Bill C-7 (Historical)

An Act to amend the Criminal Code (medical assistance in dying)

Criminal Code

[Luc Thériault, Bloc, Montcalm, QC]

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.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

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.

Proceedings on Bill C-62

[Gord Johns, NDP, Courtenay—Alberni, BC]

Mr. Speaker, a lot of discussions needs to take place at the AMAD committee, to look at the existing legislation.

However, right now, we are dealing with a timely situation, and I am going to speak to that. This is around the Liberal government's ill-advised decision to accept the Senate amendment to Bill C-7 in the 43rd Parliament. That is what has gotten us here today. This is why we are having to rush legislation, because there is not adequate support for people with the sole underlying medical condition of a mental disorder.

The Liberals changed the law before any kind of comprehensive review had been conducted, and we have been trying to play catch-up ever since. The Liberals decided to support an amendment from the Senate, the unelected Senate, that was brought back to the House. We voted against it because of that. We did not believe that the supports were in place for people to make those decisions.

We are working toward ensuring that we have parity between our mental and physical health care system, that we listen to the experts and that we do a full evaluation. This needs to take place. However, I appreciate the comments from my colleague in that there needs to be broader conversations about the existing legislation.

Criminal Code

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, I am pleased to be standing in the House today to join debate on Bill C-62. Forgive me if I am feeling a bit of déjà vu right now, because it was precisely one year ago, in February 2023, that the House was in a similar position with the earlier bill, Bill C-39.

That bill, of course, extended the delay of the implementation of the acceptance of mental disorders as a sole underlying medical condition to access MAID. That bill kicked the can down the road by one year. As a result, we find ourselves in a position where we are now approaching the deadline of March 17, 2024.

To go into a bit of detail on what Bill C-62 contains, it is not a very complex bill. It should be clear that the bill itself is not relitigating the issue that was first brought in by Bill C-7. I will get into Bill C-7 in a moment. This bill is seeking to further delay the implementation of MAID for mental disorders as a sole underlying medical condition until March 17, 2027, essentially three years down the road from now.

I also think an important part of the bill is that it inserts a legislative requirement that the Special Joint Committee on Medical Assistance in Dying be reconvened in advance of that change, so that a committee of parliamentarians made up of members of Parliament and senators can review our country's readiness and make a determination in advance of that date.

I have been a member of the special joint committee from the beginning, all the way back in the 43rd Parliament, and, speaking for myself, I am very glad to see that we do have that legislative requirement in Bill C-62 and that, more importantly, the committee is actually being given the time it should have had to study this very complex and sensitive issue in advance of its implementation. That is something we could have been much better served by in previous iterations of this legislation.

I think it is important that we explore a little of the history of how we got to this moment. As a member of this special joint committee, I personally have felt that we have been playing a game of catch-up to the change in law that was made in advance of any serious inquiry into this matter.

Bill C-7, in the 43rd Parliament, was, of course, the Government of Canada's response to the Truchon decision. It specifically created a separate track in the Criminal Code for people whose death was not naturally foreseeable. Previous to that, one had to have a medical condition in which one's natural death was foreseeable, so essentially it was for people who were suffering terminal stage cancer, who were going through a great deal of suffering and so on.

It is important to note, though, that when the government first brought Bill C-7 in, there were already questions at that time, in advance of the legislation, about what we do with people who are suffering from mental illness, who have suffered, in some cases, as my colleague pointed out, for decades, for whom treatments have not worked. What were we to do with that?

In the original version of the legislation, by law, the government was required to have the bill accompanied by a charter statement, but mental disorders were specifically excluded from the original version of Bill C-7. The government provided what I thought at the time was a fairly well-reasoned charter statement. It was understood that by excluding this, one could potentially engage two prominent sections of the Charter of Rights and Freedoms, namely section 7, which is the security of the person, the fact that everyone essentially has the right to make a decision about what happens to their own body, and section 15, the equality clause, that the law has to treat everyone equally. With reference, those two sections may potentially be engaged by an exclusion.

The government identified the following in its charter statement:

First, evidence suggests that screening for decision-making capacity is particularly difficult, and subject to a high degree of error, in relation to persons who suffer from a mental illness serious enough to ground a request for MAID. Second, mental illness is generally less predictable than physical illness in terms of the course the illness will take over time. Finally, recent experience in the few countries that permit MAID for people whose sole medical condition is a mental illness (Belgium, Netherlands and Luxembourg) has raised concerns.

