44th Parl. 1st Sess.
February 15, 2024 10:00AM
Mr. Speaker, I am thankful for the opportunity to speak about Bill C-62 and the extremely important issue of medical assistance in dying, or MAID, and mental illness.
I think all members can agree that this is a highly complex, quite sensitive and emotional issue, that raises divergent and deeply held views from the medical community, experts and the public at large. The questions of whether, how and when to expand eligibility for MAID to persons whose sole underlying medical condition is a mental illness are difficult; they do not have easy answers.
The federal government believes that eligibility for MAID should be expanded to such persons. However, such an expansion should not be rushed and should not occur before the health care system is ready to safely provide MAID in all cases where it is requested on mental illness grounds. This is why we have introduced Bill C-62, which proposes to extend the temporary mental illness exclusion by three years, until March 17, 2027. The bill also includes a provision requiring a parliamentary review prior to that date.
As members will recall, in 2015, the Supreme Court of Canada concluded in the Carter case that the Criminal Code’s absolute prohibition on physician-assisted death was unconstitutional. The Supreme Court held that physician-assisted dying must be permitted in some circumstances, namely, for competent adults who clearly consent to the termination of life and who have a grievous and irremediable medical condition. This decision led to the legalization of MAID in Canada one year later, in 2016, through Parliament’s enactment of former Bill C-14. Our original MAID law limited eligibility for MAID to competent adults with an eligible medical condition whose natural death was reasonably foreseeable. Our MAID framework was added to the Criminal Code and was made up of a stringent set of eligibility criteria, as well as procedural safeguards to prevent error and abuse in the provision of MAID.
A few years later, the “reasonable foreseeability of natural death” eligibility criterion was challenged in Quebec; in 2019, it was declared to be unconstitutional by the Superior Court of Quebec in the Truchon decision. As this was a trial-level decision, it was only applicable in Quebec. Nevertheless, the Attorney General of Canada did not appeal the decision; instead, the federal government made the policy decision to expand eligibility for MAID. This led to Parliament’s enactment of former Bill C-7 in 2021, which expanded eligibility for MAID to persons whose natural death is not reasonably foreseeable. This resulted in the removal of the eligibility criterion that a person’s death be reasonably foreseeable and the creation of two sets of procedural safeguards for the lawful provision of MAID.
The first track of safeguards applies to persons whose natural death is reasonably foreseeable; the second, more robust, track applies to persons whose natural death is not reasonably foreseeable. This second set of safeguards was created in recognition of the fact that requests for MAID by persons who are not at end of life are more complex. This is why a minimum of 90 days must be taken to assess a person for eligibility for MAID when their natural death is not reasonably foreseeable. This is not a reflection period; it is a minimum assessment period. This safeguard aims to respond to the additional challenges and concerns that may arise in the context of MAID assessments for persons whose natural death is not reasonably foreseeable. This includes whether the person’s suffering is caused by factors other than their medical condition, as well as whether there are ways of addressing their suffering other than through MAID.
This second set of safeguards also requires that two practitioners be satisfied that the person meets all the eligibility criteria, and if neither of them has expertise in the medical condition causing the person suffering, one of them must consult with a practitioner who does. Involving a practitioner with the relevant expertise aims to ensure that all treatment options are identified and explored.
Practitioners are also required to inform the person of available counselling services, mental health and disability support services, community services and palliative care; to offer them consultations with the relevant professionals; and to ensure that the person has given serious consideration to such alternative means to alleviate their suffering. Although this does not require a person to undertake treatments that may be unacceptable to them, it requires that they fully explore and weigh the risks and benefits of available treatment options.
Former Bill C-7, as originally introduced, permanently excluded eligibility for MAID on the basis of a mental illness alone. This was not because of the incorrect and harmful assumption that individuals who have a mental illness lack decision-making capacity or because of a failure to appreciate the severity of the suffering a mental illness can cause. Rather, this was done because of concerns about the inherent risks and complexities of permitting MAID for individuals who suffer solely from mental illness.
During its consideration of the bill, the Senate made an amendment that added a sunset provision that would repeal the mental illness exclusion 18 months later. The House of Commons accepted the amendment in principle, but changed the date of repeal to two years; in other words, the provision of MAID based on a mental illness alone was set to become lawful on March 17, 2023.
The decision to temporarily maintain the exclusion of eligibility was based on the recognition that additional study would be required to address the risks and complexities of permitting MAID in these circumstances. This is why the former bill also included a requirement for an independent expert review respecting recommended protocols, guidance and safeguards to apply to such requests for MAID.
