SoVote

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

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

Feb/15/24 11:21:48 a.m.
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Madam Speaker, I would challenge the member. The government is not killing people, but it is failing to put in place protections for people. There is a difference, and our language does matter, but we need to have a strong support for everyone. To simply say that people are being killed does not help our conversation. I would ask my colleague to reflect on that.

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Mr. Michael Barrett

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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The Assistant Deputy Speaker (Mrs. Carol Hughes)

Feb/15/24 11:22:56 a.m.
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I am still looking into what was said a while ago, but I do want to remind members to be very careful with some of the wording they are using because it is not quite proper to be using that type of language in the House. Resuming debate, the hon. member for Joliette has the floor.

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Mr. Gabriel Ste-Marie (Joliette, BQ)

Feb/15/24 11:23:38 a.m.
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Madam Speaker, I would first like to ask for unanimous consent to share my time with my colleague and friend, the member for Montcalm, who is a leading expert on this subject.

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The Assistant Deputy Speaker (Mrs. Carol Hughes)

Feb/15/24 11:23:43 a.m.
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Does the hon. member have unanimous consent to share his time? Some hon. members: Agreed.

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Mr. Gabriel Ste-Marie

Feb/15/24 11:23:50 a.m.
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Re: Bill C-7

Madam Speaker, medical assistance in dying is a topic as crucial as it is sensitive. By choosing to delay debate for three years, the Liberal government is aligning itself with the Conservatives, with the blessing of the NDP, to ensure this debate will never happen again. That is highly irresponsible. The Bloc Québécois was in favour of a one-year delay, but three years pushes it to after the next election. In other words, we will not be discussing this issue for a very long time. Meanwhile, Quebec has passed a law that allows advance requests. Specifically, it covers people suffering from neurodegenerative diseases such as Alzheimer’s and Parkinson’s. However, Quebec’s law is blocked until the Criminal Code is amended by the House. The entire National Assembly of Quebec has asked Ottawa to amend the Criminal Code accordingly. Although the Quebec law allows advance requests, the Criminal Code does not. This leaves doctors open to prosecution. That is why we presented an amendment addressing this issue. Again, the Liberal government, the Conservatives and the New Democrats chose to oppose it. Again, Quebeckers are reminded that we cannot decide for ourselves, even when there is consensus, and that our neighbour will decide for us. Furthermore, the government did all this by imposing a super gag order, with the NDP's support. It wanted to muzzle the House and put off debate well into the future while rejecting Quebec’s unanimous request. So much for democracy here. Here we are reviewing a bill that seeks to delay choices involving mental disorders and that says nothing about neurodegenerative diseases and advance requests, unlike Quebec’s law. All this is happening three years after Bill C-7 was passed. Regardless of what other parties choose to do, we continue and will continue to ask that the Criminal Code be aligned with Quebec’s Act Respecting End-of-Life Care by allowing advance requests. Can I ask for a bit more compassion in the House? Is it so complicated to change the Criminal Code to give effect to the Quebec law with respect to advance requests for people suffering from serious and incurable neurocognitive disorders? In an attempt to convince my colleagues of the importance of Quebec's request and the urgency of the issue, I would like to read a very moving letter sent by one of my constituents. She talks about what her mom, Jacinthe Arnault, went through. Here is what the letter says: At age 56, my mother, Jacinthe Arnaud, a clinical nurse, was diagnosed with early-onset Alzheimer's. Nothing in her family history could have predicted that this huge black cloud would darken the rest of her life. The second thing she told me in 2019 after being diagnosed was: “Promise me you won't let me die in a long-term care home. Promise me, Cath, that you'll let me go with dignity.” Back then, the MAID legislation did not allow for people with cognitive impairments to access this type of care. I scrambled to learn about the subject, to talk with MPs, to contribute to the improvement of the legislation at the National Assembly and to get informed about what was being done in other countries. What I found was that we were in a dead end—even if my mother repeated her request week after week, I could not see how I could grant her the end she was hoping for. In 2021, when the “imminent death” requirement was taken out of the legislation, there was a glimmer of hope. Fortunately—or unfortunately—my mother wasn't 100% aware of her condition and wasn't