That is what the government's original position on Bill C-7 was.

The House passed Bill C-7 and it went off to the Senate. There, for reasons that remain shrouded in mystery to me to this day, the government decided to accept a Senate amendment, essentially at the eleventh hour, which had significant repercussions for the bill. Essentially, the Senate was reversing the government's original position on whether mental disorders qualified for MAID.

The government accepted that Senate amendment. Of course, Bill C-7, because it had been amended, had to come back to the House, and the government managed to cobble enough votes together to get it passed.

Therefore, we, as parliamentarians, were left with a law that had been changed in advance of the hard work being done to properly consult, research and discuss the issue with expert witnesses and with the health systems that have primary responsibility for the oversight of the change in law.

Yes, an expert panel was convened. The special joint committee was convened. Of course, its work was interrupted by the unnecessary calling of an election in the summer of 2021. Some very valuable time was lost there, because, of course, we then had to reconvene in the 44th Parliament, and a considerable amount of time was lost due to that.

However, it is important to realize that everything that has transpired since then has been as a result of that Senate amendment being accepted by the government. Again, I feel, and as a member of the special joint committee I think my feeling has some validity here, that we have been trying to play catch-up ever since that moment.

My time on the special joint committee has been difficult. It is not an easy subject for anyone to sit through, because the opinions of the people with lived experience and those who work in a professional capacity really are on all sides of the spectrum and everywhere in between. It can be quite difficult for a parliamentarian to work their way through that to try and understand the complex legal and medical arguments that exist behind this issue, but it is important.

I would say that, personally, my work on the committee has really been a struggle to find a balance between two concepts that sometimes seem to be in competition with each other. I am a firm believer in the Canadian Charter of Rights and Freedoms. I think it is a very important document in Canadian history, and I believe that we have to respect an individual's right to make decisions over their own body, but that belief system of mine was always struggling with another concept, which is that sometimes society finds itself in a position in which it is necessary for it to step in and protect its most vulnerable members. I think those two themes were echoed, not only for me but for many of the witnesses who appeared before our committee and in the many briefs we received.

I also want to note that our special joint committee has existed twice in this Parliament. We tabled our second report in February last year, in advance of Bill C-39. The committee's mandate at that time was guided by five themes that we had to look at, and mental disorder as the sole underlying medical condition was one of those. Of course, we were reconvened after the passage of Bill C-39, but as my colleague from Montcalm pointed out, our runway was extremely short. It did not do justice to the amount of time that we actually needed and to the extreme complexity of this issue.

Just to give this clarity for people listening, I believe our first meeting as a committee was on October 31, and we had to conduct some committee business, and elect the chairs and vice chairs. We really had only three three-hour meetings with witnesses, so nine hours of testimony. We excluded, by necessity, a lot of people who I would dearly liked to have heard from, namely administrators of our public health system, elected officials of provincial governments and so on.

Because of the short timeline, we did not even have enough time to properly translate all the submissions that were sent to our committee because, of course, before they can be distributed to committee members, they have to be translated into French and English. That is a requirement that honours the fact that we are a bilingual country. We, as committee members, did not even have the opportunity to review important submissions, and those submissions came from people who had lived experience, who were dealing with the situation at home, but they also came from many professionals whose practice is involved in this specific area.

I have taken a position on this. The member for Abbotsford, in the fall, had introduced Bill C-314, and I did vote for that, so my vote on this matter is quite clear. I have been informed by the fact that at our committee, there has been a significant amount of professional discomfort expressed by people who practice medicine in this area, psychiatrists and psychologists. Sure, some of them may be acting in a paternalistic way, but I do not think that can be applied equally to everyone. I think for some of them, we have to review their opinions. We have to take them in the context in which they are given. I think we have to afford them a measure of respect, given the fact that these are their lifelong career choices and, in many cases, we can measure their experiences in decades.

I want to take a little time to read from some of the testimony we received from witnesses. We did hear from Dr. Jitender Sareen from the department of psychiatry at the University of Manitoba, who was there also on behalf of psychiatry departmental chairs at the Northern Ontario School of Medicine, McMaster, McGill, Memorial University, the University of Ottawa and Queen's University. His testimony was that they strongly recommended “an extended pause on expanding MAID to include mental disorders...because we're simply not ready.” He was quite emphatic on the point that we are not going to be ready in another year.

