SoVote

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

Feb/13/24 10:20:59 a.m.
Watch

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

175 words

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

Feb/13/24 10:22:24 a.m.
Watch

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

216 words

Hon. Arif Virani

Feb/13/24 10:23:46 a.m.
Watch

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

225 words

Mr. Luc Thériault (Montcalm, BQ)

Feb/13/24 10:24:58 a.m.
Watch

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

204 words

Hon. Arif Virani

Feb/13/24 10:26:27 a.m.
Watch

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

266 words

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

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

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

217 words

Hon. Arif Virani

Feb/13/24 10:30:44 a.m.
Watch

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

350 words

Mr. Richard Bragdon (Tobique—Mactaquac, CPC)

Feb/13/24 10:32:40 a.m.
Watch

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

185 words

Hon. Arif Virani

Feb/13/24 10:33:50 a.m.
Watch

Mr. Speaker, I thank the member opposite, but I think his comments reflect something that was raised also by the member for Medicine Hat—Cardston—Warner. Just to be clear for Canadians, if we do not proceed expeditiously in this chamber and in the Senate, the law will change on March 17 so as to allow medical assistance in dying for people who have mental illness as the sole underlying condition. If the member for Tobique—Mactaquac is concerned about supports for those who are mentally ill, and I believe he has that concern, then what he should be doing is working with us collaboratively to ensure passage of the bill to prevent that situation from arising. The logical premise of his question is false. What we are doing is proceeding expeditiously as a responsible government after hearing from the joint mixed committee of MPs and senators about the need to put a pause on this. We would be putting a pause on it. We presented the legislation expeditiously and are seeking passage of the legislation expeditiously. As we have have heard from the member for Saanich—Gulf Islands, in this context even she is making an exception to her principled approach towards closure in order to invoke closure so we can get the bill done and protect Canadians. Fundamentally, my job as Minister of Justice is to do just that, and I will not be deterred in that task.

244 words

Mr. Luc Thériault

Feb/13/24 10:35:07 a.m.
Watch
Re: Bill C-62 Bill C-14

Mr. Speaker, the minister did not answer one aspect of my question. Why the double standard? The minister had a full year to implement the recommendation of the Special Joint Committee on Medical Assistance in Dying concerning advance requests. An Ipsos poll of 3,500 people showed 85% support across Canada. If the minister does not know that, he is not staying on top of his file. As far as postponement is concerned, the minister has implemented the recommendation to the letter. Three years is too long. He knows that. However, he could have added another dimension to Bill C‑62. He had a year to do it. Will he introduce legislation on advance requests, yes or no? Bill C‑14 is bad legislation. The minister says that he worked carefully. People have been forced to go on hunger strikes to meet the reasonably foreseeable natural death criterion. Is that what he means by protecting vulnerable people?

159 words

Hon. Arif Virani

Feb/13/24 10:36:17 a.m.
Watch

Mr. Speaker, what I can add to the conversation I just had with my colleague across the way is that we created expert panels to study several aspects of expanding medical assistance in dying. Experts conducted a study on advance requests. They found that it is extremely complex when we talk in the present about articulating a desire to seek medical assistance in dying, added to the fact that a person might submit a request 30 or 40 years ahead of time. Given the context, their situation, condition and wishes could change. This said, Quebec has already addressed the issue, and a bill has been introduced in the province. We are well aware of this, and we are starting a discussion with Quebec. Discussions will be held. We have a Criminal Code that applies across the country. Consequently, the question has to be approached the same way we dealt with the other aspects, meaning nationally. This is what we did when we prudently undertook consultations while taking the necessary precautions.

170 words

Mr. Peter Julian

Feb/13/24 10:37:47 a.m.
Watch

Mr. Speaker, I am very concerned about the comments that I have just heard from the Conservatives saying that the debate should just go on for as long as Conservatives would like. That could take months. Our deadline is March 17. We have nine sitting days, including today, before the deadline. I wanted to make sure, because some of my Conservative colleagues were saying that they are concerned about having, as a condition, the sole underlying medical condition being a mental disorder. They did not want to see that. The provinces and territories certainly agree. Ten of the provinces and territories have written to say that their health care system is simply not ready to put that into place. What would happen, would the minister say, if we end up missing that deadline, going on for months afterward? What type of confusion? What situation would we find ourselves in, in Canada, if we follow the desire of the Conservatives to simply talk this out for months?