ready to let us go and choose to die, at the risk of losing her chance to die with dignity. The disease progressed very quickly, much faster than the legislative work to expand MAID. In early 2022, we had to watch over my mother almost constantly as her cognitive abilities, her memory and even her motor skills became more and more impaired. She still had enough clear-mindedness to ask her geriatrician for MAID. We started the procedure. It was very stressful not to know whether my mom would change her mind right until the very end, not because she didn't want MAID anymore, but because the disease would have made her unable to understand her condition and where she was headed. Do you know that the legislation imposes a 90-day waiting time before MAID can be granted to patients with cognitive impairments? As a nurse myself, and seeing my mother get worse and worse every day, I could not see how she would still have a clear mind after 90 days. After several discussions with the prescribing physician, we were able to move up the date. Why was my mother's credibility called into question? Why do patients with cognitive impairments have to wait before receiving MAID, but not patients with other incurable diseases? Requesting in advance to die with dignity is a very personal and legitimate choice, according to my mother and me. It is a decision that should, in a perfect world, be made quickly after diagnoses of this nature. Considering that neurodegenerative diseases evolve very differently from one patient to the next, wouldn't it be logical to allow these patients to request a dignified death in advance? Not knowing if she would be allowed to die put my mother under incredible stress. And let me tell you, as a mother of two young children, I too was under a tremendous amount of stress, not knowing if my mother would pass away or if I would have to institutionalize her within a few months, which would have been a very difficult choice to make, considering the wishes she had so forcefully expressed. During the last years of her career, my mother worked in the hemodialysis department at the Joliette hospital. She wanted to keep helping others. On May 4, 2022, she died in an operating room at the Joliette hospital, with her by her loved ones at her side. She saved three people. Both of her kidneys and her lungs live on somewhere in Canada. We're extremely proud of that. I'm so proud of her and of us. I wish with all my heart that ADVANCE requests for MAID were allowed. All these people who are sick now and who would like to die with dignity are depending on the legislation to be changed quickly. Best wishes, Catherine Joly I thank Ms. Joly for her letter from the bottom of my heart. I agree with her, because I also hope with all my heart that advance requests for MAID will become an option. As she says, it is a matter of dignity. As she points out, everything depends on how quickly the legislation can be changed. Quebec has changed its legislation. The one step left is to harmonize it with the Criminal Code. I sincerely hope that Ms. Joly's words have helped convince my colleagues about how important it is to make this change and make it quickly. I thank her.

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Mr. Chandra Arya (Nepean, Lib.)

Feb/15/24 11:30:51 a.m.
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Madam Speaker, Canada is one of the most advanced democracies in the world. That is why we bring in legislation, some of which is quite unique. In Canadian history, over all 155 years, this is the first time legislation like this has been brought forward. Whenever we bring forward legislation that fundamentally affects every single Canadian's life, is it not important that we relook at it, modify it if required, take a pause, check to make sure everything is okay and patiently advance it instead of rushing it through? I would like the hon. member's views on that.

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Mr. Gabriel Ste-Marie

Feb/15/24 11:31:36 a.m.
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Re: Bill C-7

Madam Speaker, I would like to say two things. First, there is unanimous consensus in Quebec. All parties in the Quebec National Assembly voted to pass a law, but it has no force or effect because it is being blocked. Quebec is asking that its law be aligned with the Criminal Code so it can come into effect in Quebec alone. That is what we are asking. It is not complicated. The government tells us this is very important, but it chose to do nothing and kick it down the road, even though we need to act quickly. Second, the decision to delay all debate in the House for three years brings us to after the election. Projections indicate that the Liberals will not form a majority government. In all likelihood we will never discuss this again, we will never come back to this debate. I think that is irresponsible. We first dealt with Bill C-7 in 2021. That is already three years ago. What has the government done in three years? It came up with the current bill, which says they will ensure the debate will never be over. We think that is irresponsible. I beg the government to at least try to harmonize the Criminal Code with the unanimous will of Quebec. It is a matter of dignity. My society and my nation are ready. However, they are being blocked by their neighbour, who is choosing not to act. I am asking them to act.