Dr. Trudo Lemmens, who is a professor of health law and policy in the faculty of law at the University of Toronto, was there to clarify some constitutional arguments. He was really trying to underline the fact that we have to keep the section 7 and section 15 rights in balance with section 1 and that this issue has not actually been decided by the courts, contrary to what we heard from some witnesses. Previous speakers on tonight's debate have also pointed out that the Truchon decision did not include any reference to mental disorders. That is an important point we have to make.

Dr. Sonu Gaind, who is the chief of the department of psychiatry at the Sunnybrook Health Sciences Centre, pointed out that:

MAID is for irremediable medical conditions. These are ones we can predict won't improve. Worldwide evidence shows we cannot predict irremediability in cases of mental illness, meaning that the primary safeguard underpinning MAID is already being bypassed, with evidence showing such predictions are wrong over half the time.

Scientific evidence shows we cannot distinguish suicidality caused by mental illness from motivations leading to psychiatric MAID requests, with overlapping characteristics suggesting there may be no distinction to make.

He also commented on the fact that the curriculum used does not teach assessors to distinguish between suicidality and psychiatric MAID requests, and so on.

We also heard from Dr. Tarek Rajji; he is the chair of the medical advisory committee at the Centre for Addiction and Mental Health. He stated:

CAMH's concern is that the health care system is not ready for March 2024. The clinical guidelines, resources and processes are not in place to assess, determine eligibility for and support or deliver MAID when eligibility is confirmed to people whose sole underlying medical condition is mental illness.

These provide a snapshot of the widespread professional discomfort that exists out there, and I do not think we can discount those voices.

I would agree that there were also a number of professionals on the other side who did feel we were ready, and that is what makes this such an incredibly complex and sensitive subject to try to navigate as a parliamentarian. Again, we as a committee should have been afforded the time and space to really delve into these issues and to greatly expand our witness list to make sure we were in fact ready.

Members will note that our recent committee report had only one recommendation in it. I recognize that the recommendation was a result of the majority of the committee members. There were some dissenting opinions, notably from the senators who were part of the committee. However, the committee did recognize that Canada is not prepared for medical assistance in dying where mental disorder is the sole underlying medical condition, and we did not attach an arbitrary timeline to the recommendation. Our specific call was that MAID should not be made available in Canada until the minister of health and the minister of justice are satisfied, based on recommendations from their respective departments and in consultation with their provincial and territorial counterparts and with indigenous peoples, that it can be safely and adequately provided.

We keep getting ourselves into trouble by setting arbitrary deadlines for ourselves. Setting up an arbitrary timeline is not an adequate replacement for the qualitative work that needs to be done by these departments. I would much prefer that we satisfy the qualitative requirement in the recommendation, where departments, experts and our provincial and territorial colleagues are in fact saying that they are going to be okay with that.

The recommendation and my reference to the provinces and territories is a great segue to the fact that there was also a letter sent to the Minister of Health. It was signed by seven out of 10 provinces and all three territories. The signatures include those of all the ministers of health and ministers responsible for mental health and addictions in those provinces, including Adrian Dix and Jennifer Whiteside from my own province of British Columbia. They quite clearly say:

The current March 17, 2024, deadline does not provide sufficient time to fully and appropriately prepare all provinces and territories across Canada....

We encourage you and [the] federal Justice Minister...to indefinitely pause the implementation of the expanded MAID eligibility criteria to enable further collaboration between provinces, territories and the federal government.

I will wrap up by saying that this is a very sensitive issue. I do think we should pass Bill C-62 and honour the calls we are hearing from the professions intimately involved in this issue and the calls coming from the provinces and territories. We need to step up to the plate and make sure we have a fully ready system in advance of the changing of any laws.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, we need to have a reminder of why we are in the situation we are in. I was here in the 43rd Parliament when Bill C-7 was being debated. I remember very clearly the government's original charter statement, which included its rationale for excluding mental disorder as a sole underlying medical condition. I thought the charter statement was quite reasonable. However, we are in this situation because, when Bill C-7 went to the Senate, for some inexplicable reason, at the eleventh hour, the government did a complete 180° and accepted the Senate amendment. It changed the law before the hard work had been done.

