Bill C-7 (Historical)

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

This enactment amends the Criminal Code to, among other things,
(a) repeal the provision that requires a person’s natural death be reasonably foreseeable in order for them to be eligible for medical assistance in dying;
(b) specify that persons whose sole underlying medical condition is a mental illness are not eligible for medical assistance in dying;
(c) create two sets of safeguards that must be respected before medical assistance in dying may be provided to a person, the application of which depends on whether the person’s natural death is reasonably foreseeable;
(d) permit medical assistance in dying to be provided to a person who has been found eligible to receive it, whose natural death is reasonably foreseeable and who has lost the capacity to consent before medical assistance in dying is provided, on the basis of a prior agreement they entered into with the medical practitioner or nurse practitioner; and
(e) permit medical assistance in dying to be provided to a person who has lost the capacity to consent to it as a result of the self-administration of a substance that was provided to them under the provisions governing medical assistance in dying in order to cause their own death.

Criminal Code

[The Deputy Speaker, Bruce Stanton]

It being 8:07 p.m., pursuant to order made earlier today, it is my duty to interrupt the proceedings and put forthwith every question necessary to dispose of the amendments tabled by the Senate to Bill C-7 now before the House.

The question is on the amendment.

If a member of a recognized party present in the House wishes to request a recorded division or that the amendment be adopted on division, I invite them to rise and indicate it to the Chair.

[Gérard Deltell, Conservative, Louis-Saint-Laurent, QC]

Mr. Speaker, I support medical assistance in dying, and I know what I am talking about.

Thirteen years ago, when I was a member of the Quebec National Assembly, I was part of the group that spent six years studying medical assistance in dying. It took six years for Quebec to come up with a policy on MAID. I voted in favour of that policy.

Five years ago, I was part of the parliamentary team that brought together senators and members of the House of Commons to discuss the first version of MAID at the federal level. A few weeks ago, I voted in favour of Bill C-7 in the House, and I was not alone: 15 Conservative members voted in favour of Bill C-7, including men and women from Quebec, Ontario, Manitoba and Alberta.

I am in favour of MAID, and I am in favour of Bill C-7, but that is not what we are debating this evening. We are debating the senators' amendments to Bill C-7. The amendment we are most concerned about relates to the Senate's decision to open the door to MAID for people with mental illness. Quebec studied this issue for six years and never looked at the mental illness element. Five years ago in the House of Commons, mental illness was not part of the conversation. Mental illness was not a factor in the first iteration of Bill C-7. Even the current Minister of Justice told the parliamentary committee that there was no consensus around this issue in Canada.

Now some senators have decided to bring MAID for mental illness into the conversation without the notion ever having been debated or studied in the House of Commons, and the government is supporting the Senate's stance.

I am very surprised and disappointed because, earlier, the Minister of Justice said, “Canada is ready to accept this practice”. That is surprising. What is he basing that on? This is the same person who said a few weeks ago that there was no social consensus on the subject in Canada. Now, he is even saying that there is a consensus across Canada.

Everyone has the right to change their mind, but there is a way of doing that, particularly when the person in question is the Minister of Justice. Why did the minister not have, shall I say, the courage to address this issue in the original version? Why did he go through the Senate to say that we must move forward?

It is not just people like me who are concerned about this. Take, for example, the Toronto Star, which is not a very conservative group. An article on this issue in that newspaper said:

The potential for abuse is both obvious and frightening.

That was in the Toronto Star, but it gets better.

The Justice Department's own website still states the following regarding extending MAID to those whose only underlying condition is mental illness, which is precisely what the Senate amendment is all about:

...could be seen as undermining suicide prevention initiatives and normalizing death as a solution to many forms of suffering.

The Department of Justice still has that posted on its website. This is the department led by the same Minister of Justice who today said that Canadian society was ready for this practice and that there was a consensus in society.

This is all to say nothing of the many groups, such as first nations, that oppose this, much like a number of psychiatrists' and psychologists' associations, because, at this point in time, there is still no scientific proof that mental illness is irreversible, unlike the other issues associated with MAID and with which I agree.

I am even prepared to reopen the debate and allow for consent from people with incurable cognitive or neurological diseases, such as Alzheimer's or Parkinson's, which can cause terrible suffering. That is my opinion. I am open to that, but we all know people who have struggled with emotional or mental illnesses all their lives. These people have their ups and downs, and sometimes those downs are very low and may involve suicidal thoughts. Are we prepared to give them the option of medical assistance in dying in these circumstances?

As the Department of Justice website says, this could normalize “death as a solution to many forms of suffering.” Those are not my words. That is a quote from the Department of Justice.

In closing, there were a lot of questions suggesting that the Conservatives did not want to debate this bill. That is completely false.

First of all, the reason we are struggling to meet this very tight deadline is entirely the government's fault. It was the government that decided to prorogue Parliament for six weeks this summer, forcing the House to go back to square one with the review of this bill, which was already under way. The prorogation caused the House to lose 25 sitting days. What is more, the government dragged its feet. If this bill was so important to the government, it could have introduced it the day after the Speech from the Throne in September. Instead, this government waited seven days before introducing it. It dragged its feet, it took no action, and it is the government's fault we are late. That is where we are with Bill C-7.

Let us now talk about the Senate amendments. The Senate voted on a Wednesday evening. The very next day, we were prepared to debate the amendments, but first they needed to be brought before the House. However, the first thing the government did was say that the Conservatives were calling for an extension. We did no such thing. It was the government that requested an extension.

Rather than taking a stand and immediately tabling the Senate's amendments in the House, the government asked the court to extend the deadline. That was its choice and its right. This government accuses us of dragging our feet, and yet it took five full days to respond when everyone knew which amendments would be adopted and which would be declined. That was its right and its responsibility.

Twelve hours after the government tabled its proposal for the Senate amendments, the debate began in the House and lasted a full day. However, the government never put the debate on the Senate amendments back on the agenda for the subsequent regular sittings of the House. It could have done so on the following Wednesday, Thursday or Friday, or on Monday, Tuesday or Wednesday of this week, or even today. Instead, it decided to move a closure motion today. That is its right, I acknowledge that.

