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.

Medical Assistance in Dying

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, Bill C‑7 would not have been possible and would not have passed if Bill C‑14 had not infringed on people's right to life.

I am very disappointed to hear my colleague's comments. He has not read Bill C‑390, but he is in charge of procedure. He should be able to understand the bills that are introduced in the House. He should at least have a basic knowledge of that. Since he does not know, since he is ignorant, he does not know that the proposed solution—

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I move that the second report of the Special Joint Committee on Medical Assistance in Dying, presented on Wednesday, February 15, 2023, be concurred in.

Today, I am starting off the debate on the report on medical assistance in dying that was presented in February 2023. It is entitled “Medical Assistance in Dying in Canada: Choices for Canadians” and was presented by the Special Joint Committee on Medical Assistance in Dying, which was struck in May 2021. The report was presented a year and a half ago. I am bringing this debate back to the House because, as reported in the news, Quebec began authorizing advance requests for people with degenerative and incapacitating diseases yesterday. The answers the Prime Minister gave us yesterday suggest to me that he does not understand the issues at all and has not given them any thought since May 2021. That is unacceptable to people who are suffering.

Today, I would like to take a moment to remember all those we have lost, as well as those who are currently disappearing into the abyss of dementia. They are slowly but surely and irreversibly becoming prisoners of time, of each moment that fades away as it is lived. The present moment is gradually erasing the people they once were, and they are losing contact with the things that gave their existence meaning, things like joy, sorrow, the ability to have relate to others and share their experiences, consciousness, and the ability to make others happy and plan for the future. This terrible disease is robbing them of all the things that make life what it is, that make up the experience of life, the human experience, until their life is reduced to a mere biological process. They are irreversibly losing their physical, social, mental and moral autonomy, in every sense of the word.

Wherever you are right now, I am thinking about you, Mom.

I am also thinking about Sandra Demontigny, who is suffering from early-onset dementia. She is fighting for patients who have this debilitating, incurable, incapacitating disease to have the right to self-determination. She is fighting for them to have the right to make an advance request for MAID after being diagnosed. People with dementia want to live as long as possible. They do not want to shorten their lives by requesting MAID while they are still mentally competent. They want to be able to receive it once they have become incapacitated, once they have reached their limit. They are seeking assurance that we will have the compassion needed to respect their final wishes. Fortunately, Quebec decided not to wait for the federal government to wake up. It passed a law, which took effect yesterday, that allows people to make an advance request.

I commend Sandra Demontigny for her courage, her determination and her efforts to assert patients' right to self-determination. That is what we are talking about. The principle of lifelong self-determination is enshrined in law. No one can violate a person's integrity. That being the case, why, at the most intimate moment of a person's life, the moment of their death, should the government get to decide what is best for them? I would remind my colleagues that the government's job is not to decide what is best for a patient. The government's job is to create conditions that are conducive to making free and informed choices. People need to be free to make their own choices.

The Liberals champion the freedom to choose when it comes to abortion, when it comes to a woman's right to control her own body, so how they can question a patient's prerogative to exercise their right to self-determination in a decision as personal as that of their own death? The Liberals are dithering and are still hesitant to amend the Criminal Code to make advance requests legal. The Prime Minister said yesterday that it was a deeply personal decision. If he recognizes that, why can he not put some substance behind his statement? I think I have demonstrated that this is indeed a deeply personal decision.

Why shelve the report of the Special Joint Committee on Medical Assistance in Dying? Why set up joint committees made up of senators and elected representatives, ask them to come up with a key recommendation, and then shelve their report? The committee even managed to convince a Quebec Conservative who agreed with these proposals. The government is finally waking up a year and a half later because it was waiting to see what Quebec would do. The government took a wait-and-see approach so it could see how Quebec would proceed. It was a good idea to look at the example of Quebec, which took a unanimous non-partisan approach. Ottawa could learn something from what happened in Quebec's parliament, which spoke with one voice.