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Mr. Ziad Aboultaif (Edmonton Manning, CPC)

Feb/15/24 11:32:55 a.m.
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Madam Speaker, the hon. member read a letter from a constituent. Conservatives also receive letters that speak in a different way about the dignity they look for and how they want their lives to be treated based on MAID and the new law that will be put in place. If the hon. member's emphasis is on the humanitarian and compassionate side of this, would it not apply to every Canadian rather than just narrowing it to Quebec? I understand and respect that he represents a Quebec riding, but we need to look at something that applies to all Canadians. I think that is the purpose behind what we are debating today.

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Mr. Gabriel Ste-Marie

Feb/15/24 11:33:44 a.m.
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Re: Bill C-62

Madam Speaker, from my perspective and that of my party, the substance of Bill C-62 is to ensure that we never discuss this again. By choosing to extend the exclusion by three years, there could well be a Conservative government─possibly a majority government─in power. I would be amazed if that government chose to follow up and move in the same direction. Let me remind my hon. colleague that Canada is a federation that includes several nations. The Quebec nation has a unanimous position on advance requests but cannot implement it because the federal government refuses to amend the Criminal Code. We understand that the rest of Canada may have other debates. That is the idea of a federation, to bridge different cultures and perspectives. There is unanimity in Quebec. We are not asking for a unilateral approach or for the Quebec model to apply from coast to coast, but for Ottawa to stop blocking what Quebec has unanimously decided.

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Mr. Alexandre Boulerice (Rosemont—La Petite-Patrie, NDP)

Feb/15/24 11:34:57 a.m.
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Madam Speaker, I simply want to remind my colleague that, yesterday, I voted in favour of the amendment for advance requests because there is a political and social consensus in Quebec society. I think that the message for the federal government is to find a compromise and a solution so as not to prevent Quebec from moving forward. However, we must also not block the bill, because there is no medical or scientific consensus on the issue of mental health as the sole underlying condition. I think that it is important to meet the March 17 deadline and to ensure that we can reflect together on this issue because there is no medical or scientific consensus.

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Mr. Gabriel Ste-Marie

Feb/15/24 11:35:39 a.m.
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Madam Speaker, I recognize that the member voted with the Bloc Québécois for advance requests, but I deplore the fact that he was the only one from his party to do so. This demonstrates the rift that exists between Quebec and the rest of Canada on this issue. It is deplorable. I deplore the fact that the member could not convince his entire caucus to vote with us. I recognize the importance of taking the time to talk about such important issues. However, we have been at this for three years, and the government has not done anything. Extending the deadline by three years is a hypocritical way of ensuring that we never talk about it again, because that takes us past the next election. It is irresponsible.

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Mr. Luc Thériault (Montcalm, BQ)

Feb/15/24 11:36:24 a.m.
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Re: Bill C-7 Bill C-62 Bill C-39