I have been a member of the special joint committee from the get-go, and on that committee, we feel like we have been playing a game of catch-up ever since, having to do the work racing against an arbitrary timeline. That is why we have see letters from seven out of the 10 provinces and all three territories asking for an indefinite pause. I hope the minister and the Liberal government can take responsibility for putting Parliament in this position.

I would also like the minister to comment on the fact that there are so many populations, whether they are in rural or remote communities or urban centres, that simply cannot get the mental health care they need. When is her government going to step up to the plate and start servicing communities such as those in Cowichan—Malahat—Langford along with those from coast to cost to coast? That is a huge problem that really needs to be addressed before we entertain any kind of a change to the law.

[Gary Anandasangaree, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Madam Speaker, I thank the member for Abbotsford for bringing forward Bill C-314, an act to amend the Criminal Code regarding medical assistance in dying.

I acknowledge that we are gathered on the traditional unceded lands of the Algonquin people.

The bill before us proposes to indefinitely exclude persons whose sole underlying medical condition is a mental disorder from being eligible to receive medical assistance in dying, or MAID. I will be opposing the bill for reasons I will detail in my remarks. I want to start by providing a brief overview of MAID in Canada.

MAID was legalized in 2016 for persons whose natural death is reasonably foreseeable, through former Bill C-14. Four years later, in 2021, former Bill C-7 expanded eligibility for receiving MAID to persons whose natural death is not reasonably foreseeable. Former Bill C-7 also temporarily excluded, until March 2023, eligibility for receiving MAID on the basis of a mental illness alone.

Parliament decided that a temporary exclusion from eligibility for MAID where the sole underlying medical condition is a mental illness was necessary in recognition of the fact that such requests were complex and required additional study. This is why former Bill C-7 also required an independent expert review regarding recommended protocols, guidance and safeguards to apply to such requests. The expert panel on MAID and mental illness was created to undertake this review, and its final report was tabled in Parliament on May 13, 2022.

Former Bill C-7 also required the establishment of a joint parliamentary committee to conduct a comprehensive review of the Criminal Code MAID provisions and other related issues, including MAID and mental illness. The Special Joint Committee on MAID, or AMAD, took this review and tabled its final report in Parliament on February 15, 2023.

Our government extended the temporary exclusion to March 2024 through the enactment and coming into force of former Bill C-39. This was due to concerns about provincial and territorial readiness. It is important that we get this right.

I want to take a moment to point out that the intention has always been for the mental health exclusion to be temporary. This is a complex, sensitive and polarizing issue. Some very legitimate concerns have been raised.

However, I believe that the health care system will be ready for the safe provision of MAID where the sole underlying medical condition is a mental illness by March 2024. Significant progress has been made by our government, in collaboration with the provinces and territories and other stakeholders and experts, to prepare for this deadline.

We are not ignoring the concerns that have been raised. In fact, many of these concerns led to the one-year extension of the exclusion. We are moving in a prudent, measured way with the ultimate goal of ensuring that our MAID framework supports the autonomy of those who are eligible to receive MAID and protects those who may be vulnerable.

I will now turn to Bill C-314 and outline some of the technical issues.

As I stated previously, the bill proposes to indefinitely exclude eligibility for MAID based on a mental disorder alone. It would do this by replacing “mental illness” with “mental disorder” in subsection 241.2(2.1) of the Criminal Code.

There are two main issues with this approach. First, such a change may result in the unintended exclusion of persons with some medical conditions that are not currently excluded from eligibility for MAID. This is because “mental disorder” is a clinically defined term that practitioners have explained would likely capture all mental disorders included in the American Psychiatric Association's “Diagnostic and Statistical Manual of Mental Disorders”, or DSM-5, whereas “mental illness”, as it relates to MAID, is meant to capture mental disorders that are primarily treated within the domain of psychiatry.

“Mental illness” likely captures a smaller set of conditions than what would be captured by “mental disorder”. As such, making the switch in terminology without an accompanying definition may have the unintended consequence of excluding certain medical conditions that are not currently excluded from eligibility for MAID and that do not raise the same concerns as “mental illness” does in relation to MAID.

The second issue is that the term “mental disorder” is already defined in section 2 of the Criminal Code as “a disease of the mind”, and there is extensive case law interpreting what this means in the context of the “not criminally responsible” regime. Therefore, a switch in terminology in the Criminal Code MAID provisions without an accompanying definition may unintentionally complicate legislative interpretation and may also result in the existing case law interpretation of “mental disorder” and the “not criminally responsible” regime context being applied to the MAID context.