Former Bill C-7 also required the creation of a joint parliamentary committee tasked with conducting a comprehensive review of the Criminal Code's MAID provisions and other MAID-related issues, including MAID and mental illness. The committee undertook this important work, and its interim report, which focused on MAID and mental illness, was tabled in June 2022. It urged the federal government to collaborate with regulators, professional associations, institutional committees and the provinces and territories to ensure that the recommendations of the expert panel were implemented in a timely manner.
The committee's second report was tabled in February 2023. The majority view expressed was that eligibility for MAID on the basis of a mental illness alone should be permitted. However, the final report also raised a key concern that more time was needed for standards to be developed and training to be undertaken before the law should permit a mental illness to ground a request for MAID. The federal government recognized the significant progress that had been made by the provinces and territories, stakeholders and the medical community in preparing for the expansion. However, it ultimately concluded more time was needed.
This is why we introduced Bill C-39, and Parliament enacted it. It extended the exclusion by one year, until March 17, 2024. This extension aimed to provide additional time for the dissemination and uptake of key resources by the medical and nursing communities. We thought it essential to prepare for the safe assessment and provision of MAID in all cases where a mental illness grounds a request for MAID. The committee expressed support for the extension in its second report.
I want to take a moment to recognize the work that the federal government has done during this extension to support the fulfillment of some of the expert panel’s recommendations. For instance, we amended the regulations for the monitoring of MAID last year to ensure comprehensive data collection and reporting. Such changes allow for data collection related to race, indigenous identity and disability of persons requesting MAID. These changes came into force in January 2023, and the first set of data will be captured in Health Canada’s 2024 annual report on MAID.
Moreover, Health Canada convened an independent MAID practice standards task group to develop a practice standard for MAID. In March 2023, the model MAID practice standard and supporting documents that provide guidance to support complex MAID assessments were released. Finally, Health Canada supported the Canadian Association of MAiD Assessors and Providers in the development of a Canadian MAID curriculum, which was launched in September 2023.
In Canada, certain aspects of MAID fall under federal jurisdiction and others fall under provincial and territorial jurisdiction. The federal government is responsible for the criminal law aspect, whereas the provinces and territories are responsible for the implementation of MAID within their health care delivery systems. Impressive progress has been made in preparing for the expansion by the March 2024 deadline. However, the provinces and territories have all expressed that they are not yet ready. For this reason, we are proposing to extend the temporary mental illness exclusion for another three years, until March 17, 2027.
The extension would allow more time for the provinces and territories, and their partners, to prepare their health care systems by implementing regulatory guidance and developing additional resources for their medical and nurse practitioners. It would also provide more time for medical and nurse practitioners to become familiar with the available training and supports. Our ultimate goal is to help ensure that the necessary protections are in place to protect the interests of individuals who may seek MAID on the basis of a mental illness alone.
We believe that this issue should not be rushed. Eligibility for MAID should not be expanded until the health care system is ready to safely provide MAID in these complex circumstances. I urge all members to support the bill so our partners can get this right.
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- Feb/15/24 10:42:57 a.m.
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Madam Speaker, I have sat through much of this debate, on the committee as well. The provinces and territories did not ask for a three-year pause; they asked for an indeterminate pause because they are not ready. Industry is not ready. The health care professionals cannot come to any conclusions.
As a matter of fact, Dr. Gaind, a professor of psychiatry at U of T, summed it up best at the committee last night. He said, “once again, there is no evidence that shows we can predict irremediability in mental illness, and it is vastly different from other medical conditions and neurodegenerative diseases...but we have to remember what MAID is about. It is about us predicting who will never get better, and we can't do that. And if we can't do that with mental illness, we would be providing death under false pretenses.” He equated it to being much like flipping a coin to choose who could get better and who could not. MAID would simply be killing people who could possibly get better.
What would my hon. colleague say to that?
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- Feb/15/24 10:44:08 a.m.
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Madam Speaker, the hon. member and I were both at the committee last night, which heard from quite a few experts on MAID. I think it was fairly clear that there was a difference of opinion as to the readiness of the system. There were some experts who believe that MAID for people with mental illness could be provided as early as March 17, 2024.
However, the member is right. There is a letter from seven provinces and three territories that have asked for an extension to the period. The government feels that a three-year period is the right amount of time for the medical profession and the provinces and territories to be ready to be able to provide MAID to people with mental illness, with appropriate safeguards.
