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Decentralized Democracy

House Hansard - 283

44th Parl. 1st Sess.
February 15, 2024 10:00AM
  • Feb/15/24 10:52:56 a.m.
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Madam Speaker, it should have never come to this. Had the government properly consulted with Canadians, this expansion of MAID would never have seen the light of day. Instead, what we now have is MAID in Canada, a triumph of ideology over common sense. The Liberal government's recent decision to further delay, but not cancel, the expansion of MAID to the mentally ill reflects an unserious approach to this all-important life-and-death issue. MAID was originally designed for those whose physical illness was incurable and caused intolerable pain, and where death was reasonably foreseeable. However, the Liberals soon eliminated the requirement that death be reasonably foreseeable and then went far beyond that by quickly agreeing to a demand from the unelected Senate to expand assisted suicide to include those suffering from mental illness. The government has signalled a willingness to go even further by including children in its deadly scheme. As we predicted back in 2016, when the Prime Minister introduced medically assisted death to Canadians, our country is now hurtling down a steep and slippery slope. Despite the accusations of fearmongering and exaggerating that have been levelled at us, history has proven that Conservative MPs were right. Over eight short years, our country has moved from banning assisted suicide to having the most permissive and dangerous regime in the world. The statistics are staggering. Last year, over 13,000 Canadian deaths were attributable to MAID, a 31% increase over the year before. That is without MAID being made available for mental illness. MAID is now the fourth leading cause of death in the country. When compared to other jurisdictions where MAID is available, like California, Canada's assisted suicide deaths far exceed those of other jurisdictions. That should really concern us, as it reflects a reckless implementation of MAID. Imagine how many more thousands of deaths will be added every single year, should the Liberal plan to include the mentally disordered come into force. Of increasing concern are the growing number of cases in which MAID has been improperly approved and administered outside of what the criminal law currently allows. Here are just a few of them: There is a Hamilton man who would rather die than struggle with poverty, as reported in the Hamilton Spectator Reporter; the Cape Breton woman who sought MAID over lengthy workers' compensation delays; the Ontario quadriplegic mother who applied for MAID over a lack of access to disability supports; the former paralympian who told MPs that the veterans affairs department offered her assisted death instead of help; and the Winnipeg woman who chose to die through MAID because of her futile struggle for home care. There is the case of Donna Duncan from my own city of Abbotsford, who was euthanized because mental health support was not available when she needed it the most. Indeed, she received MAID without her daughters, Christie and Alicia, knowing about it until after the fact. They had no chance to say goodbye to their mother. Then there is Kathrin Mentler, who lives with chronic depression and suicidality. Feeling particularly vulnerable, she went to Vancouver General Hospital looking for psychiatric help for feelings of hopelessness she could not shake. Instead, a clinician told her there would be a long wait to see a psychiatrist and that the health care system is broken. That was followed by a jarring question: “Have you considered MAID?” There is the case of Sophia, who suffered from severe sensitivity to smoke and chemicals, triggering rashes, difficulty breathing and blinding headaches. She died by MAID after a frantic effort by friends, supporters and even her doctors to get her safe and affordable housing in Toronto. She begged officials for assistance in finding a home away from the smoke and chemicals wafting through her apartment. “The government sees me as expendable trash, a complainer, useless and a pain in the ass,” she said in a video filmed eight days before her death. Canadians are dying unnecessarily and under circumstances that scream out for reconsideration of how far Canadians are prepared to go in euthanizing their fellow citizens. It has become stunningly clear how little the government consulted on MAID expansion. Mental health professionals are only now becoming aware of the government's plans to euthanize persons suffering from mental disorders. Psychiatrists, psychologists, clinical counsellors and suicide prevention experts overwhelmingly oppose this expansion, and only recently has the government begun to consult with indigenous communities, our fellow Canadians who are at the greatest risk from an expansive application of MAID. The provinces and territories, as has already been mentioned, have sent a joint letter to the government, saying that they are not ready for MAID expansion. Indeed, they have called not just for a delay but for an indefinite suspension of the government's plans. Ordinary Canadians, of course, have repeatedly said they do not favour expanding assisted suicide to include the mentally ill. What is worse is that this expansion is taking place at a time when Canada faces compounding national crises in mental health, palliative care, opioid addiction, affordability and homelessness. The skyrocketing cost of living has only exacerbated these profound social challenges. The government's reckless approach to MAID also flies in the face of Parliament's stated