However, I take exception to people, and in particular the government, saying that the Conservatives do not want to have this debate. That is completely untrue. This is not a matter of politics or party allegiance. The Conservatives have some serious concerns about making medical assistance in dying available to people with mental illness. The NDP shares this point of view and is against the bill, so members need to stop saying that this is a right-wing opinion. Some people are in favour of the bill, while others are against it. That is all.

I was one of the 15 Conservative members who voted in favour of Bill C-7. I support medical assistance in dying, but not for people with mental illness.

In a few minutes, we will vote on the amendment proposed by the member for Leeds—Grenville—Thousand Islands and Rideau Lakes, which would remove the amendment that deals with mental illness and allow us to proceed with Bill C-7 as is.

I am calling on all parliamentarians: if they have any doubt whatsoever about MAID for people with mental illness, I am asking them to vote in favour of our amendment. They could then go on to vote for the rest. If they have any doubt, our amendment removes that provision and accepts the rest of Bill C-7.

[Colin Carrie, Conservative, Oshawa, ON]

Mr. Speaker, I want to thank my colleague for her speech, which truly was a speech of hope. As always, it is a pleasure for me to stand today to speak for the citizens of Oshawa, but especially those who are most vulnerable, those who today may be at their lowest point. Hope is exactly what they need.

Today, we are commemorating a year since we have been locked down with COVID. I think of all of us here and in our constituencies. I think the increased mental health issues, the suicides, the anxiety and the overdose deaths. I feel so sad that today the government brought in closure for this bill. It is shutting down debate on Bill C-7, and the irony is not lost.

This is a substantially different bill than was originally debated in the House. It is substantially different from the bill that was studied in committee. It is substantially different because it opens up MAID, medical assistance in dying, to those with mental health issues.

Last month, many of us contributed to Bell Let's Talk Day. I remember being a parliamentary secretary when Bell started this initiative. Everyone was very supportive of it. I was so happy that Bell took this on. I applauded and supported them. In the House were saying to those who were suffering from mental health issues that their lives were important, and we all embraced that House.

Last night I was watching T.V. and I saw the commercial put out by CAMH. It was quite sad. It is a man who is sitting alone, and it talks about “not today“. It is about someone who is down and at his worst and needs that support. I do not know if members have seen it.

It is important that we get the opportunity to debate principles. If we look at our legal system, it is based on the principle that it is wrong to take an innocent human life. When the state is making an exception to this principle, it is incumbent that we are very careful. Why? Because the results are permanent and irreversible.

The original bill that was provided to the House had many things that the people Oshawa could support. However, substantial changes have been made by the Senate that would open MAID up to those with depression and mental health issues. I cannot support this changed bill. Frankly, I am extremely disappointed and upset with the government. The Liberals are not even allowing us to properly debate this new bill. They have invoked closure.

Today, the minister said that there was consensus, but that is simply not true. The minister said of the original bill that there was no consensus on MAID for people with mental illness. Instead of allowing committee to call witnesses affected by the bill, and the experts, the minister wants to push this bill through tonight and close down debate. He wants to pass this bill and then create a committee of experts to study the bill. This is exactly the opposite of the normal process of the House. We are here today making Canadians aware of that, because this is unprecedented. I have never heard of this before. It is almost like the government telling us to trust it, that it is going to do this, not to worry about it and to let us get this through. However, the minister and the government have a credibility issue.

I know I am challenging the minister, and I hope he questions me about it. He needs to make things clear. The original MAID bill was due for a legislative review after five years, which was supposed to happen last year. That did not happen. We know the government prorogued. We know it had the WE scandal it wanted to cover up. If it did not do its legislative duty for the original bill, how can Canadians trust the Liberals and the minister to follow through? Instead of challenging the Quebec court's decision, the minister did not even defend his own legislation, and I find this incredibly unusual.

We are talking about trust, and when people are depressed and at their lowest, they need a government they can trust. In Oshawa, we have one of the most prominent experts in palliative care. Her name is Gillian Gilchrist. She practised medicine for over 50 years. She started a palliative care clinic in 1981 and was the first chair. I called her today, and she told me that when people are on a cliff, they need someone to trust. They need someone to talk to. They need someone to care. They need someone to be there. They need someone to talk them down. She said our system needs more resources for people with mental health issues.

Proper medical care is expensive, but MAID is not. I heard the Liberals say today that no one is forced to choose MAID. However, we have heard colleagues today in the House, and I think some of our Bloc colleagues said over and over today, that we need more resources for health care. I would argue that we need more resources for mental health care, because when Liberals say that no one is forced to choose MAID, if there is no proper mental health help available and there is no one to talk to, no one to listen, no one to care and no one to say “not today”, I submit there is no choice. Until the government invests more in mental health care for that choice, the only option offered is MAID. How sad is that?

I am suggesting that the minister has to address his credibility problem. Today he said he has consensus for the bill, but in committee he said there is not consensus for MAID for people with mental health issues. I have a letter from Vulnerable Persons Standard. This letter has been signed by 129 organizations, which tells us that the minister does not have consensus.

The Liberals were mandated to do a legislative review of the original bill after five years. That would have been last year, but, as I said earlier, instead of doing what they were legislated to do, they prorogued to cover up a scandal because they have a credibility problem. I say they cannot be trusted to follow through on this one either.

This is not from Conservatives. Three United Nations experts have warned the minister that Bill C-7 will violate international human rights conventions to which Canada is a signatory, but the minister is closing down debate today. Canadian legal experts warned that Bill C-7 will violate the Convention on the Rights of Persons with Disabilities, but the minister is closing down debate today.

The people of Oshawa and the people of Canada expect us to debate these difficult issues and to study this bill at committee. This bill is sanctioning the taking of the life of someone who is mentally ill and the taking of someone's life when the mental health care system is not there for them, someone who is depressed, someone who is at their most vulnerable and someone who is reaching out to us for their voice and their life. What is more important than that?

Today I am sad because I fear our system will fail. It will fail Canadians with disabilities and with depression who want real choices. It will fail Canadians who want us to listen to their views, who want to be given the opportunity to hear from experts in committee, who want to make sure someone is there for Canadians with disabilities and depression to tell them “not today”.