The government is now refusing to amend the Criminal Code, even though we have made it easy to do so. The government is not the one that has been doing the work since 2021, or for the past year and a half. The Quebec National Assembly passed the Act Respecting End-of-Life Care on June 7, 2023. It is now November 2024, and this government is telling us that it needs to have conversations. Who does the government want to have those conversations with? We heard from many experts, groups and citizens. We received many briefs. Despite all that, the government feels it must continue to wait, wait until people are suffering.

The committee report states the following, and I quote:

...Sandra Demontigny eloquently and movingly shared with the committee the sense of peace that advance requests might provide in situations like hers...

These people can feel more at ease dealing with the challenges before them when they are safe in the knowledge that, once they have reached their limit of suffering, we will take care of them and respect their final wishes. That is what we call basic humanity.

Here is what Sandra Demontigny had to say, and I quote:

I am working to calm my vanishing brain and my troubled heart. I feel a need to be reassured about my future so that I can do a better job of living out my remaining days and coping with the more frequent trials I will be experiencing.

My plan is to make the most of my final years while life is still good, with a free mind and without fear.

If those words fail to strike a chord with members here, those members must be heartless and lacking compassion, perhaps because of sweeping ideological principles that they are not putting on the table.

This prompted the committee to say that the Carter decision needed to be respected. Under Carter, the government must not violate sick people's right to life with legislation that would force them to shorten their lives. We saw this in Carter, and it was reiterated in the Beaudoin decision. These people do not want to commit suicide.

That is what Sandra Demontigny told us. She said that she wanted to make the most of the years she has left, knowing that when she reaches her limit of suffering, she will be taken care of and will not have to go through the same appalling decline as her father. Until that moment comes, she wants to live. She does not want to commit suicide.

Is that clear? Who is more vulnerable than a person making this heartfelt plea?

When people say they want to strike a balance between preserving the autonomy of self-determination and protecting the most vulnerable, unless they have fallen down the rabbit hole of believing that everyone in the health care system is evil, it is impossible not to hear this plea.

Why is the government applying a double standard? This report was tabled in February 2023. The government ignored the key recommendation, but, because Bill C‑7 contained a Senate amendment regarding mental disorders and a deadline, the government did accept the committee's recommendation to take another look at the issue after experts had studied it for a year. The government then recommended waiting, because it does not believe that the entire country is ready for this. It accepted the recommendation and applied it, and the result was Bill C‑62. However, in the past year and a half, no bills have been drafted based on the committee's key recommendation on advance requests. If that is not an example of lacking courage and shirking responsibility, I do not know what is.

The minister is unable to understand that an advance request cannot take effect until a diagnosis has been made. It has been six months since the Quebec law was passed. I do not know what world I am living in. This is certainly not a sign of competence. He clearly finds the issue complex because he keeps inventing problems that should not exist.

We are not only criticizing. We went so far as to table a bill. Bill C‑390 offers the government a solution, because we are in suggestion mode, not just in opposition mode. This bill allows the provinces to pass their own legislation once they have debated the issue. Quebec has been juggling this issue, reflecting on MAID and doing something about it since 2009. Now, in 2024, it can start accepting advance requests. There is a law in Quebec. We have adopted a legislative framework. If the federal government thinks advance requests are too complicated, maybe it should look at Bill C‑390, which says it should go at the provinces' and legislative assemblies' pace. This is a debate that should be undertaken by each legislative assembly, by citizens and their representatives. Once they have debated the issue and established a legislative framework, they will then be able to accept advance requests for MAID. That is a very reasonable suggestion.

This is not preferential treatment for Quebec. It is an additional safeguard for the government. The idea is to amend the Criminal Code to simply say that, once a legislative assembly, a province, has adopted a legislative framework and a law, it can move ahead.

The administration of care is a matter for the provinces. End-of-life care is a matter for the provinces. The Criminal Code is a federal statute, and the federal government does not need to describe how things should be done. Furthermore, we are setting an example for all the other provinces. According to every poll conducted over the past three years, 83% to 85% of Canadians support advance requests, so I have to wonder where the political risk is. I feel like this government is afraid of its own shadow. It lacks the courage of its convictions, assuming it even has any convictions left.

I thought that freedom to choose was a cardinal Liberal Party belief that set it apart from the Conservatives, but no. I can criticize the Conservatives, but I will say one thing about them: We know where they stand and why, so we are able to position ourselves accordingly. As for the Liberals, there is no way of knowing what they think. They are dilettantes.

