44th Parl. 1st Sess.
February 15, 2024 10:00AM
- Feb/15/24 11:05:58 a.m.
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Madam Speaker, I think my colleague shares my concern that we are now 30-some days away from an arbitrary deadline that was imposed. We passed a national palliative care motion that I brought in 2016, and nothing was done. In 2019, we brought forward the national suicide prevention strategy that was based on the work in Nunavut. Everybody signed off, and nothing was done.
Now we are being told that we should be making it easier for people who are suffering with mental illness, people who are on the streets, people using opioids, people who are hopeless, and that we should be fast-tracking that rather than putting in place the protections needed to protect people.
What are my hon. colleague's thoughts are on that?
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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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- Feb/15/24 11:22:15 a.m.
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Madam Speaker, through action or inaction, the result is the same. By failing to help the vulnerable, by failing to offer those supports, we are condemning those people. The government is condemning those people to death. To take a positive action and offer them suicide in place of help and treatment, well, we can take a look at a thesaurus and decide whether or not that is to be described as the government killing them, but it is not reaching out a hand in help, and that is exactly what government should do.
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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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- Feb/15/24 1:09:37 p.m.
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Mr. Speaker, it is something that I also think about. The member mentioned courts, and sometimes, I feel that these court decisions should apply for six months to the judge who makes them before they apply to the rest of the public. I sometimes wonder, when they think these things through, that it goes back to too much legal information that clouds their judgment at times. This is where I worry that it is exactly that contagion effect. Does it then become permissible, broadly, that suicide and suicidal ideation are the go-to? Is that the type of society we want to, I do not think “encourage” is the right term, but do we want an acceptance of it? We have companies that promote things like Bell Let's Talk. What is the point of doing that when we have MAID provisions being expanded consistently through a series of legislation and court decisions?
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- Feb/15/24 1:38:14 p.m.
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Mr. Speaker, not every person who jumps off the Golden Gate Bridge actually dies, and in fact a study tracked down 29 individuals who survived. Some 98% of jumpers, by the way, do not survive the jump. A study of 29 individuals who survived their jump off the Golden Gate Bridge revealed that every single one of them regretted their decision to jump the moment they jumped.
I was just wondering if my colleague could reflect on the fact that suicide is a permanent solution to a temporary problem.
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- Feb/15/24 1:38:55 p.m.
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Mr. Speaker, I would like to, first of all, say that we cannot equate suicide with medical assistance in dying. They are two completely different issues. Second, I would say that yes, we absolutely need to take the time to make sure we get this right. That is why this legislation is so important. We need these three years to get our medical system up to the level where we can make sure that everyone who is granted the MAID provision truly is someone who has gone through the medical system, has taken all of the medical treatments that are available and has still reached this conclusion.
We need more time, and that is why we need this legislation.
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- Feb/15/24 1:56:36 p.m.
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Mr. Speaker, I am struck with how, during this debate, we have heard so much technical and bureaucratic language from the government. It masks what is fundamentally an ethical and moral issue, that is, the just way to treat the most vulnerable within our society. This discourse about maybe we are not ready or maybe we will be ready masks the more important underlying question of whether we should ever have the state involved in facilitating the suicide of those with mental health challenges. On this side of the House, we say a firm no, not now, not ever.
I want to ask the member if he is concerned about the dramatic growth in the rates of those opting for MAID in Canada, opting for it perhaps under pressure or in other circumstances. We have seen, since this practice started in Canada, dramatic increases every single year. Is the member concerned about that, or is he totally fine with this idea of exponential growth in the rates?
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- Feb/15/24 3:29:26 p.m.
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Mr. Speaker, I thank my hon. colleague for the shout-out. I will remind the House that it was not just me who did this; it was a team effort. We all chipped in to bring 988 to Canada.
Throughout our committee work on MAID, we found that countries that offered psychiatric medical assistance in dying had an almost a 2:1, where women applied for MAID more than men. More women are seeking MAID than men. That is troubling. I wonder if my colleague thinks this as well.
Should we not be looking at a national strategy for suicide prevention, rather than going down this road of offering medical assistance in death, medical assistance in suicide? We should be doing everything possible to help those rather than help them end their lives.
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- Feb/15/24 3:40:49 p.m.
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- Re: Bill C-7
Mr. Speaker, I have two comments.
First, my colleague says that we could have contested Justice Baudoin's ruling. However, Justice Beaudoin was referring to the Carter decision, which demonstrated in a way that people with a degenerative disease, like Ms. Gladu and Mr. Truchon, should have ended their lives. The right to life is certainly not about allowing people to commit suicide before reaching the tolerance threshold. That is the issue.
