- Member of Parliament
- Member of Parliament
- Bloc Québécois
- Montcalm
- Quebec
- Voting Attendance: 65%
- Expenses Last Quarter: $126,025.95
- Government Page
- May/22/24 2:19:19 p.m.
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Mr. Speaker, in February 2023 the joint committee recommended, by a strong majority, that individuals suffering from such diseases as Alzheimer's or dementia be allowed to make an advance request for medical assistance in dying.
Although 83% of Canadians support advance requests, the health and justice ministers are unequalled in their complete lack of political courage and total failure to understand the file. They still expect afflicted patients to bear the burden of having to argue their case in court.
Today, buoyed by the support of the Collège des médecins du Québec, the Barreau du Québec, the Chambre des notaires du Québec and a number of associations, we again call on the government to allow Quebec and any province so inclined to move forward with advance requests.
To those who are suffering, like Ms. Demontigny, I would just like to say that we will never forget them and we will never abandon them.
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- Apr/16/24 12:12:36 p.m.
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Madam Speaker, this is our money. What I just heard is very insulting. My colleague talks about an ATM when it is the government that manages our taxes.
All that we are asking for, and what everyone is asking for, is that the Government of Canada make a substantial and recurring investment in health transfers instead of the insignificant amount that has been put on the table.
During the third wave of COVID-19, experts told us that the side effects of the pandemic on non-COVID-19 patients could take from five to eight years before subsiding. Right in the middle of the third wave, what did the government do? It supposedly waited until after the pandemic to give the provinces peanuts to care for their people. That is not only insulting, it is absolutely criminal.
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- Mar/19/24 2:41:55 p.m.
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Mr. Speaker, in 12 days, Ottawa will cut $1 billion in health care funding, if Quebec does not agree to conditions in an area under its own jurisdiction. Quebec has been given 12 days when we are talking about amounts that Quebec and Ottawa agreed on over a year ago.
If the federal government's priority was patients, then this money would have been transferred a long time ago, but instead, in 12 days, Quebec will either have to deal with cuts or conditions. The federal government is taking sick people hostage with the money they pay in taxes.
Why not simply give priority to patients by transferring the money right now with no strings attached?
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- Feb/29/24 2:58:00 p.m.
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Mr. Speaker, when it comes to health, Quebeckers want care, not threats.
A year after forcing Quebec to accept an increase in transfers that cover only one-sixth of our needs, the federal government is threatening to steal $900 million from Quebec if it does not meet the government's conditions by March 31. The Liberals are once again playing political games at Quebeckers' expense and with Quebeckers' own money.
When will the Liberals stop holding patients hostage and start paying Quebec the money it is entitled to?
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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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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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Madam Speaker, let us try to calm down a bit.
In this debate, the government is basing itself on the Special Joint Committee on Medical Assistance in Dying for its amendment to Bill C‑62.
The Bloc Québécois would have liked to lend its support. The problem is that we believe that we should not indefinitely delay the possibility of medical assistance in dying for people with an irremediable mental disorder, when no psychiatrist worth their salt has been able to treat them or relieve their suffering. After 10, 20 or 30 years of suffering, the decision whether or not to request MAID should not lie with this person, who is supposed to determine whether the patient is eligible.
We asked for an amendment to the bill. Why take three years when, last year, we were told that it would take a year to make sure that MAID for people with mental disorders could be set up in a safe and appropriate manner? The main issue we have is that, in 2015, there was an election, but there was also the Carter decision. The government and this Parliament passed terrible legislation, similar to the one Quebec adopted a year earlier.
Quebec passed a law that only covers end-of-life cases, people who are terminally ill. I want to reiterate that, in the terminal phase of life, the process of dying has begun and is irreversible. People can be well taken care of in palliative care. Good palliative care, as described by Cicely Saunders at the time, is full, comprehensive, holistic support for people as they are dying. It involves adequately managing the person's pain and suffering, both physical and emotional, and supporting their family. All of this should be done in an environment that resembles a normal environment as much as possible. However, it is possible that, all of a sudden, in the midst of this process, the patient, who is slowly dying, will request MAID because, one day, they are feeling at peace and ready to let go. That is not a failure, in my opinion. It can be seen as successful palliative care. When my colleagues are about to depart this life, I hope that they will be calm and at peace. That is what I would wish for everyone.