commitment to suicide prevention, including the recently activated 988 suicide helpline, which is thanks to my colleague from Cariboo—Prince George. How can members claim to support suicide prevention efforts, when at the same time they are promoting state-facilitated suicide? Clearly, the government's contradictory approach has been one in which blind ideology has trumped common sense and reason. More troubling is that the message to our most vulnerable Canadians, the mentally disordered, the opioid addicted, the homeless and hungry, and the veterans, is that their government would rather euthanize them than provide them with the mental health and social supports they need to live productive, meaningful lives. The utilitarian implications of the government's approach are deeply disturbing and profoundly wrong on so many levels. By any other definition, expanding MAID to include the most vulnerable is nihilism hiding behind the fig leaf of compassion. In a briefing recently, Liberal government officials indicated that they are still hell-bent on expanding MAID to the mentally ill. It is just that their masters, namely the Prime Minister and his Liberal colleagues across the floor, do not want to face the voters' wrath for placing their corrosive ideology above the interests and welfare of the most vulnerable among us. That is why they, the Liberals, have kicked the ball down the road to avoid the political consequences. We can and should do better. What is really required and what Canadians are demanding of the Prime Minister and his justice minister is that they put a full stop to this madness now. There being no national consensus on MAID expansion, completely rescinding this policy is the only reasonable and responsible thing to do.
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Madam Speaker, we come here to debate the most serious of issues, and we are faced with one of those issues today. I want to start by being very up front. I do not think that a pause is appropriate for the expansion of medical assistance in dying to those whose sole underlying medical condition is mental illness. There must be an abolition of the expansion to those who are most vulnerable and to those who are suffering. We have heard that the Liberal government is pushing this off to avoid political consequences in the next election, and it is shameful. However, it does present an opportunity, because a Conservative government would not allow the expansion of doctor-assisted death to people for whom our country should be offering hope and help. The concrete solutions that have been put forward by Conservative members have been heard in the House, including by my hon. colleague from Cariboo—Prince George with the 988 suicide prevention hotline, which he shamed the government into taking action on. While it took that shame for the Liberals to act, it does offer some help to those who desperately need it. The hon. member for Abbotsford spoke just before I did. His Bill C-314 would have scrapped doctor-assisted death for those whose sole underlying medical condition was mental illness, but the government rejected that. With respect to the provinces and territories, which are constitutionally obligated to deliver on health care, the majority of their heads of government have had to call for the government to stop this reckless march forward. While I will vote in favour of a pause, I cannot abide anyone believing that I am okay with this continuing three years from now. This debate is following the Liberals' pulling the emergency brake on the reckless expansion of MAID just a year ago. Given the chance, there would be a wide expansion of MAID, and not just to those who are suffering from mental illness and addiction. This expansion of doctor-assisted suicide cannot be carried out safely or justly. It is difficult, if not impossible, to determine the irremediability of a mental disorder in individual cases, meaning we cannot say, with the certainty that is required in a matter that truly is life or death, whether a person suffering from mental illness will get better. In appearing before the Special Joint Committee on Medical Assistance in Dying, on which I sat as a vice-chair, Dr. Jitender Sareen, a physician in the department of psychiatry at the University of Manitoba, testified, said: We strongly recommend an extended pause on expanding MAID to include mental disorders as the sole underlying medical condition in Canada, because we're simply not ready. In our experience, people recover from long periods—“long” meaning decades—of suffering with depression, anxiety, schizophrenia and addictions with appropriate evidence-based treatments. We strongly believe that making MAID available for mental disorders will facilitate unnecessary deaths in Canada and negatively impact suicide prevention efforts. The clinical role is to instill hope, not to lead patients toward death. Dr. Sareen went on to say: Unlike physical conditions that drive MAID requests, we do not understand the biological basis of mental disorders and addictions, but we know that they can resolve over time. The real discrimination and lack of equity is not providing care for people with mental disorders and addictions. I could not agree more with the doctor. We have a moral obligation in our society to ensure that every person is treated with the inherent dignity and value with which they are created, everyone. They do not get that when we offer them death instead of help and hope, treatment and care. Psychiatrists and even the Prime Minister's so-called expert panel cannot know if someone is going to recover from mental illness, and this under a government where wait times for