How can the Conservatives denounce suicide on one hand and say that we must be careful when it comes to suicide and all that, which I agree with, and on the other hand not understand that the only alternative for these people is to end their life? The Baudoin decision was relevant in that regard, because Bill C‑7 allowed these people to not end their life.
Second, as for the example that the member gave, I would like to say to him that the conclusion he came to himself is found in the expert panel on MAID and mental illness' sixth recommendation. I will read an excerpt:
...the Panel recommends that ‘community services’ in Track 2 Safeguard 241.2(3.1)(g) should be interpreted as including housing and income supports as means available to relieve suffering and should be offered to MAiD requesters...
If his party ever comes to power, will his government increase health transfers? We did not hear a peep from that side when the stingy Liberal government did not put anything on the table that could help us take care of the people he is talking about today.
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- Feb/15/24 3:56:03 p.m.
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Mr. Speaker, I have spoken and shared, probably a little too much at times, in this House, regarding my own family's struggles and my own struggle with suicide, and why I fight so passionately on this issue and others. I want to say a heartfelt “thank you” to my colleague across the way. I have only known him for eight and a half years, but for me that is perhaps the most profound speech or intervention that he has made.
I do want to offer this. From the testimony we have heard from the medical community, we know that seven provinces and three territories have asked the Liberal government, not for a three-year pause but, for an indefinite pause.
How does our colleague feel about that? Is that something we should look at?
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- Feb/15/24 4:44:09 p.m.
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Mr. Speaker, it was not that long ago that “made in Canada” was a phrase we were proud of.
We have teenagers who, sometimes for the very first time in their lives, are encountering adversity. It is a psychological crisis to them. They react in such a way that they are actually trying to commit suicide. It is often said that an attempt at suicide is a cry for help. They end up in the hospital for a time.
We have seen, with veterans, how some of them who seem to be near the end of life have been encouraged to use MAID.
Is there anything in this legislation that would explicitly prevent medical workers from suggesting MAID to people who attempt suicide but thankfully are not deceased as a consequence of it?
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- Feb/15/24 4:46:38 p.m.
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Mr. Speaker, we do not have the supports we need for people with mental health challenges.
The member mentioned ethnicities. I am indigenous. I am Métis. I know that a lot of indigenous, first nations and Métis groups are very concerned, because the number of suicide attempts among adults is at least double the rate in the rest of Canada's population. Among youth, it is six times higher.
It is a very vulnerable population, and this is a concern, especially for indigenous Canadians.
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- Feb/15/24 4:59:58 p.m.
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Mr. Speaker, I think it is irresponsible and untrue, honestly, to claim that MAID has anything to do with suicide. The Government of Canada recognizes the importance for all Canadians to have access to critical mental health resources and suicide prevention services. I am a member of the special MAID committee, and not one witness I heard when I was there said that this is suicidal.
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- Feb/15/24 5:02:11 p.m.
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Mr. Speaker, the member for Sherwood Park—Fort Saskatchewan just suggested that somebody like my father-in-law, who was laying in a hospital bed with a brain tumour bulging out of his head, knowing full well that it was only a matter of days before he died, and who wanted to die with some form of dignity while his family was around him—
Some hon. members: Oh, oh!
Mr. Mark Gerretsen: Can the Conservative member for Barrie—Innisfil please not heckle me just this one time, possibly?
I am wondering if the member would agree that perhaps it is extremely inconsiderate to think that somebody who realizes what the future holds for them, and who wants to die with some dignity, and that perhaps they can be saved from a bit of the pain, is thinking about more than just committing suicide?
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- Feb/15/24 5:04:18 p.m.
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Mr. Speaker, to our hon. colleague for Kingston and the Islands, our colleague for Sherwood Park—Fort Saskatchewan only said that when speaking of MAID for those with mental illness, how do we differentiate between suicidal ideation and MAID?
Indeed, it is what we are hearing from the experts who said, “There is no evidence that shows we can predict irremediability in mental illness and it is vastly different, vastly different from other medical conditions and neurodegenerative diseases.... We have to remember what MAID is about. MAID is about predicting who will never get better, and we can't do that, and if we can't do that with mental illness, we would providing death under false pretenses.”
This is completely different from what our hon. colleague talked about with this father-in-law, who was struggling with a brain tumour, choosing MAID and those who are struggling with mental illness, which has been associated with flipping a coin on who can get better and who cannot get better.
I ask my hon. colleague this: Is she okay with flipping a coin when it comes to offering MAID to somebody who is wishing to die by suicide.
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