Madam Speaker, I will start with an assertion whose veracity will become clear. With Bill C-62, the cowardly Liberal government brought forth a mouse. If we are talking about Bill C‑62 today, it is because Bill C‑7 created the Special Joint Committee on Medical Assistance in Dying when it passed. The committee's mandate was to review the medical assistance in dying legislation, in particular as regards the issue of advance requests. Because we knew that the problem was more difficult in cases of mental illness, the government set up an expert panel to help MPs do their job. The panel was to issue a report to the special joint committee. The expert panel was indeed set up. The problem is that, instead of putting everything in place following the adoption of Bill C‑7, the government decided to call an election in 2021. That delayed the process. Immediately after the useless election, we would have expected the special joint committee to sit but, no, we had to wait. They took their sweet time. The committee was finally convened, but it had a huge mandate. Its mandate was so huge that Bill C‑39 on mental illness had to be introduced, delaying the committee's recommendation. Since February 2023, the committee has been very clear on the issue of advance requests. In fact, that was its most widely held recommendation. During the entire debate on Bill C‑62 in the House, the government said that we needed to be cautious and proceed slowly. That is fine, but when caution involves making patients suffer, I cannot agree. I think we need to be diligent. The government took its sweet time. Here we are in 2024, and it introduced legislation seeking to postpone the issue of mental illness. Fine, but what is happening with the main recommendation the committee made in February 2023? The government knew very well that Quebec was laying the groundwork on the issue of advance requests. It knew very well that Quebec would bring in its own law. Instead of taking inspiration from that and seeing what measures could be included in the regulation accompanying Canada's MAID legislation, it did nothing. I have stood in the House many times to ask the Minister of Justice and the Minister of Health why the government did nothing. Why does the bill not include a component on advance requests, which should have been prepared over the past year? After all, the government introduced legislation enacting the special joint committee's February 2023 recommendation on mental illness. On the issue of advance requests, however, it did nothing, despite the majority recommendation. Yesterday, I got my answer. The Minister of Health demonstrated in front of the whole committee that he was unfamiliar with the Quebec law, yet he rises in the House and says he has enormous respect for Quebec's process. The Liberals do not even know what they are talking about. The minister told me that the issue of advance requests is more difficult than the issue of mental illness because, for example, there might be family quarrels at the patient's bedside. I realized that the minister had not read section 29.6 of the Quebec law, which stipulates that, as soon as patient is diagnosed, they can appoint a third party. The third party will not determine when the person can access medical assistance in dying, but will advocate for their wishes, which will be included in the advance request, or the person's criteria. People in my riding have told me that, when they become incontinent and can no longer control their bowels, when they have reached the point where they no longer have any appetite and it becomes a chore for their caregivers to feed them, although they are well compensated for their troubles, when they are no longer able to recognize their friends and family members and when they can no longer maintain relationships, they would like to have access to medical assistance in dying. The third party in whom they have placed their trust will then ask the care team—because patients are indeed cared for by entire teams—to evaluate whether they are meeting the criteria, if they are there yet. If people make advance requests, it is because they want to avoid shortening their life. They want to live as long as possible. We could be good to them and take care of them until they cross their tolerance threshold. The minister does not even know what I am talking about right now. Do members think it is normal that people say they respect Quebec, that they have great admiration for Quebec's progress on this issue, but that they do not even know what is in Quebec's law? It is no surprise that they come out with a bill like Bill C‑62, that does not address this at all. Then they have the gall to say that Quebec has made good progress, but that not all Canadians are ready for that, so they have to wait and watch their patients suffer. Quebec is not the only province that supports advance requests. According to an Ipsos survey, 85% of Canadians from coast to coast support advance requests. The Conservatives claim that they want to do good, they want to take care of Canada's most vulnerable. I, too, want to take care of the most vulnerable, but who is more vulnerable than a patient who is about to cross their tolerance threshold, who is suffering and who is being told no by the government? Some claim that there could be abuses, as if the Criminal Code did not provide for punishment of abuses. They seem to believe the medical system to be inherently evil. I heard my Conservative colleague earlier. Listening to the Conservatives, one would think everyone working in the health system wants vulnerable people euthanized. I heard another Conservative member say there is an opioid crisis, there are people in the streets, and we are going to euthanize them. That is absolutely false. It is really far-fetched. That kind of rhetoric is meant to scare people; it amounts to spreading misinformation on a crucial topic. When we care, we do not infringe on individual autonomy. The role of the state is not to decide matters so personal as how someone wishes to cross their threshold of tolerance. It is not to tell patients what is right for them. It is to provide the conditions so they can make a free and informed choice.