psychiatric treatment can be over half of a decade. If the government goes ahead with this, people who would have gotten better will not get the chance, because they will have been killed at the hand of the government. Further, it is difficult for a clinician to distinguish between a rational request for medical assistance in dying where mental illness is the sole underlying medical condition and one motivated by suicidal ideation. On the question of suicidality, Dr. Sareen said: ...there is no clear operational definition differentiating between when someone is asking for MAID and when someone is asking for suicide when they're not dying. Internationally, this is the differentiation. If somebody is dying, then it can be considered MAID. When they're not dying, it is considered suicide. On the same question, Dr. Tarek Rajji stated, “There is no clear way to separate suicidal ideation or a suicide plan from requests for MAID.” With the line being blurred between suicidal ideation and so-called rational requests for medical assistance in dying, evidence from jurisdictions that have assisted suicide for mental disorders, both suicides and medically facilitated death go up. We cannot move forward with this dangerous game that the government is playing, the plan of moving full steam ahead no matter what the cost. The minister said that the Liberals had the moral imperative to move ahead with an assisted suicide regime. Hopelessness and misery, that is their imperative. A moral imperative? It is immoral. This is the same government that has degraded life in the country to the point where an entire generation of people is giving up hope. Two million Canadians are lined up at food banks a month and once former middle-class families are living in their cars. People are being offered MAID instead of a wheelchair, after serving our country and going to veterans affairs for help. People are being offered MAID at routine doctor appointments. People are seeking MAID because they cannot afford housing. People are seeking MAID because they cannot get the psychiatric care they need. This is blind ideology ahead of evidence. It is death on demand for any reason. Depression, anxiety, schizophrenia, personality disorders and addictions will all become justifications for death under the Liberal government if this plan is allowed to be carried forward. A new generation of addicts will have been created, by normalizing and legalizing opioids that are being peddled to our children. The MAID regime seems like it will become the government's plan for addictions. Rather than offering treatment and a chance to get better to people who are suffering, they are being offered death. There is hope yet, if we pass this bill, that we could stop the expansion of MAID to people who are suffering. We can make a commitment, as the representatives of Canadians, to deliver on the health, help, hope and treatment that Canadians deserve, that every human person deserves. Dignity, respect, hope and life, that is what we are going to have to vote to protect. I am proud to stand and vote in support of life.
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  • Feb/15/24 11:18:12 a.m.
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Madam Speaker, I do not believe that this is a question of religion. I think it is simply a question of humanity and how we care for the most vulnerable among us. This is an imperative that we have as parliamentarians. Ensuring that we care for the least of us, those who are most in need of our help, is the highest calling we can answer. To allow MAID for folks whose only medical condition is mental illness would be an abdication of that. Allowing state-sanctioned death, or doctor-assisted suicide in that case, is an abdication of our responsibilities to the most vulnerable, regardless of one's beliefs or creed.
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Madam Speaker, I am glad to be joining debate on Bill C-62. Off the top, I will mention that I will be voting for it. Like the shadow minister for justice on the Conservative side said, this is about protecting the vulnerable. Though the federal government has dropped the ball in this latest iteration of its legislation, these three years, I hope, will be taken to basically fix the mistakes that were made all the way back to Bill C-14. I want to talk a little about what brought us to this moment, and then refer to some constituents of mine who have emailed me over the last few months on the issue of assisted suicide. I will also mention that I am sharing my time with the member for Mission—Matsqui—Fraser Canyon. I am sure he will add more to this debate. To go back to the beginning, not too far to the beginning because I could get into Genesis, the Carter decision is what kicked off multiple debates that I have now been a part of. I have now seen this debate go from Bill C-14 to Bill C-7 to Bill C-62, and the attempts by my hon. colleague from Abbotsford, who, I think, tried to do right by vulnerable Canadians all across Canada to make sure that we would not see an expansion of the MAID provisions to those who are still suffering with mental health conditions. The great thing about Hansard is that I was able to go all the way back and review what I had said on Bill C-14. I spent quite a bit of time complaining that the reasonably foreseeable clause would be knocked down by a court. It was knocked down by a court in the Truchon decision, because all our deaths are reasonably foreseeable; that is what living is all about. At the time, I had said that all of us who are born are born with one foot in our grave. One is assured one will die; one does not know just what it is, but it