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- Feb/15/24 10:46:08 a.m.
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Madam Speaker, I will take exception to the member's comment because a tremendous amount of work has been done to create the appropriate safeguards. Not only are there legislative safeguards in place in the Criminal Code, which I alluded to in my remarks, but there are also safeguards being developed within the medical profession.
We need to make sure we listen to our health care providers, those who deliver health care at the provincial and territorial level, and extend the date for the change in eligibility criteria for three years so MAID could be administered with all the appropriate safeguards in place.
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Madam Speaker, the government is taking the most prudent approach in making sure people get the care they need. This is a very sensitive issue that requires that we work closely with medical professionals to ensure that all the appropriate safeguards, training and associated curriculum are in place. If there is doubt, as we see by the request that we create an extension, it is only prudent for the government to do so. That is why we are encouraging all members to support Bill C-62 and extend the pause on eligibility for MAID on the sole basis of mental illness by three years.
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- Feb/15/24 10:49:41 a.m.
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Madam Speaker, our number one job is to protect people's rights. Given that the various decisions of the courts have said that it is a person's right to determine their end of life, we need to make sure that right is protected.
Of course we need to ensure that they get all of the care they need in order to be able to recover, but as the courts have said, if their suffering is irremediable, they should have that option available because it is a matter of their rights. That is why we are working so hard, along with our provincial and territorial partners, to ensure that all the right safeguards and all of the right training are in place before MAID is extended to people whose sole underlying condition is mental illness.
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- Feb/15/24 10:50:43 a.m.
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Madam Speaker, we know we are in this situation because a radical justice minister and a radical government have pushed this agenda.
I want to get the member's thoughts on this quote from 32 law professors. They state:
We disagree as law professors that providing access to MAiD for persons whose sole underlying medical condition is mental illness is constitutionally required...as Minister Lametti has repeatedly stated.
I asked the minister, when he appeared at the justice committee, who was right, these 32 legal experts or him. He said, of course, that he was right.
I want to ask the member this. Does he believe that these 32 legal experts are right or that the former minister of justice was right?
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- 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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- 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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- Feb/15/24 11:50:28 a.m.
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Madam Speaker, I congratulate my colleague for his responsible speech. Scaremongering is absolutely deplorable. That said, even though the Conservatives make a habit of scaremongering, I consider it our duty to address any reasonable apprehensions that the public may have.
Obviously, MAID is a permanent and irreversible solution. Could my colleague briefly tell us how MAID precludes the possibility of rash decisions and how it will be implemented in a structured, responsible and reasonable way?
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- Feb/15/24 11:51:05 a.m.
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Madam Speaker, first of all, we have to start from the premise that all health care workers are basically caring and compassionate people. The premise of MAID's opponents is based on their belief that certain fundamentally malevolent and evil people want to get rid of vulnerable members of our society.
It seems rather surprising that the Conservatives, as economic libertarians, believe that the state should get mixed up in such a personal decision as an individual's death. The reason is that other determinants are at play. I have asked them repeatedly why they think that they are in a better position to make that decision than the person who is suffering. Today, I will say the thing they lack the courage to admit: it is because of religious beliefs.
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Madam Speaker, that was a passionate speech by the member. He spoke in particular about northern Canada, where maybe the resources are not the same as those Canadians enjoy in metro areas. He also brought up the Senate situation.
I think we are seeing in the House of Commons these days that we are having issues with the Senate, in particular with Bill C-234, which we have brought back several times here, and the MAID legislation. This is a concern. As the member said, they are not elected. They are appointed. It has caused some strain on families, not only with the MAID legislation but also for the agriculture sectors with Bill C-234.
I just wanted to point that out and have the member comment on the issues we are having with the Senate. It looks like we could have these issues for a number of years with the Senate, compared to the House of Commons.
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- Feb/15/24 12:17:36 p.m.
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Madam Speaker, a few weeks ago, I attended the funeral of a friend's mother who had decided to avail herself of MAID. In her farewell speech to her mother, my friend said the following: Mom, when you told us about your decision, I did not agree because it was going to deprive me of a mother, but I had no choice but to respect your decision, because it was yours to make.
I thought it was a testament to her generosity of spirit.