166 words

Hon. Arif Virani

Feb/13/24 10:39:05 a.m.
Watch

Mr. Speaker, I thank the member opposite for his second contribution this morning, because it is very salient and very pointed. I would urge my Conservative colleagues to actually reconsider their presumed position with respect to this legislation and the need for passing it efficaciously, as soon as possible. As a candid response to his question, so that we are crystal clear, if we do not pass this legislation by March 17, it would be possible in this country for someone whose sole underlying condition is mental illness to avail themselves of MAID. That would occur in the riding of Medicine Hat—Cardston—Warner, in the province of Alberta, as well as in the province of New Brunswick, which the member for Tobique—Mactaquac represents. The ministers of health for New Brunswick and Alberta have both said to us unequivocally that their health care systems, their MAID assessors and providers, are not ready. I do not want a situation where we have that kind of lay of the land in terms of the criminal law in Canada. We have the power to prevent that from happening by voting in favour of this bill.

196 words

Mr. Gérard Deltell (Louis-Saint-Laurent, CPC)

Feb/13/24 10:40:05 a.m.
Watch

Mr. Speaker, first, I would like to thank the minister and congratulate him on the quality of his French. I knew him when he arrived in 2015, and I have seen his progress, step by step. I would like to sincerely congratulate him on his French. That is where my congratulations end. It is never a victory when a time allocation motion is introduced in a debate on an issue as sensitive as medical assistance in dying. This topic should be free from partisanship, because there is no right or wrong position. There are only the positions with which we are at ease as legislators. Opposing opinions should always be respected. Some of our friends, family members and loved ones may take the exact opposite view, and they are right. That is what a non-partisan debate is. That is what a debate about personal quality of life is. As my colleague from Montcalm illustrated so well, the minister had a year to take action, but he did nothing. We realize that the Prime Minister decided to change justice ministers, as is his right and privilege, and we also realize that the predecessor to this Minister of Justice had a different approach. However, in the face of such a delicate issue, why act so quickly when we need to make room for every possible opinion? This is not a partisan issue, let us not make it one.

237 words

Hon. Arif Virani

Feb/13/24 10:41:28 a.m.
Watch

Mr. Speaker, I appreciate the comments of the member for Louis‑Saint‑Laurent. I want to note two things. First, my colleague is absolutely right when he says that we must avoid partisanship when we are dealing with such a sensitive subject and where the consequences are so serious for Canadians. I might add that he and his colleagues sat on the special joint committee both the first and second time. So we have already had the opportunity to hear the Conservatives' views on the matter. We have reflected on those comments and indeed we introduced a bill that reflects the will of their caucus. I believe that we need to move forward with that expressed will and promote the adoption of this bill today in the House.

130 words

The Deputy Speaker

Feb/13/24 10:42:25 a.m.
Watch

It is my duty to interrupt the proceedings at this time and put forthwith the question on the motion now before the House. The question is on the motion. If a member participating in person wishes that the motion be carried or carried on division, or if a member of a recognized party participating in person wishes to request a recorded division, I would invite them to rise and indicate it to the Chair.

74 words

Mr. Kevin Lamoureux

Feb/13/24 10:42:39 a.m.
Watch

Mr. Speaker, I request a recorded vote.

7 words

The Deputy Speaker

Feb/13/24 10:42:57 a.m.
Watch

Call in the members.

4 words

Call

The Deputy Speaker

Feb/13/24 11:25:43 a.m.
Watch

I declare the motion carried.

5 words

Mr. Gord Johns (Courtenay—Alberni, NDP)