is reasonably foreseeable. I am just repeating it now. I know that it is morbid, but it is the truth. A lot of what we are dealing with here are issues of life and death and how one's death will happen. Therefore, at the time, this reasonably foreseeable clause would get knocked down, and it was knocked down in the Truchon decision. My issues, just generally, are that, in a perfect world, this would not be necessary because people would not suffer. However, because this world is not perfect, people do suffer. People suffer in deep and different ways. Members know that I had a disabled daughter who passed away a few years ago. Had she lived longer, and I know at least one little girl in Calgary who has lived much longer with the same conditions my daughter had, she would be one of those vulnerable Canadians who would be facing the possibility that her physician, her specialist, might push for and might offer MAID. I say “offer MAID”, but it seems so weird to say “offer MAID”, to offer something that I do not consider to be a medical service and to rush one's death sooner. Although we all die, as I said many Parliaments ago, the act of dying is not one that one does alone; it is done as a family, as a group of friends and with those loved ones around. It is not something that happens in solitude. There are others who will miss one when one is gone. I know that it is difficult in a moment of suffering and a moment of great pain, or chronic pain, to believe it, to know it. A lot of the emails, the correspondence and the meetings I have had were with people who are worried about the assisted suicide MAID provisions, which the government has ineffectually dealt with through successive pieces of legislation. I think it was a grave error not to appeal the Truchon decision. I really do. I think it was a mistake. I said it to constituents at the time. I have a Yiddish proverb, because I always do. They are great proverbs, and everybody should live by them and should know more of them. I just wish I could pronounce them in Yiddish: The truth never dies, but it is made to live as a beggar. This legislation is a beggar. This legislation should have been a permanent fix to the issues. I think that Conservatives have suggested, both in committee and outside of committee, what some of those fixes would be. Although I disagree with an acronym, I will use RFND, reasonably foreseeable natural death. It should be limited to those who are terminally ill, where their death is foreseeable within the next six months, where there is a prognosis from a medical professional saying that one will indeed pass away. For those most terrible conditions, I am thinking of a lot of cancers. My grandfather passed away from brain cancer in Canada, which brought my family to Canada. His death was very much reasonably foreseeable when it was terminal. There are others who have mental health conditions, which are caused by a physical condition. The mental health condition alone should not be the reason to seek assisted suicide. Different Conservatives have mentioned, and I very much agree with this, that patients should be the ones requesting it. These are all things the government could have legislated into law. These are things that experts have said, and I want to read some of what the experts said in different committees. Professor Trudo Lemmens and Mary Shariff persuasively rebutted a bunch of arguments that were made in Truchon. They noted again that reasonably foreseeable natural death applied to “all” persons, “not only to persons with disabilities”. “The judge in Truchon failed to appreciate how such a restriction reflects a constitutional duty to protect the equal value of the lives of all Canadians.” I have read the Carter decision twice now. As many in the House know, this is something I take pride in saying that I am not a lawyer. I am not burdened with a legal education. I know the member for Fundy Royal is disappointed and that the member for St. Albert—Edmonton will be disappointed too, so I come to this as a layperson. Even the Carter decision did not say he had a right to die. It goes back to this idea, like I have said, that all of our deaths are reasonably foreseeable. It will happen; it is unavoidable in life. These two experts said that the judge in Truchon made a mistake. This concept, this expertise, was then repeated in observations made by 72 disability rights organizations that penned a letter to the then justice minister. They said that reasonably foreseeable natural deaths are the ones where there is terminal illness that is coming up very quickly, and that this idea is an equalizing effect, guaranteeing a common thread among persons accessing MAID, assisted suicide, namely that they are dying within a very short time window. That is how I think this legislation should work. I am not saying there should be no MAID. The Carter decision stands as a Supreme Court decision in Canada, so there has to be a provision of it in a method. It should be rare and should be restricted to the very few people for whom it was originally intended. I feel that Bill C-14 to Bill C-7 to the situation we are in today do not address that. That is why we have this legislation that is a beggar. It is not in the original form that it should be. The truth lies in abiding by what Carter decided. Another one reads, “From a disability rights perspective, there is a grave concern that, if assisted dying is made available...regardless of whether they are close to death, a social assumption might follow (or be subtly reinforced) that it is better to be dead than to live with a disability.” That is a terrible message to send to persons with disabilities. I am thinking