[Arif Virani, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Mr. Speaker, I point out that the issue of discrimination was squarely before the court in Truchon and the findings are exactly the opposite: that not making MAID available to those who are not at the end of life, including persons with disabilities, violated their competence, their autonomy and their dignity.

The second point is that scrutiny has been provided with respect to this bill. One hundred and thirty-nine MPs have spoken, and 45 hours of debate have occurred. On three separate occasions, given the opportunity to extend debate to discuss these very amendments, the Conservative Party turned it down.

Would the member opposite agree that it is entirely speculative to say that the only thing that will be offered to persons who are mentally ill is MAID, which I believe is what she effectively just stated, given the fact that even under the current regime of Bill C-7, prior to the Senate addressing it and working to amend it, there were already protocols in place, such that one must be informed of counselling, mental health supports, disability supports, community services and palliative care, and that those must have been discussed and appropriately considered?

[Rosemarie Falk, Conservative, Battlefords—Lloydminster, SK]

Madam Speaker, I want to note that I will be splitting my time this evening with the member for Oshawa.

It is interesting that we are speaking to Bill C-7 today under these circumstances. As legislators, we have a very weighty responsibility to do our due diligence in considering legislation. We have a duty to Canadians and the constituents who elected us to thoroughly analyze and review the legislation that is passed in the House. When we are considering issues of life and death, that responsibility is only heightened, and it is absolutely reprehensible that the Liberal government is limiting debate on this legislation and hastily accepting amendments from the other chamber without due diligence.

When the House last debated Bill C-7, mental illness as the sole underlying condition was explicitly excluded from the eligibility criteria for accessing medically assisted death. The explanation to allow for it is therefore obviously significant. It requires additional scrutiny. It was not part of the justice committee's study of the legislation, and members of the committee did not have the opportunity to hear from mental health advocates on this expansion. There has not been an adequate parliamentary review of this change.

In addition to that, and of greater concern, there is no consensus in the medical community that mental illness should be considered irremediable. There is no consensus that MAID should be expanded to include persons with mental illness.

The Liberal government is amending this legislation at the end of the parliamentary process to, as I can imagine, avoid scrutiny by ramming it through the House. To proceed with this significant expansion of MAID would be absolutely reckless. This legislation endangers vulnerable Canadians and, frankly, we owe them better. We owe the one in five Canadians who struggle with mental health and mental illness better.

There are a range of effective treatments available for mental illness. However, we know that access to these treatments is limited. That is where the focus of the government should be. It should be focused on providing additional mental health supports, not recklessly expanding MAID.

The need to improve access to mental health supports has been even more pressing during the pandemic. We know that the pandemic is negatively impacting the mental health of many Canadians. We have heard about the impact that pandemic restrictions have had on the well-being of seniors in particular. Depression and loneliness are spiking, and I am reminded of the heartbreaking stories of seniors who chose MAID. They did this to avoid continued isolation during the pandemic.

To only offer a person MAID when they are at their most vulnerable point is indefensible. For those who have a mental illness, the only attainable tool in their tool box cannot be medically assisted death.

There is a serious and reasonable concern that expanding MAID to include persons with mental illness will undermine suicide prevention initiatives and recovery-based care efforts. In fact, the justice minister's own department has expressed that concern. This reckless amendment paves the way for Canadians suffering from mental illness to prematurely end their life.

We also cannot ignore the fact that this legislation continues to pre-empt the required parliamentary review of the existing MAID framework. The Liberal government's entire agenda of broadening access to medical assistance in dying in advance of that review is, on its own, deeply concerning. We have heard from persons with disabilities and medical professionals who have clearly stated that the expansion of MAID in Bill C-7 is dangerous and requires greater scrutiny.

As the Liberal government continues down this path of broadening access to MAID without ensuring proper access to appropriate care, it is actually eroding the value we place on human life. It is robbing a person of the opportunity to live with dignity.

Medical assistance in dying should not be a solution to all forms of suffering, but as the government broadens access to MAID to persons whose natural death is not reasonably foreseeable, we as a society are moving away from medical assistance in dying and ultimately toward medical-assisted suicide. The underlying message of moving in that direction is that death is a treatment for suffering.

It is my core belief that as a country, government, society and community, we have a responsibility and moral obligation to care for one another: to care for the elderly, the poor, the sick, those with disabilities and the vulnerable. We cannot sidestep our duty to care by offering death as a treatment for suffering. If the desired goal is to increase personal autonomy, we cannot accomplish that without meaningful choice. We certainly cannot do that at the expense of ensuring appropriate safeguards to protect vulnerable persons.

The united voice of disability advocates across the country who have come out in strong opposition to the bill should give all of us great pause. Shamefully, the Liberal government is not putting on the breaks. Rather, it is moving forward, full steam ahead, ignoring the serious concerns that this legislation is fast-tracking the deaths of persons with disabilities.

By removing the reasonably foreseeable death clause in the current MAID framework, this legislation opens MAID up to persons with disabilities who are not themselves when close to death. Simply put, this legislation is discriminatory and promotes ableist assumptions. Intended or not, it suggests that the lives of people with disabilities are not worth living. Instead of ensuring that a person with a disability has the accommodations and supports they need to thrive, it offers them medically assisted death as a solution.

This is particularly salient when we consider that concerns regarding a lack of appropriate safeguards for persons with disabilities in the existing MAID framework pre-existed this legislation. The former UN special rapporteur on the rights of persons with disabilities expressed concerns to the Liberal government on this very issue. She raised the issue that there were no protocols in place to ensure that a person with disabilities was offered viable alternatives to assisted death.

She recommended to the Liberal government that it investigate allegations that persons with disabilities were being pressured into seeking medical assistance in dying. She also recommended that safeguards be in place to ensure that persons with disabilities are not requesting MAID simply because there are no other appropriate alternatives available to them. These same concerns have been raised by disability advocates across the country. However, the justice minister and the Liberal government have not addressed them. Instead, they are removing and weakening the safeguards that were in place.