Although many experts and practitioners have noted a preference for the term “mental disorder” since it is a clinically defined term, this preference has already been expressed in the context of developing protocols, standards or guidance for MAID. It is important to remember that MAID is not just a health care issue. It is also a criminal law issue, and as I have just explained, things can get complicated in the legislative context given existing definitions and legal interpretations.

Finally, I simply want to point out that Bill C‑314 also restructures the exclusion set out in the Criminal Code but does not seem to change its application.

Currently, in order to be eligible for MAID, a person must have “a grievous and irremediable medical condition”, which is present when a person has a serious and incurable disease or disability, is in an advanced state of irreversible decline and is experiencing enduring and intolerable suffering, as per subsection 241.2(2).

Right now, a mental disorder is not considered an illness, disease or disability under the first part of the definition of a grievous and irremediable medical condition.

As such, a mental illness cannot satisfy the definition and therefore cannot be grounds for a request for MAID.

Under the proposed new exclusion, a mental disorder would not be considered a grievous and irremediable medical condition at all. In other words, it would exclude mental disorders from the whole of the definition, even though some of those aspects may well exist in the case of a mental disorder, namely intolerable suffering and an advanced state of decline. Although this new exclusion would operate slightly differently than the existing exclusion, it seems as though its effects would be the same.

I want to reiterate that Parliament considered this two years ago during its consideration of former Bill C-7 and decided that a MAID mental illness exclusion should be temporary. The point was reinforced by Parliament's enactment of former Bill C-39 this past March.

The expert panel on MAID and mental illness has tabled its final report, which notes that the existing MAID eligibility criteria and safeguards, supported by other key resources, provide an adequate framework for the provision of MAID where the sole underlying medical condition is a mental illness. Parliament considered the issues again via the Special Joint Committee on MAID, and the majority of members agreed with the expert panel's findings.

I urge members to join me in opposing the bill and not reverse Parliament's decision by unintentionally complicating legislative interpretation in the criminal law.

Mental Health

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Chair, I will be splitting my time with the member for Yorkton—Melville.

Millions of Canadians live with a mental illness. Tragically, each year more than 4,000 Canadians commit suicide, the vast majority of whom suffer from a mental illness. Concerningly, many more Canadians who suffer from mental illness will have their lives prematurely ended as a result of the Liberal government's ideologically driven, evidence-free expansion of MAID in cases where mental illness is the sole underlying condition.

It was not long ago that the Minister of Justice himself cautioned against expanding MAID in cases where mental illness is the sole underlying condition. In this very place, when Bill C-7 was debated, he said that there are “inherent complexities and risks with MAID on the basis of mental illness as the sole criterion, such as suicidality being a symptom of some mental illnesses”. What has changed? Those inherent complexities and risks remain. What has changed is purely political.

When Bill C-7 went over to the Senate, the Senate adopted a significant amendment to drastically expand MAID in cases of sole mental illness by way of a sunset clause that would come into effect in March 2023. Despite having spoken of “inherent complexities and risks”, the Minister of Justice, incredibly, did a 180° turnaround and accepted the Senate amendment, despite the absence of meaningful study and the absence of meaningful consultation. Then, the Liberal government shut down debate to ram through the bill and ram through this radical expansion of MAID.

By law, in order to qualify for MAID, it must be established that the patient suffers from a “grievous and irremediable” condition that is “incurable”, in which one is in an “irreversible” state of decline. In other words, in order to qualify for MAID, it must be established that one cannot get better.

The Special Joint Committee on Medical Assistance in Dying, of which I am a vice-chair, has heard testimony from medical experts, including psychiatrists, and the evidence is that it is not safe to move ahead. That is because it is not possible, or at the very least it is difficult, to predict irremediability.

Even the government's own expert panel concluded as much. On page 9 of the government's own expert panel report, the expert panel said, “it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient” in cases of sole mental illness. That means persons who are suffering from mental illness who could get better and go on to lead happy and productive lives will have their lives prematurely ended.

As such, I submit that it is reckless and irresponsible for the government to move ahead. What the government should do instead is take the evidence of the expert panel, listen to the experts who have come before the special joint committee and put a pause on this significant and, I would submit, dangerous expansion of MAID. Anything less would be a betrayal of some of the most vulnerable people in this country.