of my daughter, had she lived. That would have been a terrible message to send to her. All three of my living kids have a chronic kidney condition. My boys will likely need a kidney transplants. What a terrible thing to tell them, that they are a burden on the medical situation and that maybe they should seek faster death. Is that what specialists are going to tell them when they are adults? I will not be in the room, but they will be in the room. Will that be pushed onto them? For those who are on dialysis, it is hard on their bodies to go three to four days a week to get dialysis in a hospital setting. I am not speaking of peritoneal dialysis that can be done in the home. There have been lots of experts. The member for Fundy Royal explained a lot of what has been said on the issue. The government keeps erring in the wrong direction with more expansive legislation to allow more people to access something that was not the original intention of Carter. We should abide by Carter, as I mentioned before. I have had constituents write to me. I just want to make sure that I read some of their thoughts into the record. Leanna wrote, “Please Halt the expansion of MAID to include those facing mental illness.” Catherine wrote, “As a parent who has seen my own children experience mental health challenges while in their teen years and early twenties, I am writing to express my deep concern about people with mental illness alone becoming eligible for medical assistance in dying. The move towards this will put countless vulnerable people at risk.” Joe, in my riding, is a regular writer. I respond to most of his emails. I will send this to Joe just to make sure he knows I read his emails. His second and third points read, “By offering MAID for mental illness governments may put less money into treating mental illness.... Canadians may wish for MAID because of despair. They have not have been offered treatment for their mental illness.” Cameron talked about a friend of his who is a nurse working in a mental health unit in Calgary. Mental health for him is all about seeing the intrinsic value of every human being, as celebrating the person not for what they contribute but for the beauty of their existence. He feels that once we stop seeing the dignity of one person, we will doubt our own worth and validity. I know my time is running short, so I will not belabour this. I have heard comments from some members of the House who have tried to impugn a person's faith, religion or philosophical affiliations with whatever beliefs; although, all of us come to the House with our different beliefs. Some of them are sacred. Some of them are secular. It really does not matter where they come from, but all of us try to ascribe value to life, what that life is and what autonomy should be like. To those members, I note that I did abstain from one vote that was specifically on advance directives because I have a constituent, Jim, who communicated with me over email that he and his spouse saw the experience of his mother, who passed away from Alzheimer's, and how terrible it was. In situations like that, it is incumbent upon the government to find a way to meet the requirements of the original Carter decision so that Jim and his spouse, when that time comes, can have their wishes met.
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Mr. Speaker, I rise today to address a question of paramount importance and profound concern to many of my constituents in Lambton—Kent—Middlesex: Will Canada cross the Rubicon and expand access to assisted suicide for otherwise healthy individuals whose mental disorder is the sole underlying medical condition, or do we have enough common sense and moral clarity to stop this radical and dangerous expansion of MAID to mental health cases? The issue at hand stands at the juncture of ethics, medicine and our societal values. This is not merely a policy decision. It is a profound moral question that strikes at the heart of who we are and how we value life and respond to suffering. The core concern here is the difficulty, if not the impossibility, of determining with certainty that mental disorders are irreversibly incurable. Unlike many physical ailments, the trajectory of mental illness is often unpredictable and can respond to treatment over time. The NDP-Liberal government's push toward expansion, despite substantial opposition from medical professionals and the public, raises serious questions. It reflects a troubling trend of policy-making that seems to prioritize ideological considerations over careful, evidence-based deliberation. How can we, in good conscience, move forward with a policy that many experts in psychiatry and mental health view with significant trepidation? The opposition from the medical community, particularly from mental health professionals, is not just significant but deeply insightful. The expert panel on MAID and mental illness, the very panel established by the government to study this issue, acknowledged the complexities involved. It noted the difficulty in predicting the long-term prognosis of mental disorders, underscoring the near impossibility of determining with certainty whether a mental disorder is truly incurable. Leading psychiatrists across Canada have expressed reservations. The Association of Chairs of Psychiatry in Canada, which includes the heads of the psychiatry departments of all 17 medical schools in the country, called for a delay in implementing MAID for patients with mental disorders as the only underlying medical condition. Its concerns centre on the challenges in assessing incurability and differentiating genuine MAID requests from suicidal ideation rooted in treatable