If we as a country offer MAID to the vulnerable while depriving them of adequate care and the resources to have a dignified, secure and healthy life, then we have failed them. We cannot pursue increasing personal autonomy at all costs. We cannot, in the name of autonomy, sacrifice safeguards for the vulnerable, undermine suicide prevention efforts, erode respect for human life and perpetuate negative stereotypes about age, abilities or illness. There has to be a balance.

Certainly, we cannot make decisions lightly without proper scrutiny and review, and that has not happened. The Liberal government has not allowed a parliamentary committee to hear from a single witness about expanding MAID to include those with mental illness. It is ignoring the pleas and serious concerns raised about this legislation. It has limited debate on it and continues to delay a mandated parliamentary review of the existing MAID framework.

I urge all members of the House to oppose the Liberal government's attempt to recklessly adopt significant amendments to this legislation in the final hours, and to oppose its efforts to steamroll these legislative changes through this place without proper scrutiny and care. Let us do our proper due diligence on this legislation. We owe that to all Canadians and the lives that hang in the balance.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Madam Speaker, I do not blame the hon. member for Sarnia—Lambton for not knowing the historical reality that the Senate of Canada has done much more egregious things against the democratic will of the House of Commons. In November 2010, which I remember vividly, the Senate killed a climate accountability act that had been brought forward by Bruce Hyer, Bill C-311. Bruce went on to become a Green Party colleague of mine in the House, but what the Senate did was even worse than anything we can imagine, in that it killed the climate legislation without first referring it to committee as a result of procedural shenanigans ordered by the PMO.

To come back to the main point here of the legislation before us, Bill C-7, I agree with the hon. member that we have not had adequate time to review the changes the Senate has proposed in relation to mental health provisions. I am deeply troubled by how quickly we are now moving ahead with something that just weeks ago I stood in the House to support, namely, the original bill. That bill specifically said that we were not dealing with mental health issues, and yet now here we are. To that extent, I agree with my colleague. I am very troubled by how quickly we have to move—

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Madam Speaker, I am glad to be able to rise this evening to speak to these amendments from the Senate on the medical assistance in dying bill.

It is unfortunate that we have such a short amount of time to talk about these amendments, because this is quite literally a matter of life and death. I would think the government, on something as serious as this, would want to spend some time thinking about these changes, which are far outside the scope of the original bill.

Let me talk about the purpose of the Senate. The Senate was put in place at its inception as a mechanism to look at the legislation from the government of the day and decide whether it was good for Canada. If not, it was to provide fixes for it and send it back. Clearly, what has happened with Bill C-7 is far beyond that.

The unelected members of the Senate have come with items like MAID for people suffering only from mental illness, advance directives, and all kinds of things that were beyond the scope of what was presented. That is not its role, and the government, by accepting these things outside of its scope, is really putting ideas in the minds of the senators to encourage them to continue to do what is not their role.

Let us go through the amendments one at a time. The first one allows those with only mental illness to have access to MAID and says we will talk about it in a while: not in 18 months, but in 24 months. This is really unacceptable. After the first medical assistance in dying legislation was brought in, the Liberal government put together consultants and a panel from the Council of Canadian Academies. This was done by the Hon. Jane Philpott and the hon. member for Vancouver Granville, to study whether people with mental illness only should have access to MAID.

That working group could not agree that this was a good thing to proceed with. It was quite concerned about whether people with mental illness really had the capability to give informed consent. It was concerned as well that we were going down the wrong path. Even the Netherlands, which has such a broad euthanasia range, only allows people with dementia to have medical assistance in dying, and there is still a ton of controversy with that. Even the Netherlands has not gone down this very dark path.

The Centre for Addiction and Mental Health issued a report to the government and said:

Canadians themselves are divided on the issue of MAiD, and most do not support making it available to those with only mental illness.

If the government is not going to listen to Canadians when they say this is not what they want, that is a concern.

These experts from CAMH also said:

The federal government should not make an amendment to MAiD legislation for people with mental illness as their sole underlying medical condition at this time due to a lack of evidence that mental illness is an irremediable medical condition in individual cases.

CAMH also expressed:

The concern is that many individuals with mental illness...[may have] impairments in [their] reasoning capacity that [would] make it difficult for them to connect their symptoms with their illness, fully understand the risks and benefits of treatment, and/or make...decisions based on personal goals and values.

With that, the Liberal government should be listening to Canadians who do not think this is a good idea, the mental health experts who do not think this is a good idea and the many people who are suffering from mental illness.

Not to be coarse, but the reality today is that people who only have mental illness as their condition can already commit suicide. In fact, sadly, thousands of Canadians are doing it, and thousands more are likely to do it as a result of the failure of the government to address the pandemic and restore the economy. People are losing their businesses and their livelihoods, and they have been under lockdown. This is a very serious condition.

A time when the government is talking about suicide prevention is no time to be saying, “Let us put extra help in here so people can have medical professionals assist them in their suicide efforts.” That is offensive at the very least.

The second amendment has to do with the review of the MAID regime. Absolutely, I see the government wants to have a review, but the fact is, there was a review in the first legislation, and the government did not do it. That was unacceptable and should have been addressed then. I do not think we need a new formula on how to do a review. I think we just need to do the review.

The third amendment is about collecting race-based data regarding MAID. I see in the discussion of this and it has been mentioned that we collect this kind of data on other things, such as palliative care. Well, palliative care, as members know because my private member's bill on palliative care was unanimously supported in the House, is a topic that is near and dear to my heart. In fact, the framework on palliative care to get consistent access for Canadians was begun because the data shows that where there is good quality palliative care, 95% of the people choose to live as well as they can for as long as they can.

However, sadly, this government has prioritized the killing of people through medical assistance in dying and de-emphasized palliative care. When we talk about people who, maybe due to their race and social standing, do not have good access to palliative care, we are talking about 60% of Canadians left without any access. That certainly should have been the priority for the government, instead of expanding the regime to help people end their lives.

I see that the clarification of neurocognitive disorder not being considered a mental illness was rejected as an amendment. The justice minister clarified in his testimony that the exclusion is not intended to capture neurocognitive disorders that are due to Alzheimer's or Parkinson's disease. Well, the justice minister has a habit of needing to clarifying things, because what is in the bills is never clear enough. We saw that in Bill C-6 where a clarification had to be put on the website about the definition. It was not in the bill, but it needed to be done because of the hurry with which these things are brought forward. I think that we need to take the time to get things right and not rush.

