative government, which will surely be formed after the next election, will not recklessly expand the application of MAID to include vulnerable Canadians whose sole underlying health condition is a mental illness.
MAID is for people who cannot get better. It is for people who have no reason to hope that they can get better because they are in an irreversible, terminal state. It is for people capable of making a rational decision and not as a means of potentially fulfilling suicidal ideation.
The impossibility of creating a regime that could determine appropriate MAID for mentally ill but otherwise healthy people who are not in the final stages of a terminal illness seemed intuitive to me, but, of course, I am not a medical professional. However, I can also point to the clear message that was sent from the joint committee that studied this. Its recommendation to Parliament was very simple: Do not do it. It was the shortest list of recommendations I have ever read in a parliamentary report. It just said: Do not do it. That was the recommendation based on months and months of testimony from experts.
My recommendation to this government is to listen to the committee and strike it from the bill that passed. This time last year, the Liberals could have done that, but they kicked it ahead until this year, and nothing has changed. We find ourselves here where a full 80% of members of the Ontario Psychiatric Association do not believe that Canada can safely implement MAID for mental illness. Here we are just pushing this back a couple of years.
I want to share with the House the words of one of my constituents who met with me in November. She said in a letter to me, which I got before I met her, that, “Twenty-three years ago, age nineteen...I made the desperate decision to try and escape what appeared to me to be a dark world.... While taking a course in Pharmacology, I calculated the quantity of poison needed to arrest the heart of an adult male, multiplied it by three, and chose to ingest it.... I felt compassion for the suffering of others and the weight of constant, terrible news...though I formerly had the capacity to deal with this, the ingestion of a single pill coerced upon me by a well-intending physician inadvertently plummeted my thoughts into despair.”
What she told me later was that the side effect of the medication that she had been prescribed caused her to immediately become suicidal, and her survival was described as miraculous by the professionals who attended her.
She is now a wife and a mother and lives a productive, meaningful life. She is convinced that had MAID been available to her earlier in her life, she would have sought it and potentially have been granted it. She told me that the sufferings earlier in her life may well have been thought to be irremediable and thus would have made her eligible.
So, this government has failed to defend its original law. It failed to focus the new law on the narrow constraints of the Truchon decision. It used the Truchon decision in Quebec as an excuse for a reckless expansion of MAID. When it was obvious that it made a mistake, its members dithered instead of acting decisively and they are dithering now by pushing this two more years down the road. That is not leadership. This is just bizarre enthusiasm for the most radical expansion of MAID possible, which has now run amok.
So, I do support swift passage of the bill. Given the extensive debate that has already taken place, I was prepared to let it pass unanimously, but here we are. I had an opportunity to get some of my thoughts on the record, and I am happy to take questions.
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- Feb/13/24 7:36:44 p.m.
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Madam Speaker, I was encouraged when the member indicated that he supports the swift passage of the legislation and ultimately the motion. I take it that is because he realizes the consequence of the House not having the bill passed before the deadline. I am wondering if he could give an indication of whether that is his personal opinion or if that is the Conservative Party's position.
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- Feb/13/24 7:37:12 p.m.
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Madam Speaker, Conservatives know that we cannot allow this bill to fail and thus stumble into a wild, unprepared territory where those whose sole underlying health condition is mental illness are permitted to access MAID, when it is so clear that the country is not ready for it.
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Madam Speaker, my colleague is claiming that Bill C-14 resulted in good legislation with its reasonably foreseeable natural death criterion. However, that did not even address the Carter ruling, since Ms. Carter did not have a condition that made her terminally ill. The Supreme Court ordered Parliament to regulate situations like those of Ms. Carter and Ms. Taylor. Limiting medical assistance in dying to people who are terminally ill completely ignores people like Ms. Gladu and Mr. Truchon, who had to go to court to assert their constitutional right. People have had to go on hunger strikes to meet the reasonably foreseeable natural death criterion.
Is that what my colleague calls compassion?
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