So Quebec had taken those steps. Then in Parliament came the Carter decision, which stated that Ms. Carter was not at the end of her life, but she was suffering a great deal. It was therefore decided that depriving her of medical assistance in dying impinged on her right to life. Why? She was being forced to end her life prematurely, when the fact is that letting her decide what happened next would empower her. It was up to her to define when her suffering became intolerable.
It was a bad law. Bill C‑7 had to be introduced. When we began studying Bill C‑7, there was another factor that had to be considered; that was in 2021.
The Carter decision states that there cannot be an absolute prohibition on MAID simply because people belong to a particular group, one that is vulnerable. It must be assessed on a case-by-case basis.
The reality is that people can and do struggle with irremediable mental disorders. Irremediability is established through a rigorous process. During that process, practitioners must be certain that the person has never refused treatment that we know would have absolutely improved their situation.
There are indeed people whose mental disorders cause intolerable suffering, and psychiatry does not help them. If anyone here wants to claim otherwise, I would say that they lack intellectual integrity. Psychiatrists cannot cure everyone; it is impossible. That said, psychiatry is rife with medical paternalism.
That being said, what we wanted was for the government, whose Bill C‑62 is based on the work of the Special Joint Committee on Medical Assistance in Dying, to plan ahead for when it might have to introduce Bill C‑62 and include another key recommendation of the special joint committee in the bill. That recommendation was presented a year ago and was the subject of a consensus. One Conservative member even joined the majority. There is a consensus in favour of advance requests.
Why was that not included in the bill? It should have been anticipated. The government knew that the date would have to be pushed back. It had a year to introduce a measure in the House that would have also covered people suffering from dementia and Alzheimer's. Why did the government not do that? We asked the government why it was not doing so when it had the chance. Quebec drafted its own legislation. It is structured, rigorous and unanimously supported in Quebec.
An Ipsos poll shows that 85% of the Canadian population supports advance requests. In British Columbia, 84% supports advance requests. In Alberta, it is 84%; in Saskatchewan and Manitoba, it is 81%; in Ontario, it is 84%, in Quebec, it is 87%; in Atlantic Canada, it is 81%. I could go on. There are other figures. They vary. The results are based on a sample of 3,500 people. That is not nothing. When will the government take action? Why has it not heard this request? Why has it not spoken with Quebec, who has worked on this issue? Why did it not hear the unanimous will of the National Assembly, just last week? Why is it afraid of its own shadow? Why do the Liberals lack courage so?
The last time they lacked courage, we ended up with Bill C‑14. What is the problem with Bill C‑14? The real problem with Bill C‑14 is not a legal problem. The problem is for a patient who is suffering, who, to satisfy the reasonably foreseeable natural death criterion, has to go on a hunger strike. We have seen that. The problem is for people who, like Ms. Gladu and Mr. Truchon, have to fight for their constitutional rights in court. When I say there is a lack of courage, that is what I mean.
My only viewpoint is the viewpoint of patients who are suffering. The only thing I am standing for here is the suffering patients' right to self-determination. Patients had to fight an uphill battle against medical paternalism when it comes to MAID.
As I mentioned last week, there was a time when the palliative care that is so dear to the heart of my Conservative friends and that I personally consider to be very important was called passive euthanasia. Doctors obstinately used aggressive life-support measures because their duty was to save their patients. As we know, every doctor thought that they could save every patient back then. It was actually doctors suffering from cancer who started to assert their right to refuse treatment. Today, cessation and refusal of treatment are part of what are considered to be good medical practices.
Why are we not studying the bill today? The government is imposing a gag order. We will not be overly critical of this decision. I understand that this has to be done before March 17. We are not getting too worked up about this, but still, we have not consented and will not consent to this. Why not? It is because we wanted a bill that was based on the recommendations from the Special Joint Committee on Medical Assistance in Dying. I want answers from the government in that regard.
Why the delay in expanding medical assistance in dying to people with mental health issues? We did what the committee asked. Bill C‑62 even provides for the Special Joint Committee on Medical Assistance in Dying to reconvene in order to determine whether the groundwork has been laid. That is what we are doing. We basically took the recommendation and inserted it into the bill. Then, there is the issue of advance requests. There is a consensus on that across the country, but the government lacks the courage of its convictions.
The Liberals are afraid of demagoguery because there has been a lot of it on this issue. They are lumping everything together. However, at some point, they need to be consistent in their approach. The Liberals are well aware that the state's role is not to decide for the patient what is best for them when it comes to a decision as personal as one's own death. The state or the patient's neighbour is not the one who is going to die. The state's role is to determine the proper conditions and ensure that they are put in place so that patients can make a free and informed choice. If people are worried about abuse or the slippery slope when it comes to advance requests, then they should look at Quebec's law, which is a model to follow.
