SoVote

Context: House Hansard - 283 - Feb/15/24

Mr. Todd Doherty (Cariboo—Prince George, CPC)

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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Mr. Yasir Naqvi

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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Mr. Charlie Angus (Timmins—James Bay, NDP)

Feb/15/24 10:45:05 a.m.
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Madam Speaker, the issue of what guidelines should be in place to allow someone to die is perhaps one of the most profound things we have to discuss. Parliament agreed to move forward with MAID, and we expected that we were going to get a review. Instead there was a Quebec provincial court decision, the Truchon case. The federal government did not appeal the decision; it just rewrote the law. Then the Senate, an absolutely unaccountable, dismal group as far as I am concerned, decided to just throw in an arbitrary date to allow people with mental illness to die, and the government accepted it. We are now scrambling, with a month left. The government is saying it is going to put some guardrails in place to punt it down the road. Why is the government not taking the issue seriously? The member for Abbotsford's bill would have dealt with this. The government has put us in this situation, and it is not credible.

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Mr. Yasir Naqvi

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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Mr. Luc Thériault (Montcalm, BQ)

Feb/15/24 10:46:51 a.m.
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Re: Bill C-14

Madam Speaker, we just witnessed a great NDP-Conservative coalition. The member is reiterating the Conservatives' argument to the effect that the ruling in Gladu and Truchon was not challenged before the Supreme Court. However, the reason why it was not challenged before the Supreme Court is that people were suffering and Ms. Gladu and Mr. Truchon deserved to have relief. This was based on the Carter decision. However, the NDP voted against Bill C-14, which did not go far enough. I do not know why the member is being so inconsistent today. I would like to know whether the member is aware that, basically, his party is trying hard not to say that it lacks courage, that it is backing down when it comes to mental illness and that it is throwing the ball back into the court of the Conservatives who, as they announced, are going to do away with all of this.

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Mr. Yasir Naqvi

Feb/15/24 10:47:50 a.m.
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Re: Bill C-62

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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Mr. Ken Hardie (Fleetwood—Port Kells, Lib.)

Feb/15/24 10:48:50 a.m.
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Madam Speaker, as the provinces and territories are not ready to implement medical assistance in dying for people with mental disorders, personally I am also not ready. I could not vote for something like it right now. I am taken by the case of a woman, E.F., who was granted the right to have her life taken with medical assistance in 2016, after reports that she suffered from severe conversion disorder. Nobody could read the media accounts of this and not understand that there are some people for whom life is clearly not worth living anymore. Would that provision, in the Court of Appeal decision in Alberta, still provide a way forward for the people who are in a terrible condition right now and who need relief?

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Mr. Yasir Naqvi

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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Hon. Rob Moore (Fundy Royal, CPC)

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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Mr. Yasir Naqvi

Feb/15/24 10:51:35 a.m.
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Re: Bill C-62

Madam Speaker, this is a very sensitive issue. It is highly emotional and complex. I would urge all members that calling names and ascribing labels is not the responsible way forward. Canadians are looking to us to make responsible decisions. That is why it is incumbent upon us to work with everyone, including the legal community. The hon. member across the way knows that if we talk to 10 lawyers we will get 10 different legal opinions on any matter. Most importantly, we need to work with health care professionals and understand from them what is required with respect to all the appropriate safeguards. Last but not least are the provinces and territories, which are primarily responsible for delivering health care. We need to listen to them carefully, and they are asking for an extension. That is what Bill C-62 is doing.

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Hon. Ed Fast (Abbotsford, CPC)

Feb/15/24 10:52:40 a.m.
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Madam Speaker, I seek unanimous consent to split my time with the member for Leeds—Grenville—Thousand Islands and Rideau Lakes.

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The Assistant Deputy Speaker (Mrs. Carol Hughes)

Feb/15/24 10:52:48 a.m.
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Does the hon. member have unanimous consent to split his time? Some hon. members: Agreed.

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Hon. Ed Fast

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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Mr. Francis Scarpaleggia (Lac-Saint-Louis, Lib.)

Feb/15/24 11:02:00 a.m.
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Madam Speaker, the member and I sat on the third edition of the special joint committee together. I know the member is a lawyer, and my question is really a legal one. I agree with the recommendation of the committee for an indefinite delay, but does he expect that this case will come up at the Supreme Court eventually? What does he think the reasoning of the court might be, given that the definition of irremediability in law is very different from irremediability in clinical medical practice, which requires a bit more certainty? There is a tension between the two, so I would be interested in his perspective on that.

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Hon. Ed Fast

Feb/15/24 11:02:49 a.m.
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Madam Speaker, let me first of all thank that member for bringing such a thoughtful approach to our work at the committee and now here in the House. I agree with him that we should have an indefinite pause on this expansion, but with respect to the Supreme Court of Canada, I think it would be wrong to presume what the court might read into any additional changes that might happen. We do know that the federal government refused to appeal lower court decisions, like the EF decision in Alberta and the Truchon case in Quebec, to the Supreme Court of Canada, which is where this type of final decision should rest. I expect fully that eventually a case will make its way up to the Supreme Court of Canada, and the Supreme Court of Canada will opine whether the Carter decision should go beyond just the incurable, intolerable illnesses where death was reasonably foreseeable and should in fact include vulnerable populations like the mentally ill.

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Mr. Luc Thériault (Montcalm, BQ)

Feb/15/24 11:03:54 a.m.
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Madam Speaker, my colleague complains that people are accusing him of fearmongering, but he is unable to use the right technical terms to debate this issue. The Council of Canadian Academies does not refer to children. Referring to children in general shows a lack of intellectual rigour in a debate like this. The right term is “mature minors”. For example, at the age of 15, Charles Gignac was diagnosed with a cancer that ate his bones. He was fit as a fiddle, an athlete with a very strong heart. He suffered for two years because he was not eligible for medical assistance in dying. He requested medical assistance in dying. He passed away at 17 years and 10 months, without MAID, in pain and anguish. What treatment did he receive? He was given palliative sedation because no one was able to relieve his suffering. After he received palliative sedation, his loved ones watched him spend 24 hours in an agitated, delirious state before he died. Is that what my colleague calls compassion?

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Hon. Ed Fast

Feb/15/24 11:05:08 a.m.
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Madam Speaker, I am deeply disturbed that individual would actually promote assisted death for children. Let us not forget this. The suggestion is not only that this would be assisted death for mature minors. There is the suggestion that parents would not have the final say over whether their children would be euthanized. This is appalling. Is this the state of our country, where we have parties in the House of Commons actually promoting the deaths of children when in fact they can be helped and treated? We can do better as a country; I know we can.

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Mr. Charlie Angus (Timmins—James Bay, NDP)

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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Hon. Ed Fast

Feb/15/24 11:06:43 a.m.
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Madam Speaker, I want to thank my colleague for his work at the Special Joint Committee on Medical Assistance in Dying, where we did excellent work in coming up with a recommendation, which unfortunately the government did not choose to follow in its entirety. We had called for an indefinite pause. Unfortunately, the government felt an arbitrary three years was sufficient. To answer his question, I have great concern the government's promises to deliver improved palliative care supports to the provinces and to deliver improved mental health supports to them have not been fulfilled. Now people are asking for death because they are not getting those supports. That truly is sad.

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Mr. Michael Barrett (Leeds—Grenville—Thousand Islands and Rideau Lakes, CPC)

Feb/15/24 11:07:36 a.m.
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Re: Bill C-314

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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