mental health conditions. Surveys conducted within the psychiatric community reflect this opposition. For instance, a significant majority of Manitoba psychiatrists have indicated that Canada is not ready for the implementation of assisted suicide for patients with mental disorder as the sole underlying medical condition. A similar sentiment was echoed in a survey conducted by the Ontario Medical Association, where a two-to-one majority of respondents opposed the availability of MAID for such cases. These results are in line with public opinion, which has consistently shown discomfort with this expansion. In fact, I have heard from hundreds of residents of Lambton—Kent—Middlesex who are opposed to this expansion, and polls such as those conducted by Angus Reid reveal substantial public reservations about MAID for mental illness. If we ignore experts' warnings and the public sentiment and proceed with this expansion, we risk making irreversible decisions in cases where there might be potential for recovery and improvement with the appropriate treatment. The ethical implications of such a scenario are profound and disturbing. In our examination of this issue, we must not overlook the societal context in which decisions about MAID are being made. The CEO of Food Banks Mississauga recently issued a stark warning that the inability to afford basic necessities is pushing people towards considering MAID. This is a harrowing indication that, for some, the choice to pursue assisted dying may be influenced more by socio-economic despair rather than by unimaginable physical or mental health conditions. This revelation is deeply troubling. It compels us to question whether we are addressing the root causes of such despair or merely offering a tragic and irreversible solution to what are fundamentally social and economic problems. This is particularly concerning in light of the ongoing mental health crisis that was exacerbated by the COVID-19 pandemic and the government's divisive response. Additionally, we must also reflect on the alarming reports concerning our veterans. There have been stories of veterans being offered MAID. This raises profound concerns about the support and care that we provide to those who have served our country. These individuals, who have sacrificed so much, deserve better than an expedited path to assisted death. These stories underscore the need for robust mental health support and the dangers of expanding MAID without adequately addressing these needs first. When the Liberal government has such a cavalier attitude toward assisted suicide, with a one-way slope toward access expansions and safeguard removals, is it any surprise that, according to the latest available numbers, the annual growth rate of MAID between 2021 and 2022 was 31.2%? Between 2016 and the end of 2022, 44,958 people died by MAID. That is more than the number of Canadians who died in military service during World War II. My point is that Canada's current MAID access may already be the most discretionary in the world. That is before the proposed mental health expansion. We are the only country whose legal system does not see assisted suicide as a last resort. What can we expect to happen to the growth rate if the House enables the “treatment” of mental illness with assisted suicide? We would be past the slippery slope concern if that were to happen. Crossing the Rubicon here would put us closer to free fall. Why are we debating the radical expansion of assisted suicide? Just four months ago, the hon. member for Abbotsford's bill, Bill C-314, was in the House. Conservatives urged the House not to give up on Canadians living with mental illness. Nevertheless, the government voted against the bill, sticking to its original plan, as per Bill C-7, to expand access to MAID to Canadians who are healthy except for their mental disorder. If it were not for the Special Joint Committee on Medical Assistance in Dying's tabling, on January 29, 2024, its findings and recommendations, the unprecedented MAID expansion would have been implemented within two months. Thankfully the committee, after extensive consultations and a review of expert testimony, concluded that Canada is not ready for the expansion of MAID to include cases where a mental disorder is the sole underlying medical condition. The report highlights the unresolved issues in accurately assessing the irremediability of mental disorders and the challenges in distinguishing between genuine requests for MAID and those stemming from treatable mental health conditions. The report confirms what common-sense Conservatives have been saying for months: Expanding assisted suicide to those suffering from mental illness would result in the deaths of those who could have gotten better. That is why, just like last year when the government introduced eleventh-hour legislation to put a temporary one-year pause on expanding assisted suicide to those suffering with mental illness, we are once again here at the eleventh hour. There is no question that there is an urgent need to pass Bill C-62 to delay until 2027 the implementation of MAID in cases where a mental disorder is the sole underlying cause and condition. As highlighted by the report of the special joint committee and the voices of experts and Canadians alike, a mere delay may not suffice. What is required is a comprehensive re-evaluation of our approach to MAID, particularly in the context of mental health. The issues at stake are not just medical or legal but are deeply rooted in our societal values and the respect we need to afford the dignity of human life, especially in its most vulnerable forms.
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