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Mr. Michael Cooper (St. Albert—Edmonton, CPC)

Feb/15/24 11:46:07 a.m.
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Re: Bill C-62

Madam Speaker, I have to say that I find the position of the Bloc to be somewhat curious insofar as it is inconsistent with the position taken by the National Assembly, which rejected the policy of the government to expand MAID in cases where mental illness is the sole underlying condition. I understand that the position of the Bloc members to oppose Bill C-62 is on the basis they would like to see the policy implemented in one short year from now. Can the member explain why the Bloc is taking a position that is inconsistent with that of the National Assembly?

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Mr. Luc Thériault

Feb/15/24 11:46:47 a.m.
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Re: Bill C-62

Madam Speaker, I have said it repeatedly, the Bloc Québécois wants Bill C‑62 to include a section on advance requests for MAID. This is our main objection. We tried to introduce amendments in step with Quebec's request and that of the whole National Assembly. Where mental disorders are concerned, we start from the premise that psychiatry is unable to ease the suffering of every patient stricken by a severe mental disorder. Psychiatrists told us that 50% of their diagnoses are wrong. It is a wonderfully precise science. However, one thing is true. Although there is no exact diagnosis and a diagnosis can change, what is clear, straightforward, specific and a constant in a patient's journey over the decades is that they suffer. Psychiatrists cannot deny that their patients suffer, and that all they can offer them is a path to palliative care. In fact, Dr. Gagnon told us we had to develop palliative care for people afflicted with mental disorders because that is all we can offer them. Quebec made its decision in 2021. It did not have the opportunity to work off the expert report that the Special Joint Committee on Medical Assistance in Dying had in 2022.

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Ms. Elizabeth May (Saanich—Gulf Islands, GP)

Feb/15/24 11:48:26 a.m.
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Madam Speaker, this morning is my first opportunity to take part in this debate. I have heard a few comments from people who think the Government of Canada is going to have a hand in murdering Canadians. I know it has come up in a point of order. We are stuck, but it does not mean that anyone wants to murder any Canadians. I think we need to be concerned, with a choice and a debate this deeply personal and moral, and with such complicated questions. Given the constraints of Supreme Court decisions and the work of the Senate, how do we keep the focus here not on the partisanship of this place but on making and passing good laws?

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Mr. Luc Thériault

Feb/15/24 11:49:25 a.m.
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Madam Speaker, I challenge anyone to find petty partisanship or political calculation in any of my speeches. I always focus on the issue at hand. Since 2015, what I have come to realize is that, unfortunately, parliamentarians here in the House are not on the same page as Quebec parliamentarians. Time for reflection is sorely lacking here. We could have had some time for reflection—since 2021, actually—but the government dragged its feet. That meant that we had less time and less of an opportunity to do thorough work. The issue of mental disorders is now being postponed until 2027, which basically amounts to choosing not to deal with this issue. I would like us to work on this issue immediately after royal assent, but that is not going to happen.

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Mr. Simon-Pierre Savard-Tremblay (Saint-Hyacinthe—Bagot, BQ)

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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Mr. Luc Thériault

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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The Assistant Deputy Speaker (Mrs. Carol Hughes)

Feb/15/24 11:52:01 a.m.
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Order. The member for Saint-Hyacinthe—Bagot rose on a point of order earlier. I checked the record. The member for Leeds—Grenville—Thousand Islands and Rideau Lakes' comment was not directed at the member. It was a general comment. When he repeated his remarks, I heard him clearly that time. I then mentioned that such comments should not be made in the House. It can cause disorder, but I am also certain that no member in the House wants to kill anyone. I checked the record. It was a general comment that went: “If there are members in this place...who would rather have the government kill people”. I just wanted to add that. The hon. member for Saint‑Jean is rising on a point of order.

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