Feb/13/24 11:26:12 a.m.
Watch
Re: Bill C-7 Bill C-62

Mr. Speaker, it is an honour to rise today on the unceded lands of Tseshaht and Hupacasath on Vancouver Island in Nuu-chah-nulth territory to speak to Bill C-62, which is calling for the extension of the temporary exclusion of eligibility for medical assistance in dying for persons suffering solely from a mental illness by three years, until March 17, 2027. Clearly, without an intervention by Parliament, this expansion would come into effect on March 17, 2024, in just one month. New Democrats agree with the majority decision made by the Special Joint Committee on Medical Assistance in Dying, also known as the AMAD committee, which I will refer to it as in my speech. It reported that Canada is not adequately prepared to deliver medical assistance in dying to individuals whose sole underlying medical condition is a mental disorder. The bill would allow more time to implement the necessary safeguards and address the capacity concerns that are expected to be the result of the expansion of medical assistance in dying for those with the sole underlying medical condition of a mental disorder. It would give medical practitioners more time to become familiar with available training and supports, while providing time for the public to become more aware of the robust safeguards and processes in place. I know this is a very sensitive and very personal matter to so many people around this country. Especially in my riding of Courtenay—Alberni, I have heard from many people about this. We also need to ensure that we have the understanding and compassion to respect the right of an individual's choice of dignity when they have deep, prolonged and ongoing suffering. I will speak to that. Suffering from mental illness is extremely serious, and it is just as real as suffering from a physical illness. In our health care system, we clearly do not have parity when it comes to mental and physical health, and I will speak to that as well. We must also affirm and protect the most vulnerable when we do any sort of decision-making on such a serious piece of legislation as expanding medical assistance in dying. This additional delay is necessary and needed right now to ensure that we have a health care system in place that can safely provide medical assistance in dying for those whose sole underlying medical condition is a mental disorder. We know how we got here. The Liberal government made an ill-advised decision and did a complete 180° by accepting the Senate's amendment to Bill C-7 in the 43rd Parliament. That is what got us here. The government changed the law before any kind of comprehensive review had been conducted, and we have been trying to play catch-up ever since. I am going to speak about the important work that needs to be done, and I want us to be thoughtful in our approach to expanding medical assistance in dying. As New Democrats, we take people's concerns and feedback very seriously. We are committed to helping find the best possible solution for Canadians in the policy of medical assistance in dying to ensure that it does what it was always intended to do. One of the biggest concerns New Democrats have with the expansion of medical assistance in dying is with the barriers that many Canadians face when they reach out for mental health treatment. Because of the Liberals, and the Conservatives before them, the chronic underfunding of our health care system has become even more apparent. It is now more than ever, as we see the disparity between mental and physical health and how people are taken care of. We heard the Prime Minister promise to implement a new mental health transfer of $4.5 billion over five years, but he has still not done that. Even with the bilateral agreements, the Liberals are falling far short, and that would not even be enough. Everyone should be able to access mental health supports when they need it, but under the Liberal government, and that of the Conservatives before it, this has not been the reality. It is the same with all provinces and territories. New Democrats wholeheartedly support the delay in expanding medical assistance in dying for those who have a mental disorder as the sole underlying condition, but the Liberal government needs to ensure that proper consultation happens between now and the expansion date, or it would need to be extended again. It needs to ensure that people will be protected while respecting their individual choice. The Liberals cannot just delay the expansion either. They need to fund adequate supports and treatment options for people dealing with mental illness. Members have heard me say this repeatedly, but we need a pathway, a road map, to how we are going to achieve parity for mental and physical health and ensure people get the timely help they need when they need it. Seven of the provinces and all three territories have said that they are not ready and have signed a joint letter to that effect, including my home province of British Columbia. That was signed by the ministers of health in those provinces and territories. They are calling for an indefinite pause on the expansion for individuals whose sole underlying medical condition is a mental disorder. That is what those ministers identified. As New Democrats, we want to see a MAID regime where guardrails are in place to protect vulnerable populations while still allowing for personal bodily autonomy and end-of-life choices. We must make sure that people do not request medical assistance in dying because they do not have access to treatments, supports and services. This has to be absolute. The Liberals need to make sure everybody can access mental health supports. However, after nine years of carrying forward with the Conservative cuts to health care, this is where we are at right now right across the country. Help is out of reach for many people. This needs to change before medical assistance in dying can be expanded. We know that the housing, toxic drug and mental health crises that are happening are not being addressed. I see that I do not have a lot of time left, but I want to ensure I outline that the AMAD committee heard from plenty of witnesses who cautioned the committee on expanding MAID in cases of persons suffering solely from a mental illness. I want to share what a couple of those experts had to say. Professor Brian Mishara, who is with the Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices at Université du Québec à Montréal, said, “The expert panel report on MAID and mental illness states that there are no specific criteria for knowing that a mental illness is irremediable”, and that there is absolutely no “evidence that anyone can reliably determine if an individual suffering from a mental illness will not improve.” He warned us that “any attempt at identifying who should have access to MAID will make large numbers of mistakes, and people who would have experienced improvements in their symptoms and no longer wish to die will die by [medical assistance in dying].” We heard from many experts. The CAMH raised similar concerns. Because I see that I only have a couple of minutes left here, I want to talk a bit about the system and the lack of access. We are talking about a crisis going on from coast to coast to coast, according to a poll done just a year ago. The Mental Health Commission of Canada and the Canadian Centre on Substance Use and Addiction released a report talking about postpandemic findings. It cited that 35% of respondents reported moderate to severe mental health concerns. This is alarming. It should also be alarming to all parliamentarians that it found that fewer than one in three people with current mental health concerns accessed services. The report identified key barriers to accessing services as financial constraints and help not being readily available. We know that right now we are in a financial crisis, and I am sure those numbers have only gone up. It identified that one of the top stressors was between income and unemployment with mental health concerns. We need to create a system of parity with mental and physical health. The government has not delivered when it comes to a plan, a road map, on how we achieve parity with physical and mental health. I hope in this budget, it is going to release funding on top of the bilateral agreements directly to community-based organizations as a COVID emergency recovery response because, post-COVID, we know some people are struggling financially, but the biggest concern right now and the biggest epidemic post-COVID is in mental health. I hope the government is hearing that. I see that I have run out of time. I have a lot to say on this matter. I look forward to taking questions from my colleagues.

1528 words