How can they be so unconcerned when it comes to an issue like this, an issue of human suffering? What are the Liberals waiting for? I can answer that question. What were the Conservatives waiting for in 2015, when the Carter decision forced Parliament to take a stand and an extension had to be sought? This Parliament has never been able to deal with the MAID issue except under a court injunction. The court had to order the government to change the law and the Criminal Code. Parliament has never taken the lead or even listened to patients and the public. Since 87% to 90% of Quebeckers support advance requests, it seems to me we should be moving forward.

Why is there a problem today? There is a problem because the Canadian Medical Protective Association has always said that physicians will be protected so long as they follow the most restrictive law. At certain times, Quebec had the most restrictive law, after the passage of Bill C‑7 and Bill C‑14. In Canada, there is no law like Quebec's. Quebec applies the Criminal Code and the regulations that explain how to proceed. Quebec ended up having to ensure that people like Ms. Gladu and Mr. Truchon could not access MAID. Bill C‑7 would have allowed this, so Quebec had to tweak its law.

I am appealing to people's sense of duty and humanity. I hope that my colleagues will set aside government paternalism and get on the same page as the people of Quebec and Canada. I suggest that the government take Bill C‑390 and make it a government bill.

Today, the government is claiming that a national conversation is needed. I thought that forming a special joint committee of senators and members from both chambers in a parliamentary democracy gave those committee members the standing to make recommendations that reflect what the public thinks.

I look forward to seeing what my colleagues have to say during this debate. I invite the government and the Prime Minister to quickly do their homework so they can get up to date on this file, allow advance requests and amend the Criminal Code to harmonize it with what is happening on the ground and eliminate any legal confusion.

Government Business No. 39—Proceedings on Bill C-64

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, I listened attentively to what the health minister was saying, so I am glad to be the first person to rise on my side to maybe provide a rebuttal and also to reset the debate, because the debate is not directly about Bill C-64; it is about a programming motion.

When I listened to the minister's speech, I also had the time to compare it to his speech that he gave at second reading. The same three anecdotes he raised today were raised then. Two of the three are completely misleading, and one was a very personal experience of his that he raised, which is his right as a member and a minister.

However, this is about a programming motion that would guillotine debate in the House. It would order a committee of the House to basically consider a bill within 10 hours, a bill that would have profound impact on the structure of Canada's health care systems, plural because they are systems. Quebec has a different system than Alberta, than British Columbia, than Saskatchewan and than other provinces in Canada.

We know from much research that has already been done by CIHI, The Conference Board of Canada, Statistics Canada, and CLHIA, which is the life insurance trade association, that 97.2% of Canadians already have access or are eligible for access to an insurance benefit plan of some sort. I know that in my home province, we have Blue Cross, which is usually the insurer of last resort that provides a lot of the services that the minister talked about.

The worst part of all is that we would be programming a committee of the House to study what essentially amounts to a pamphlet of legislation. The minister talked about finding common ground and solutions. I have also heard other members of Parliament talk about how important committee work is to them. Now we would basically be guillotining and gag ordering a specific committee of the House, the Standing Committee on Health, to do its work in 10 hours.

That is why I asked a question for the health minister on why he felt the need to exclude himself from having to come to testify before the health committee. One would think that he would put himself before the members at committee and answer all of their questions on the reasoning behind C-64 and the wisdom of it, because it is not a national pharmacare plan. That is not what it would do. It would cover two very small areas of medicine.

I will note that in the minister's second reading speech about Bill C-64, he had all of one sentence devoted to rare disease drugs and rare disease patients, typically the source of the most expensive therapies, the most expensive drugs, on an individual basis, not on a broad basis. Typically most drug plans in the provinces, whether private or public, spend the most on things like the very basic medication for infections. Medications like amoxicillin or penicillin and variations thereof are the ones that are quite expensive because people get a lot of infections, so it it just a question of volume in those situations.