With respect to the advance request amendment, I would say that the same group that was put together to consult on this issue consulted on advance consent. The government already had this information, and it was not recommended that we go with advance consent. There were concerns about a few things.

First of all, who decides what is intolerable suffering when the person has lost capacity? When do we take action? How do we prove that it is informed consent? How do we make sure there is a third party responsible to enforce the decision if there is a disagreement after the person has lost capacity? These were the issues that had been brought forward, and they were ignored altogether in this discussion. I would add that Belgium and Luxembourg only allow advance consent when a person is permanently unconscious, and so that should be a consideration.

I would be remiss on the palliative care discussion if I did not do a plug for the Granfondo Cycle of Life fundraiser in my riding on April 9 at 7:30 p.m. Members can get details from my web page.

The other topic of discussion is about the work that needs to be done to actually make sure there are alternatives. We talked about the need for mental health supports and the need for palliative care. These are important considerations.

In short, I feel that the Senate overstepped its bounds with the amendments that it brought. I feel that the government should have appealed to the Supreme Court with the Quebec decision in the first place. Certainly, the government should not be expanding the scope of medical assistance in dying without doing its due diligence on the review that was originally desired, and spend more time listening to what Canadians want and what the people who are going to be impacted are feeling.

With that, it is clear that I will be voting against these amendments, as well as the medical assistance in dying legislation that has been brought forward.

The House resumed consideration of the motion in relation to the amendments made by the Senate to Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), and of the amendment.

Motion in Relation to Senate Amendments

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, several times, I have been touched by the speeches and have been able to understand where my Conservative colleagues are coming from. I am in favour of any speech urging more social measures to help the most vulnerable and marginalized people.

When we consider the position of the Conservatives, who voted against Bill C-14 and Bill C-7, we get the impression that the only solution for dying with dignity is palliative care.

Unfortunately, palliative care and suicide prevention require investments in health and social services. How can the Conservatives get so worked up over the idea that these conditions could be trivialized, when they made cuts to health transfers, reducing the escalator from 6% to 3%? It takes money to offer social services, suicide prevention services and access to care. I cannot follow their logic.

For 50 years, holding up palliative care as the only solution has not resolved the end-of-life issue, as they know full well. Why do the Conservatives not sit down with us in 30 days? They could invite anyone they like, and we could have a cross-party discussion to find solutions.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Madam Speaker, as I begin my speech today, I am grieved to the core of my heart by the amendments from the other place that reveal an even greater lack of compassion for the most vulnerable in our society through expansion of Bill C-7 to those with mental illness. These amendments go well beyond what the House voted on last year and go well beyond the Truchon decision itself.

The Senate-Liberal Bill C-7 justifies a thorough debate and more amendments in addition to the one introduced by my colleague from Leeds—Grenville—Thousand Islands and Rideau Lakes. I must respond to Canadians' alarm with the worrisome evolution of assisted suicide propagated by the other place and the Liberal government.

Opening the door to mental illness as a stand-alone reason to request assisted death is a frightening revelation of the lack of compassion and care for those who need and deserve it most. What is the underlying intent of such an outward attack on the value of the lives of vulnerable people? The message to those who face mental illness as well as those who have dedicated themselves to the care and treatment of anxiety, personality disorder, panic attacks, gender dysphoria, mood disorders, dissociative disorders, sleep disorders, on and on, is no longer a message of hope and “Let’s talk”.

Where is the merit in collecting race-based data when they ignore the pleas of indigenous leaders, palliative care and mental health professionals, physically and mentally disabled Canadians raising strong concern over the lengths gone to by both places to normalize and prioritize assisted suicide? It is this legislation in itself that will cause greater harm to the marginalized and the disadvantaged. A culture of suicide prevention is what we in this place should all strive for as caretakers of the people’s business.

In a letter recently penned to federal and provincial parliamentarians as well as health care regulators, indigenous leaders, including Siksika Health Services' CEO Tyler White, former lieutenant governor of New Brunswick Graydon Nicholas, retired senator Nick Sibbeston, indigenous health and suicide prevention advisers and elders, the desire for a culture of assisted life is made clear, “Bill C-7 goes against many of our cultural values, belief systems, and sacred teachings. The view that MAiD is a dignified end for the terminally ill or those living with disabilities should not be forced on our peoples.”

They are concerned that the government will not respect their indigenous beliefs and values by shutting down a palliative care facility. No doubt they should be concerned as this would not be the first example of a left-leaning government in Canada shutting down a palliative care facility, which also sought to stay true to its calling to provide a service perpetuated by a unique belief and values connection to their communities, a place where assisted suicide is not offered, a place to die a natural death with dignity.

They have called on the Liberals to respect their right to determine how health services are delivered in first nations communities. Indigenous leaders have been working tirelessly on strategies to combat the crisis of suicide in their communities. At the same time, the government is creating an environment that enables assisted suicide. The Liberal government is turning its back on indigenous people.

Renowned Dr. John Maher, an ACT psychiatrist specializing in the treatment of severe mental illness, was frank in his assessment of the proposed amendments. He has made clear that the long, drawn-out process of mental health treatment makes it irrational to offer or provide assisted death to patients. In his experience, not only is initial treatment expected to last up to three years in which symptoms are brought under control, but several more years need to be accounted for in order for patients to thrive under their condition. Dr. Maher is clear that not only is it possible for those who live with mental illness to survive, but they can live satisfying lives.

The Canadian Mental Health Association stated, “As a recovery-oriented organization, CMHA does not believe that mental illnesses are irremediable.” Psychiatrists, doctors, nurses and professors from the University of Saskatchewan and the Saskatchewan Health Authority have expressed grave concern over the inclusion of mental illness as grounds to request assistance in dying. They appeal to the dedicated and wise leaders of our country to “please help protect the young people of Canada, our greatest resource for the future.” Today, we will see who the dedicated and wise leaders are.