The government could have easily inserted elements of the Quebec law into its regulations. It is all well and good to say that the law is a little vague, but the amendment we are making to the medical assistance in dying legislation, expanding section 241 of the Criminal Code, is followed by a procedure, regulations on enforcing regulations. That is where the various safeguards are put in place.
There are standards of practice when it comes to mental disorders. A year ago, a committee began looking at standards of practice, and they will be sent to the regulatory bodies in each province, namely the colleges of physicians. Once we have clear guidelines and standards of practice and the criteria I was talking about earlier are met, someone in a suicidal crisis will not have access to medical assistance in dying.
It bears repeating, because I am hearing a lot of confusion over this. A suicidal person is not eligible for medical assistance in dying, even if they suffer from a mental disorder and are in suicidal crisis, and even if they have recently been admitted to care and diagnosed. I have often asked psychiatrists if they thought that giving access to medical assistance in dying to people with mental disorders could also provide an opportunity for prevention. Some people commit suicide and no one sees it coming. No one knows those individuals today, no physician took them on.
For example, knowing that MAID is an option, a person might come forward because they are suffering and want to exercise that option. Well, that person would not qualify. However, they would then be taken care of and get the treatment they need, since suicidal ideation is reversible. There is no question about that. However, it is not about those patients. When we asked the chair of the expert panel, psychiatrist Mona Gupta, how many patients in her practice would have been eligible, she told us of two or three patients over her entire practice. Still, these are people who are suffering.
When people talk about the fact that the resources are not there—the resources in terms of someone to assess capacity, for an independent psychiatrist to look at a case—I would point out that right now, the decision-making capacity of a person struggling with a mental disorder, but who has cancer, for example, is verified. Psychiatrists are currently assessing the decision-making capacity of people with a mental disorder and a comorbidity. Depending on their condition, practitioners are able to determine the decision-making capacity of these people who have a mental disorder.
The Supreme Court was clear: Not allowing these people to access MAID creates stigma. Not only does it stigmatize them, it discriminates against them. Why infantilize and weaponize people who have a mental disorder and who, in their entire existence, have not found treatment that can alleviate their suffering?
I rather like having discussions and debating with my Conservative colleagues. They have a sense of conviction, but there are some Conservatives who use scare tactics and conflate everything. It is not enough to repeat some 20 times that someone came to say that irremediability is hard to address. Everyone agrees. Even the expert panel starts with that. They did not hide that fact. In fact, they say that because irremediability is hard to establish there must be safeguards and precautionary principles put in place.
I therefore move the following amendment:
That the motion be amended in subparagraph (b)(ii):
(a) by adding after the words “be deemed referred to a committee of the whole,” the words “that an instruction be deemed to have been given to the committee granting it the power to expand the scope of the bill so as to take into account provincial medical assistance in dying frameworks for advance requests from persons who have an illness that could deprive them of the capacity to consent to care,”;
(b) by replacing the words “deemed reported without amendment” with the following: “deemed reported with the following amendments:
That the bill be amended by adding the following new section 241.21 to the Criminal Code:
New section 241.21
Medical assistance in dying eligibility criteria for advance requests
“241.21 The government of a province may establish a medical assistance in dying framework for advance requests from persons who have an illness that could deprive them of the capacity to consent to care, in accordance with the laws of that province.””; and
(c) by replacing the words “deemed concurred in at report stage” with the following: “deemed concurred in at report stage, as amended”.
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- Feb/8/23 4:35:48 p.m.
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Mr. Speaker, before I begin my speech, I would like to say that my thoughts are with the friends and families of the children and adults who were the victims of the terrible tragedy at Garderie éducative Ste‑Rose in Laval. I think we are all in shock following this terrible incident, and words fail us. I cannot imagine what the parents of the children who go to this day care are feeling. I want them to know that we are with them.
I have had the privilege of representing the people of Montcalm since 2015. It is as much an honour for me today as it was the first day. During the first oral question period in which I participated, the member for Rivière-du-Nord asked for an increase in health transfers. Members will recall that, in 2011, the Harper government cut the health transfer escalator in half, reducing it from 6% to 3%. That was grossly insufficient to cover system costs. By 2015, we were feeling the repercussions of that decision. I have had the privilege of sitting in the House for almost eight years, and all that time, we have been constantly repeating that health transfers must increase.