There is a lot of medication out there that is expensive because it is brand new; it is coming onto the market for the first time. Recently I learned about a new oncology drug that is going to be made available in the United States, but it is cutting-edge, specialized medicine made for the individual patient. The drug comes with a few tens of thousands of dollars of cost associated with its delivery. There will be some cancer centres in Canada that will not be able to have it available for patients, but it will be available to other patients in other parts of Canada. Oncology drugs would not be covered under the plan.

There would actually be nothing covered in the plan except for those two areas of medications, which are very specific ones as well. Like I said, there would be nothing for rare disease patients. The minister talked, in his original speech at second reading, though not today, about the $1.5 billion being devoted to rare disease drugs. That announcement was made in 2019, yet only now has some of the spending gone out, not to cover drug costs but to cover things like the creation of rare disease registries to get foundations, universities and private organizations to start up a rare disease registry specific to one individual drug.

There is often a problem in how the Liberals propose things. They say something, make claims, and then it takes years before anything actually happens. As an example, in 2019 there was an announcement. In 2024, still not a single rare disease drug has been covered by the $1.5 billion. It took five years of waiting. Rare disease patients cannot wait. In fact it was the Liberal government that cancelled the original rare disease strategy in 2016. At that time, the president of the Canadian Organizations for Rare Disorders, Durhane Wong-Rieger, said that it was the kiss of death for patients with rare diseases.

She is a literal ball of energy and an amazing woman, an amazing advocate for patients with rare diseases. This was in 2016. It took the government three years just to announce funding and five years after that to roll out a single dollar. Now the government wants to convince us that it needs to expedite Bill C-64 by programming and ordering the Standing Committee on Health to consider certain things but not others.

I will go through the programming motion, since the minister did not feel the need to even explain why this was necessary. He repeated, essentially, his second reading speech on why we need to expedite this so quickly. There were three days of debate in the House before there was a vote at the Senate and in the Standing Committee on Health. I looked at the work the Standing Committee on Health had done. It did not even have the chance to consider the bill. That is how quickly the government is now programming what is going on.

The first line of this programming motion is very simple: “the committee shall have the first priority for the use of House resources for the committee meetings”. It seems quite reasonable that it would be given first right to interpretation, rooms and catering services if the committee is expected to sit for hours and hours on end. I guess a programming motion would have to have that in it.

The second part is, “the committee shall meet between 3:30 p.m. and 8:30 p.m. on the two further sitting days following the adoption of this order to gather evidence from witnesses, provided that any meeting on a Friday may start at 12:00 p.m. for a duration of not more than five hours”. Essentially, that is saying there will be two more meetings of the Standing Committee on Health and 10 hours of testimony. There are countless members in the House who will say that, during consideration of a bill, witnesses will testify, explain an idea or perhaps a missing amendment or particular line in a bill between the French and the English, which happens on a fairly regular basis. They either do not match, do not make sense or there could be more added to a bill to clarify or constrain a bill. Ten hours is simply not enough for a bill that would have such a substantive impact.

According to the health minister, the Liberals are going to celebrate a bill with such a substantive and profound impact as some great achievement. I do not believe that. I believe this is a pamphlet. This is not national pharmacare. There is no spending associated with this bill. Every one of my constituents back home knows there is no spending associated with this bill. If the Liberals keep ramming the bill through at this pace and it passes through the Senate at some point in the future, not one single drug will be paid for through this legislation because there are no dollars associated with it. There is no, what we call, ministerial warrant from the Minister of Finance connected to this bill. There will be no medication paid for through this particular bill. That is why I do not understand why this programming motion is of such necessity when the committee has not even had a chance to consider it.

I understand perhaps it would be easier to tell Conservatives, members of the Bloc and independent members that they are slowing down the committee's work, that they are not allowing the committee to proceed with witness testimony or consider the contents of the bill, but that has not even happened yet. We have not even had a chance to invite witnesses to explain to us their views on the contents of the bill.

When the minister talks about finding common ground and solutions, he accuses the Conservatives of being against it. Of course we are against it. We voted against the bill, but that doesn't mean we cannot improve an F product and make it maybe an F+ product. I know that is not a grade in universities or colleges in Canada, but we can always make something terrible a little less terrible. This is essentially, like I said, a pamphlet. For me, it was easier to vote against it because I saw nothing for patients with rare diseases. That is not a surprise to anyone in this place.