Rather than champion hope for those suffering with mental illness and those who care for and provide treatment for their healing, the Liberal government hides behind an all-encompassing MAID regime. It cannot continue to offer suffering Canadians a skeleton of suicide prevention measures with one hand and an ever-expanding assisted death regime with the other.

As Dr. Maher has confirmed, better results can be realized through a culture of life and attentive treatment.

I had the personal privilege, and that is exactly what it was, an incredible privilege, to serve as a nurse’s aide in a long-term mental hospital, taking care of patients with very deep scars. I have given daily care to precious elderly residents in seniors homes and level 4 nursing homes. I have assisted students with special needs in elementary and high school education. Every experience has made me laugh and made me cry. Without any reservation, all these human beings have made such a significant difference in the quality and purpose of my life.

This bill is also deeply disturbing to veterans and their families. I have no desire to share their names here today or their personal experiences. Many are my personal friends. Those veterans who suffer with mental illness as a result of their service see this as another blow to their value to their country.

There has been an ongoing long-term lack of access to mental health care for themselves and their families, exacerbated by VAC's downgrading of OSISS to an online service and its failure to replace coordinators who were on the ground with them, backlogs that mean the care they need is so far away that hope turns to despair, while mental health counselling for their spouses and children who are deeply impacted by their loved one’s injuries must prove that their treatment is required for the health of the veteran.

There are a growing number of suicides in our armed forces and veterans communities already. At a time when a culture of life and of accessible and timely treatments is what is needed, the government is sending them the opposite message.

As I close, I want to encourage every member of the House, every member of the other place and every Canadian to watch a YouTube video called “Tell Me to Stay”. It is a plea from the young woman whose words will end my intervention today.

These are Garifalia’s words:

“Unless you have attempted suicide before, you will not understand how patronizing it is to hear health care practitioners and politicians talking placidly about suicidality as if it were different from MAID. Suicidality is supposedly about wanting to die, the argument goes, whereas a request for MAID is a rational and well-thought-out desire to end one’s suffering, not merely a desire to die for the sake of dying. And yet, if you had told me when I was 16 years old that I could live and not suffer, I would have chosen that option over the death that I sought.

For me, both then and now, any delineation between MAID and suicide as methods of ending suffering is a distinction without a difference. The outcome is the same—one is just medicalized.

People talk about safeguards as if they would prevent someone like me from accidentally or intentionally slipping through the cracks. As a highly intelligent individual with over 10 years of experience in pretending to be okay, let me be clear: The proposed safeguards will not catch me. Had I been able to access MAID in the depths of my struggle, the full life that I have since lived would never have happened...

As someone who endures ongoing and at times debilitating psychological suffering, I firmly believe in and support physical, emotional, mental, social and spiritual responses to suffering. What I do not support is the creation of a two-tiered system that would offer suicide prevention to one person and suicide assistance to another.”

She continues to say, “I ask you to prioritize the mandatory review so that the Government of Canada can do its due diligence and consult with Canadian society appropriately first, rather than recklessly expanding the legislative framework based on one judge’s reasoning, thereby undermining the democratic process on which our country is built. I ask you to heed the feedback of disability rights groups, indigenous communities, and international legal scholars, all of whom have spoken out against Bill C-7. Finally, I ask you to prioritize the needs of the vulnerable and the marginalized—the indigenous, the disabled, and the mentally ill.”

March 11, 2021, will be remembered as the one-year anniversary of the COVID pandemic. If this bill is passed, March 11, 2021, will be the day the Canadian government chose to tell Canada's disabled, mentally ill, marginalized and vulnerable people that they are not needed, not valued and not worthy of care.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Madam Speaker, when we watch a movie and a person is standing on a bridge, people are coming to help that person, to reaffirm the value of his or her life. Those people are not taking the person by the hand and leading him or her up to the bridge. No, they are trying to take the person off of the bridge, to walk the individual back from the edge.

I find it absolutely appalling that the government is doing what it is doing. I mentioned in my speech that we have had the Bell Let's Talk Day. We also voted on a motion in the House for the 988 suicide prevention hotline. Immediately after that, the House also voted in favour of Bill C-7. What are we trying to do? Do we support people or do we not?

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Madam Speaker, I will be sharing my time with the member for Yorkton—Melville.

It is an honour to stand in the House today and give this speech on behalf of the constituents of Cypress Hills—Grasslands. This has been a very heavy issue for a lot of my constituents, and there has been a lot of engagement on it.

The Liberal government, already with many other scandals and failures, has hit an all-time low with the bill. The Liberals were already seeking to legally expand assisted suicide in ways that are unnecessary and uncalled for. However, now for Canadians everywhere, especially those with disabilities or mental health challenges and our medical professionals, the situation has suddenly gotten much worse.

The other place sent Bill C-7 back to us with some radical and outrageous amendments. They are unthinkable and should have been rejected immediately. Instead, the Liberals have accepted the unacceptable, and at the last stage of the process, they somehow thought to allow the bill to be made even more dangerous than it already was. They have been trying to rush it along ever since, and now they are shutting down debate after everyone has barely started to process what exactly is going on.

The Liberals have shown complete disregard and disrespect for the public, who are supposed to be represented in our democratic process. However, what is even more disturbing and offensive is the statement they are making to the people who are most at risk of suffering the consequences of their legislation. The message is already clear, not only in Canada but in the rest of the world.

We are supposed to be a place that cares about human life and dignity. We are supposed to a country that leads the way and takes a principled stand for people's rights. This is Canada.

Before the government agreed to make Bill C-7 even worse, The Washington Post published an article about it entitled “Canada is plunging toward a human rights disaster for disabled people”. In a way, it is more shocking to hear it from outside observers. This is a warning sign of where our country is headed. However, the point is not new. The article focuses on Roger Foley, who keeps fighting to survive and demands better from government and the health care system. He wants assisted life before he is ever offered assisted suicide.

Major disability organizations in Canada, which are now joined by mental health advocates, have been calling out the same discrimination and dangers involved. At the same time, the United Nations has specifically called out Canada for these same issues with MAID under the current law, never mind what the Liberals are bringing forward and what the Senate has put forward here now. Before the Truchon decision happened, the special rapporteur on the rights of persons with disabilities publicly stated:

I am extremely concerned about the implementation of the legislation on medical assistance in dying from a disability perspective. I have been informed that there is no protocol in place to demonstrate that persons with disabilities have been provided with viable alternatives when eligible for assistive dying. I have further received worrisome claims about persons with disabilities in institutions being pressured to seek medical assistance in dying....