Two years ago, Quebec and the provinces agreed to call for an increase in health transfers that would raise the federal government's share of health care funding from 22% to 35%. The way things are going, Quebec and the provinces will not be able to provide quality health care to the public.
If Ottawa underfunds health care, which is what it is doing, then there are three possible scenarios. Either health services decline, other government services decline because the governments of Quebec and the provinces have to use their own money to make up for Ottawa's cutbacks, or provincial debt spikes and the fiscal imbalance gets worse. Those are the three scenarios Quebec and the provinces are facing because of this lack of federal funding: deterioration of health services; underfunding of other government programs, including education, social services, roads and culture; or a growing fiscal imbalance. That is the choice that the federal government made by refusing to consider the premiers' legitimate and necessary demands. It has been putting the provinces on the road to austerity for 10 years.
Worse yet, the government is jeopardizing the quality of the services provided to the public. As the leader of the Bloc Québécois rightly said, the gap between the premiers' demand and this government's offer, which really ought to be called an ultimatum, should not be calculated in dollars. No, it should be calculated in terms of the number of people who will be abandoned. How many surgeries will be postponed? How many nurses and orderlies will be left to fend for themselves most of the time? What heartbreaking decisions will the health ministers in Quebec and the rest of Canada have to make in order to balance their budgets in a tight fiscal environment?
For years, my Bloc Québécois colleagues and I have been raising the matter by moving opposition motions, appearing with health care professionals, and tabling unanimous motions adopted by Quebec's National Assembly. We have asked questions relentlessly and reiterated the need to support exhausted and overworked health care workers. We have spoken about the tragedies unfolding in oncology and pediatric departments and the patients forced to wait months and months at the risk of their health, and sometimes even their lives.
The government said that our colleague was right and that that is why it was investing money, because it is so important. If it is that important, then it needs to invest the money because people are dying as we speak.
Yesterday, the government demonstrated that all it is capable of doing is saying the right thing, nothing more. The minister was also eloquent earlier.
Ottawa let its chequebook do the talking. It did not have much to say, other than that the provinces should just deal with it. Its offer is despicable. I say its offer, but when it is a take-it-or-leave-it situation, then it is more like an ultimatum. Its ultimatum is a 5% escalator for five years. I would remind the House that before the Harper era, it was 6%. They are not even going back to the Martin era. They are fixing the escalator issue, but only partly, because the cost of the system is now counted in sick people.
The aging population has put more pressure on the system, and the direct impact this has on health costs needs to be taken into consideration. We are talking about a 5% escalator for five years. The Prime Minister did not need to meet with the premiers of Quebec, the provinces and the territories to do that. He could have done it whenever he wanted to, unilaterally, just like when Stephen Harper unilaterally lowered the escalator from 6% to 3%. The Prime Minister could have announced this on his own, without an agreement.
The provinces were calling for an additional $28 billion a year for health. The federal government's response was $4.6 billion and that was its final offer. The government would have us believe that this is good news. Does the government have any mission more sacred than taking care of people? There are people who are sick, health care workers who are at the end of their rope. What is more important than being there for them? The Liberals would have us believe that they know more about health care needs than the health ministers for Quebec and the provinces and territories, that they know where to invest the money and how much is needed.
We are supposed to believe that the people who are not even capable of managing passports, managing borders and paying employees know how to fix the health care systems in Quebec and across the country. That is ridiculous. Quebec and the provinces needed a minimum of $280 billion over ten years. That was the minimum. Ottawa responded with $46 billion. That is a minimum shortfall of $230 billion in the coming years.
Basically, the federal government announced yesterday that the underfunding of health care will continue for the next 10 years. That is it, and that is all. The Liberals promised us a big offer, but all we got was a big disappointment. Sick people in Quebec and Canada are the ones who will pay the price.
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- May/19/22 2:02:57 p.m.
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Mr. Speaker, today, May 19, we are celebrating World Family Doctor Day.
I want to congratulate them all for the essential work they do at the heart of our health care system. Family doctors are the closest to patients, with whom they build personalized and lasting relationships focused on prevention. It takes a special person with a lot of empathy and compassion to play this role at the crossroads of medical science. They are on the front line and they deserve to be commended for the crucial role they play, especially after years of dealing with the pandemic and having to constantly adapt to new data with unending dedication.
We need more of them, of course. To get there, the least we can do is start by sincerely thanking them. I thank family doctors from the bottom of my heart.
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