I remember the original debate on an NDP private member's bill, which I believe was Bill C-340, if memory serves. It was on national pharmacare. At least the title was on national pharmacare, not the contents. It was put forward by the member for Vancouver Kingsway. He and I debated it for most of the day. I was all about access for patients with rare diseases, and I said that was why I could not vote for that bill at the time.

It is not a big surprise to many members of the House and members of the other place that I would be against a bill that has has a title of national pharmacare, but would not do anything for patients with rare diseases. Members know of a personal anecdote I have mentioned many times in the House. I have three living kids with a rare disease called Alport syndrome. One daughter passed away very young, at 39 days old, with a different rare disease. I always joke with my friends in the rare disease community that I am due. I should probably play the lottery as I would I have a decent chance of winning because both of those conditions are rare.

In the case of my living kids, it is a rare disease of the kidneys, CKD, a chronic kidney condition. In the case of my youngest daughter who passed away, she had Patau syndrome, which is a chromosomal condition and very, very rare.

If one knows a child with Down syndrome, one should hug them. They are very special little kids. My daughter had a condition that is considered much worse than Down's. Down's is survivable. There are a lot of very sweet kids who live with Down syndrome, and their families are made incredibly happy by them because they are sweet into the teen years, into their twenties, thirties and forties. One never has to go through those teenage years, as I am going through right now with one of my kids, where suddenly, as the dad, I know nothing and they know everything, which is okay. I will go through this three times in my life.

I will move on to the next part of the programming motion, which reads, “all amendments be submitted to the clerk of the committee by 4:00 p.m. on the second sitting day following the adoption of this order”.

We are quite fortunate there was unlimited time provided, I believe, for the first two speakers on a programming motion. Perhaps members are surprised I would rise on this, but I intend to use this time to explain why I do not like the programming motion and the defects with Bill C-64, and to remind the minister about what the summary of his own legislation says that it does, because it is the complete opposite of what the minister just explained to the House. It is the complete opposite from his second reading speech as well, so members can stay tuned for that part.

On these amendments, we are fortunate because we have a constituency week coming up. I can guarantee many of us will be sitting down and working with patient advocacy groups. We will be going to our stakeholder groups and meeting with our constituents. I have a few who have emailed me on this subject. I will be finding useful amendments to this bill that would improve it in my eyes and in the eyes of my constituents. We have the time.

Had we had a sitting week coming up, had there not been unlimited time for the first speaker on the official opposition side, we could have been rushed to provide amendments by 4 p.m. after the first day. That is an incredibly low amount of time considering this first came to the House February 29 and then the last vote was on April 16 before it was sent to the committee.

Doing a programming motion like this, or a gag order to the committee, is wrong. I do not agree with programming motions. I believe I voted against nearly all of them that ever came through the House. I believe the health minister was also the House leader at one point when Motion No. 16 was being moved through the House. There was also a previous one, and I believe it was a member for Waterloo who moved Motion No. 6, which would have programmed how committees work in the Standing Orders forevermore for the Houses.

I cannot base our opposition or our support for any particular motions and programming motions on good faith coming from that side because I simply do not believe the cabinet, the front-benchers. I do not believe them. There are many good-hearted backbenchers in the Liberal benches. They are easier to work with, I find, than those on the front bench. The front bench I just do not trust. I do not trust the front-benchers to do the right thing for Canadians. In fact, Canadians do not trust them. If we look at the polls, there is about a 20-point disparity, depending on which poll we consider, between what the government is polling at and what the official opposition is polling at.

I will move on to the next point, which reads, “amendments filed by independent members shall be deemed to have been proposed during the clause-by clause consideration of the bill”. I actually do not have a problem with that. Independent members should be treated like every other member of the House, especially during considerations of bills.

Now comes the next one, which gets gets quite technical:

the committee shall meet at 3:30 p.m., on the third sitting day following the adoption of this order to consider the bill at clause-by-clause, or 12:00 p.m. if on a Friday, and if the committee has not completed the clause-by-clause consideration of the bill by 8:30 p.m., or 5:00 p.m. if on a Friday, all remaining amendments submitted to the committee shall be deemed moved, the Chair shall put the question, forthwith and successively without further debate on all remaining clauses, amendments submitted to the committee as well as each and every question necessary to dispose of the clause-by-clause consideration of the bill, and the committee shall not adjourn the meeting until it has disposed of the bill...