Since then, a new person has filled the role of special rapporteur, who, while testifying on Bill C-7, said, “even if safeguards would be strengthened to ensure genuine consent, the damage is still done by portraying—not directly but effectively nonetheless—that the lives of persons with disabilities are somehow worth less than others.”

However, we are not even talking about stronger safeguards either here. The government is choosing to remove multiple safeguards for disabilities, and now for mental health because of the amendments that the Senate sent us. The problem is clear to different Canadians, regardless of whether they support the law currently in place for MAID. I have heard this from several members, even within my own party, for example. The problem is that we are not discussing MAID anymore, and these amendments have made that absolutely clear, if it was not before.

I recently finished reading the book 1984 by George Orwell. Some members will say this sounds cliché and exaggerated, but they need to pay more attention to the point he makes about doublespeak and the meaning of words. If we twist the meaning of words, we subliminally change the values of society. If we do not say what we mean and mean what we say, we can easily lose sight of reality. What is worse, we can cover up harm and injustice.

We heard a Liberal minister defend Bill C-7 in a very telling way when he said, “Mental illness is a very serious illness. It is an illness. It needs to be treated as an illness. It was always going to be looked at in the second stage of the bill.” This was in response to a question about the concern of mistreating Canadians with mental illness.

The Bell Let's Talk Day was not long ago, and there are several other initiatives for mental health throughout the year. Are we going to contradict the message we all unanimously used in the House back then as we were supporting people who were dealing with mental health, or are we now going to think of suicide as treatment? Are we supposed to believe it is an option for improving someone's mental condition? I should hope actual treatments and care are provided and that suicide is actively prevented rather than offered, even as a last resort, for those who want to kill themselves but are not dying. This is no way to treat people who are suffering.

When people consider suicide, we offer them a help line. We reaffirm their value that their lives are worth living. Suicide prevention is already hard enough. How are we going to convince them? If this law passes and if it keeps us from reaching them in time, what message is that telling those people who are signalling that they have already lost hope and that this bill essentially offers them no further chance at hope? This new law and the tangled web it weaves will not make any sense whatsoever.

When the government first opened a Pandora's box for assisted suicide back in 2016, it said there would be a required review process in five years. Five years went by and it never happened. It would have been a perfect opportunity to address the growing concerns with the current law for MAID. The Liberals did not wait and they did not prioritize doing it before trying to expand the law in response to a provincial court ruling.

In case anyone forgot, Bill C-7 goes far beyond the actual decision of the court, which the Liberals claim is a time restraint even though they did not bother to appeal it in the first place. They are forcing us into last-minute amendments with one afternoon, really, of debate, and that is it.

I do not believe these rules reflect the true Canadian spirit. They would silence too many voices and perspectives that deserve to be heard after ignoring them for the past year and more. The average Canadian does not find it hard to be horrified at these changes, especially when they have barely seen the light of public scrutiny. Whether we live with or love people with disabilities and mental health challenges or if we have the basic idea of respecting the dignity and value of our fellow human beings, the problems are obvious. Someone who for any reason is distressed by what this decision represents is apparently not worth the government's time or consideration.

The Liberals say they have run out of time, but they have failed to make time or give time to those who need it most. They are the ones who control the legislative calendar. It was up to them. It is a lot like getting stuck with a pushy sales rep who avoids questions while trying to make a quick sale. By now, Canadians are used to Liberal excuses for their incompetence, but it is becoming clearer than ever how some of their radical views on social issues try to get passed through unnoticed.

This is all the more reason why we needed to have a thorough review of the current law, which was promised but not kept. The government now says that it will accept one amendment, requiring a review after the bill comes into effect. We will have to see how that goes.

Despite all the frustration and discouragement coming forward from strong advocates and citizens, which I share right now, I still have hope in the human spirit for the future. If the government wants to take us backward and if its allies in Parliament turn a blind eye, it will not be able to stop the truth and justice from winning out. It makes me think of a line sung by Johnny Cash, “What's done in the dark will be brought to the light.”

It is a shame that there will not be much longer to speak today, because there are so many more things that do need to be said about this important issue about these amendments from the Senate. Human life is worth far more than just a few minutes of debate and discussion.

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, as the parliamentary secretary knows, even as late as today at the justice committee, Liberals rejected an opportunity for us to hear from mental illness professionals, from those who would be impacted by this legislation, and that is our job. We are listening.

I received a letter signed by 129 organizations, such as Inclusion Canada, the Canadian Hospice Palliative Care Association and the DisAbled Women's Network. There are 129 organizations asking us to please support the Conservative amendment, and please do not include mental illness as a grounds for someone to receive assisted dying.

We need to listen to the experts first, and the parliamentary secretary knows that we have not done that. We had committee meetings on Bill C-7, but this was not part of Bill C-7 when we had those meetings.

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, I will be splitting my time with the member for South Surrey—White Rock.

Madam Speaker, it has been very interesting to hear the Liberal speakers today on this sad day when the Liberals have brought in closure on what is a very important life-or-death amendment from the Senate, and to hear the Liberals spinning their wheels and making up excuses and pretending that past studies on other bills dealing with medical assistance in dying somehow should be taken and counted in support of the huge expansion suggested by the Senate, which has only had a very few hours of consideration in the House before this closure motion today.

For those who are watching, closure by the government means that members of Parliament will not be able to further debate or further study the application of medical assistance in dying to those suffering with mental illness.

It is important to have a bit of context on this because when the Minister of Justice appeared at our justice committee when we were studying this bill, we did not hear from those in the community dealing with suicide prevention and with mental illness because that was not an aspect of the bill. The minister at the time said that there was no consensus in Canada when it comes to mental illness, and there was no consensus among physicians when it comes to mental illness; yet now, a few months later, the Liberals are ramming this through today in a very unfortunate and contemptuous way.