In his speech, the member for Timmins—James Bay talked about respect. Since he is so knowledgeable on the subject, I would like to ask him a question that I did not have the opportunity to ask earlier. Although it is not necessarily the subject we are debating today, I would like to know why he decided to vote against the amendment to allow Quebec to offer advance requests. The purpose of this amendment was to allow the Government of Quebec to proceed with the safeguards we have in place, and this request did not require a specific provision for Quebec in the Criminal Code. The purpose was to ensure that all provinces could use the program if they wanted to. I would like to hear why the member for Timmins—James Bay—
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- Feb/15/24 12:20:11 p.m.
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Madam Speaker, we know that a joint committee was struck, and we heard a lot of testimony, in particular, that the process in place to make this work is not there. We need the legislation to say that the right of someone to die because there are no other options out there for them is not good enough. We need to close this loophole.
We need a committee to be struck, I think, to examine how MAID is rolling out to make sure that it protects rights. Also, I think we need a conversation about proper mental health services, which are being denied to people across the country.
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- Feb/15/24 12:22:15 p.m.
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Madam Speaker, I thank the member for his advocacy on this issue.
I have heard from constituents who have given up hope, who are struggling with the housing crisis and the high cost of living and feel like that they have been legislated into poverty. They are worried about the expansion of MAID and what that means for them and the people they love who are in the same situation.
I am wondering if the member can talk about the responsibility of successive Liberal and Conservative governments in putting people in this dire situation.
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Madam Speaker, I will be sharing my time with the member for Fundy Royal.
I am pleased to have the opportunity to speak in the House today in support of Bill C-62, the bill that proposes to extend the temporary exclusion of mental illness as an eligible condition for medical assistance in dying by three years, until March 17, 2027. I will speak today about the importance of a delay before lifting this exclusion to provide more time for the provinces, territories and their health care partners to prepare for this critical juncture in the evolution of medical assistance in dying, which we refer to as MAID in Canada.
The legal framework for MAID is set out in the federal Criminal Code. However, it is the provinces and territories who have the responsibility for health care delivery, including MAID implementation. We have been working in close collaboration with the provinces and territories to support the safe implementation of MAID since before the original legislation permitting MAID was enacted in the Criminal Code in 2016. This is an important relationship built on the mutual goal of ensuring quality health care for the people of Canada.
Both the expert panel on MAID and mental illness and the Special Joint Committee on Medical Assistance in Dying emphasized the importance of clear practice standards and consistent implementation of guidelines across the country, training for physicians and nurse practitioners, and case review and oversight to support best practices and trust in the appropriate application of the law.
Provincial and territorial governments and their stakeholders, such as health care professional organizations, regulatory bodies and practitioners, have been actively planning for eligibility for MAID for persons whose sole medical condition is a mental illness. As has been recognized across the board, critical progress has been made in this regard. However, the provinces and territories face different challenges within their jurisdictions and are at varying stages of work in implementing these key elements and consequently their readiness for the lifting of the exclusion.
For example, a model practice standard for MAID was developed by an independent task force group made up of clinical, regulatory and legal experts as a resource for physician and nursing regulatory authorities to adopt or adapt in their development or ongoing revision of MAID standards. In addition to the model standard, the task group also released a companion document entitled “Advice to the Profession”.
Practice standards are developed and adopted by regulatory bodies responsible for ensuring that specific groups of health professionals operate within the highest standard of clinical practice and medical ethics. While some provincial and territorial regulatory bodies have successfully implemented MAID practice standards into their guidance documents for clinicians, others are still in the process of reviewing and updating their existing standards. To support the safe implementation of the MAID framework, health Canada supported the development of a nationally accredited bilingual MAID curriculum to support a standardized approach to care across the country. The Canadian Association of MAiD Assessors and Providers has created and is now delivering a training program that has been recognized and accredited by the appropriate professional bodies.
The MAID curriculum includes a series of training modules to advise and support clinicians in assessing persons who request MAID, including those with mental illness and complex chronic conditions, or who are impacted by structural vulnerability, as well as help with the practical application of the MAID legislative framework. The curriculum will help achieve a safe and consistent approach to care across Canada and ensure access to high-quality MAID training for health practitioners. So far, more than 1,100 clinicians have registered for the training, which is impressive given the curriculum was just launched in August 2023. This is only a portion of the workforce. More time would allow additional physicians and nurse practitioners to register and participate in the training, and to internalize these learnings and put them into professional practice.