This means that, once the 10 hours of testimony are done, once that particular portion of the committee's work is done, every single amendment has to be voted on immediately, with no debate for amendments. In those 10 hours, if witness testimony takes five or six or seven hours, we then have a few hours left over to consider and debate amendments. We could not even persuade the other side of the wisdom of the amendment. This is so profoundly wrong. I see this programming motion all the time when it comes to omnibus budget bills.

I will remind the House that the Liberal platforms in 2015 and 2019 promised not to do omnibus budget bills, yet they have done them repeatedly, over and over again. In fact, in Liberal budget 2023, they had section changes to clauses 500 to 504 on natural health products. That has nothing to do with the budget. There are no spending items related to it, but it was a regulatory expansion to apply rules for pharmaceuticals directly onto natural health products.

It caught a lot of people by surprise, including myself, that in a budget bill, which sometimes has hundreds of pages, one would do such a thing. They basically clip what they usually do at the finance committee, and now they have dropped it and ordered the Standing Committee on Health to do it in one particular way, in their way, their preferred way, with no debate on any amendments.

Why should one allow backbenchers from any of our political parties to freely consider the judgment and the argument being made by another member of another political party, individually or on behalf of their political movement, on the wisdom of a particular amendment to a government bill? I know, it would be shocking to even have that consideration.

It would be even more shocking for some members of the government benches to know that I have voted for government amendments at committee. I know. I hear “shame” from my side of the benches, but it happens. Sometimes they have a good idea. I am willing to consider good ideas. I am willing to. I have been on several committees over my time, from foreign affairs to finance to the Standing Joint Committee for the Scrutiny of Regulations. I am on the immigration committee and the Canada-China committee now, the select committee. I will vote for reasonable amendments. I will even talk to my own side to try to convince them if there is a reasonable, logical amendment that makes sense. Sometimes there is an argument made by a member of another party that actually makes sense. This section prevents that. There will be no debate on amendments. One is just supposed to vote on them.

Of course, what will happen is that there will be a question of having a recorded division on every single one of those votes. This means the committee will continue, likely, late into an evening, because it is basically programmed. To demonstrate that this is wrong and should not be done, I am fairly sure that there will be members of the committee who will want a recorded division on every single item so that we can go back to it later with our errors and mistakes and illogical situations that arise because two sections perhaps conflict with each other. This type of amendment process, clause by clause, is incredibly important, and we now will not be allowed to be given this opportunity.

The sixth portion of this guillotine gag order on the Standing Committee on Health says:

a member of the committee may report the bill to the House by depositing it with the Clerk of the House, who shall notify the House leaders of the recognized parties and independent members, and if the House stands adjourned, the report shall be deemed to have been duly presented to the House during the previous sitting for the purpose of Standing Order 76.1(1)

This is a fairly reasonable amendment that is often provided by members in other committees to make sure that, when reporting on a bill, the House leaders are informed, typically to go on the Notice Paper. I do not have a direct issue with this particular portion, apart from the fact that this is a programming motion, a gag order, that is going to guillotine a committee of the House without that committee even having had the chance to consider a bill.

The next section is section (b). It says:

not more than five hours shall be allotted to the consideration of the bill at report stage, and at the expiry of the time provided for the consideration of the said stage of the bill, or when no member rises to speak, whichever is earlier, any proceedings before the House shall be interrupted, and in turn every question necessary for the disposal of the said stage of the bill shall be put forthwith and successively, without further debate or amendment, and, if a recorded division is requested, the vote shall not be deferred...

It continues. There is another one, but I am going to stop right here. This essentially means that, when amendments come back from committee, they are sometimes ruled out of order. They cannot be considered at committee but they can be considered by the House because the House has control of its committees, and the House can decide whether certain amendments can be voted on. Those are typically then submitted to the Speaker.