I expect that desperation we hear in the voices of Liberal members is because they are getting the same emails, phone calls and messages that the rest of us are getting. These messages are from those who are fighting for vulnerable people, those who are fighting for people with depression and people suffering from mental illness, saying, “Please do not pass this Senate, and now Liberal government, amendment.”

From the beginning the government has mismanaged this issue. The Liberals say that Bill C-7 was originally aimed at responding to the Quebec Superior Court decision from 2019. Conservatives, at the time, said very clearly that the government should defend its law and should have appealed this decision to the Supreme Court of Canada. Instead, the Minister of Justice, who himself voted against Bill C-14 on medical assistance in dying because it did not go far enough, saw this as an opportunity to rapidly expand the medical assistance in dying regime under the cover of responding to that Quebec court decision.

I disagree with the position of the Liberals not to appeal this to the Supreme Court. As the Conservatives said, that would have given Parliament clarity on how to legislate going forward. However, the Liberals took the highly unusual approach of not defending their own legislation. If the Liberals simply wanted to respond to the Quebec court decision, they would and could have done that. They chose not to do that. Instead, today, they are trying to ram through this bill that goes dramatically beyond that. It is very clear that the Liberal government sees the work of Parliament as a nuisance and that anything other than complete acceptance of its legislation must be opposed.

When this bill was first introduced just over a year ago, it was done one week after the government had already asked for its first extension from the Quebec court decision. Therefore, the Liberals were already failing to meet the court deadline that they said was their goal. Then, rather than introduce a bill that simply addressed the Quebec court decision, the Liberals introduced a far more expansive bill that requires a significantly greater amount of scrutiny by Parliament.

Under Bill C-14, the government's original MAID legislation, a legislative review was required five years after the bill received royal assent. That was scheduled to take place last year. This review would have looked at the impacts of Bill C-14 and would have provided insight on how to proceed forward. Let me be clear: Rather than allow Parliament to do that work first, the government decided to expand MAID legislation in Bill C-7. Again, rather than simply responding to the court decision and allowing Parliament to do the work necessary to study this issue, the Liberals overreacted and brought in expansive new legislation.

The government ended up receiving an extension from March 11 to July 11, 2020, and, with the COVID outbreak, Parliament's scrutiny was limited for a number of months. As time ticked toward July 11, it was apparent that yet again the Liberals would not be able to ram their bill through Parliament, and another extension was requested on June 11, this time for December 18, 2020. When Parliament eventually resumed in September 2020, we could have had the opportunity to debate Bill C-7, but of course we were, ironically, prevented from doing so by the Liberals who are now so keen on passing Bill C-7, because they prorogued Parliament, wiping the legislative slate clean. We all know this was done to avoid scrutiny of the WE scandal to protect the Prime Minister and other senior members of cabinet.

Based on the communications over the past couple of days, one would expect that the Liberals may have had a sense of urgency to reintroduce Bill C-7, instead they did not introduce Bill C-7 again in the first week or the second week. It took the Liberals until the third week of Parliament after they prorogued to actually reintroduce Bill C-7.

The Liberals have set themselves up time and time again to miss their own deadlines, and they have set themselves up for failure, but now there is this rapid rush. however, as has been pointed out, this is an entirely new bill that has come back from the Senate because it includes what was explicitly excluded by our House of Commons, which is made up of elected members of Parliament from all across this country. The mental illness component was specifically and deliberately excluded, and now it is being added in.

By including mental illness as a sole underlying condition to be eligible for MAID, the government wants to expand MAID even further in a way that is a complete 180° turn from Bill C-7 as it was introduced a year ago. This is a completely different bill than was originally debated in the House. As the vice-chair of the justice committee, I know we did not seek to hear from experts on this topic because the government's bill explicitly said expanding medical death to those with mental illness was not being considered. Now, at this last stage of the bill, the government is recklessly accepting a dramatic expansion of the bill, an expansion to which the Minister of Justice himself said there was no consensus.

What are people saying on this mental illness issue? It is unfortunate because Canadians are not going to be able to be engaged and participate in this conversation before we vote on the matter tonight. However, for those of us who are listening, the CEO of the Mental Health Association sounded alarm bells in an article urging all members of Parliament to please vote against the Senate amendments. Her point in the article is that MAID should not be broadened to those with mental illness until at least the health care system adequately responds to mental health needs of Canadians.

She highlights that it is not possible to determine whether any particular case of mental illness represents an advance state of decline and capabilities that cannot be reversed. She concluded her article writing, “We have to cure our ailing mental health system in Canada before we even begin to consider mental illness incurable.”

In a CBC, Dr. Mark Sinyor, a psychiatrist and associate professor of psychiatry at the University of Toronto recently wrote, “As a scientist, I have to be open to the possibility that all of the claims advanced by MAID advocates are accurate. But enacting law, one which literally governs life or death decisions, based on a possibility isn't good enough.”

He continued, “In other areas of medicine, thoughtful scientists typically devote whole careers to meticulously studying benefits and harms of treatments before rolling them out. Here, that proven approach has inexplicably been replaced with hand-waving and moralizing.”

We know that it is our job as members of Parliament to study these things and hear about them at committee from experts, those that are directly impacted, before passing new legislation. We heard this week at a press conference from Wayne Wegner. He told his story of struggling with mental illness. Wayne had a series of difficulties in life that led him to a very dark place, and he urged members of Parliament to please vote against this legislation.

In conclusion, this is not how we should be operating. We should not be dealing with closure today. We should be listening to persons with disabilities and persons suffering from mental illness issues and their advocates. We should all do our jobs as members of Parliament and listen first before we act. That is our duty.

[Jenica Atwin, Green, Fredericton, NB]

Madam Speaker, the parliamentary secretary mentioned thousands of hours of debate around Bill C-14 and Bill C-7.

Would the member not agree that, in comparison, when we are talking about this amendment about mental health or those who are mentally ill having access to MAID, that such a little amount of time has been given to debate such a large expansion of the definition of MAID?

Could the member comment on the discrepancy between the thousands of hours that went into the beginning stages of this bill and the short time frame we have been given for this new piece of legislation that is a critical component that, I think, we need more time for?