Now let me turn to case review and oversight of MAID. In Canada there is a process of self-regulation within the medical and nursing professions. The provincial and territorial regulatory bodies, which I spoke of earlier, have a mandate to protect the public for all health care, and MAID is no exception. In addition to the presence of health professional regulatory bodies, several provinces have implemented formal oversight mechanisms specific to MAID. For example, in Ontario, the Chief Coroner reviews every MAID provision, as does Quebec’s end-of-life commission. Both of these bodies have strict policies regarding the timing and type of information to be reported by clinicians, and the Quebec commission issues annual reports.
While the provinces with formal MAID oversight processes represent over 90% of all MAID provisions in Canada, other provinces do not have formal MAID quality assurance and oversight processes in place to complement existing complaint-based oversight processes undertaken by professional regulatory bodies. Work is being planned to explore case review and oversight models, and best practices, through a federal-provincial-territorial working group, with a view to supporting consistency across jurisdictions.
All provinces and territories were united in their request to delay the lifting of the exclusion in order to have more time to prepare their clinicians and health care systems to manage requests where mental illness is the sole underlying condition, and to put the necessary supports in place. Provincial and territorial governments must ensure not only that practitioners are trained to provide MAID safely but also that the necessary supports are available to clinicians and their patients through the assessment process.
Both the expert panel and the special joint committee on MAID emphasized the importance of interdisciplinary engagement and the knowledge of available resources and treatments. Experts and practitioner communities have also expressed the need for support mechanisms to be in place for providers undertaking assessments and persons who request MAID, irrespective of their eligibility.
While some jurisdictions have robust coordination services to manage requests and provide ancillary services, other jurisdictions take a decentralized approach, which can result in less coordination across services and disciplines. The availability of necessary support services for both practitioners and patients is also variable, depending on the region. For example, we have heard about the challenges of accessing health care services generally in rural and remote areas of the country. Additional time would allow more work to be done to support patients and clinicians involved in MAID.
The Liberal government is committed to supporting and protecting Canadians with a mental illness who may be vulnerable, while respecting personal autonomy and choice. The provinces and territories are ultimately responsible for the organization and delivery of MAID and supporting health services. Given their responsibility for how MAID is delivered, moving forward before provinces and territories are ready would not be the responsible course of action.
We believe that the extension of three years proposed in Bill C-62 would provide the time necessary to work on these important elements for the safe and consistent application of MAID for persons suffering solely from a mental illness.
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- Feb/15/24 12:35:32 p.m.
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Madam Speaker, I served on the special joint committee on MAID, and the overwhelming evidence from experts, including leading psychiatrists, is that there are fundamental political problems with MAID in cases where mental illness is the sole underlying condition. This includes the difficulty in predicting irremediability and in distinguishing a request that is rational from one motivated by suicidal ideation.
What evidence can the member cite to indicate that these fundamental political problems will be resolved in three short years?
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- Feb/15/24 12:37:43 p.m.
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Madam Speaker, the short answer would be what I always say, which is that whenever we bring in legislation that fundamentally affects all Canadians, especially the kind of legislation that has never been thought of during the last 155 years, we need to take a real look at it, modify it and change it if required. I am sure there will be a time in the future when we can have a real look at the whole MAID legislation to see whether we can tweak it to better serve Canadians.
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- Feb/15/24 1:10:28 p.m.
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Mr. Speaker, we have heard from a lot of people in the disability community, advocacy groups, who advocate for persons with disabilities. They have come out very strongly against expanding MAID for people where the sole underlying condition is mental illness. I wonder if the member can speak to that, if he has heard that as well, and also to the concept that it should not be easier to get MAID than it is to access mental health and addiction treatment.
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Mr. Speaker, I obviously agree with the member. The dog that ate the government's homework has been fattened up over the last nine years, because it had a lot of homework to eat that the government has not done or pretends not to have done.
However, we had an opportunity to close the door completely with the bill from the member for Abbotsford, Bill C-314. I think it was a grave mistake of the House not to have voted in favour of it. There would have been no expansion of MAID to those with mental illnesses. The House and future Parliaments could have reviewed the situation and redecided on the matter in five, 10, 15 or 20 years. Then, there would be more data and more people looking at how the system had been used, what the demand was like, and whether there had been advances in the psychiatric and mental health services provided to Canadians. If we do not provide the service at the front end, so that a person could choose to get healing and have the ability to live a fulsome life the way they want to live it, then we cannot really be pushing MAID on the other side as the only path available to those who are vulnerable or suffering from mental illness.
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