This essentially says that this process will also be guillotined after five hours. I know they love gag orders. I know they love to guillotine debate. My hope is, too, that during this debate on the programming motion, they do not gag order the gag order. I would hate to see that. It would be like a double gagging of the orders of the House and really limiting debate.

They have done it before. They have done it on Bill C-7 and Bill C-14, the two medical assistance in dying bills. At different stages of those bill, they both programmed and then shut down debate on them. I have seen, plenty of times, allocation motions being moved by cabinet to force bills through the process on matters of conscience.

It is not as if they are technical bills where perhaps there is timeline the Liberals need to reach and where, for the proper administration of government, they can perhaps make an argument they can stand on, but for matters of conscience, to guillotine debate is wrong. In this particular case, I would say that this is not a matter of conscience. I think this is about administration of government services and what the contents of the bill are actually about versus what they are not about. When the Liberals impose a guillotine with time allocation and force the closure of debate, the major disadvantage to Canadians is that they cannot prepare themselves. They cannot organize themselves when they are opposed to particular ideas and when they want to ask questions like, “Why is my rare disease, my health condition or MS not covered in this bill? Why is diabetes covered?”

I know a lot of diabetics, and I am not picking on them directly. I am just asking a simple question. The most common rare disease is multiple sclerosis, or MS. A lot of people in my family have it, as well as friends, colleagues and co-workers. There are spouses of members on this side who have it. Therefore, why is that particular condition, and its medication, which is expensive medication, not in this particular piece of legislation?

It is a choice the government made, so why can we not debate that choice the government has made for those two particular conditions and the medications associated with them? If they are being covered, why not others? There are so many other types of medications, such as the most common ones: penicillin, amoxicillin and all the variations of the “-cillins”, because there are so many of them. Why are they not covered in this particular piece of legislation?

On this programming motion, should we put forward such an amendment to be considered at committee? If it is deemed non-votable at committee, why can it not be considered at report stage?

I guess I will only get through the programming motions, and I will have to come back later to finish talking about Bill C-64 and some of the things the minister said, as well as my concerns with the PMPRB, CADTH, pCPA and the entire architecture of drug approval in Canada.

The motion reads, “not more than one sitting day shall be allotted to the consideration of the bill at the third reading stage, and 15 minutes before the expiry of the time provided for Government Orders”, and it goes on like that, which basically means that there will be one day for final speeches, and then it will be done and sent to the other place. It is wrong to ram through a bill in this method, with bad faith being shown by the health minister, claiming that we were opposing it and not willing to consider things, when he has never bothered to listen.

Alleged Premature Disclosure of Bill C-63

[Andrew Scheer, Conservative, Regina—Qu'Appelle, SK]

Mr. Speaker, I am rising this afternoon on a question of privilege concerning the leak of key details of Bill C-63, the so-called online harms bill, which was tabled in the House earlier today.

While a lot will be said in the days, weeks and months ahead about the bill in the House, its parliamentary journey is not off to a good start. Yesterday afternoon, the CBC published on its website an article entitled “Ottawa to create regulator to hold online platforms accountable for harmful content: sources”. The article, written by Naama Weingarten and Travis Dhanraj, outlined several aspects of the bill with the information attributed to two sources “with knowledge of Monday's legislation”.

I will read brief excerpts of the CBC's report revealing details of the bill before it was tabled in Parliament.

“The Online Harms Act, expected to be introduced by the federal government on Monday, will include the creation of a new regulator that would hold online platforms accountable for harmful content they host, CBC News has confirmed.”

“The new regulatory body is expected to oversee a digital safety office with the mandate of reducing online harm and will be separate from the Canadian Radio-television and Telecommunications Commission (CRTC), sources say.”

“Sources say some components of the new bill will be modelled on the European Union's Digital Services Act. According to the European Commission, its act “regulates online intermediaries and platforms such as marketplaces, social networks, content-sharing platforms, app stores, and online travel and accommodation platforms.””

Then, today, CTV News published a second report entitled “Justice Minister to Introduce New Bill to Tackle Harmful Online Content”. In Rachel Aiello's article, she says, “According to a senior government source [Bill C-63] would be expected to put an emphasis on harms to youth including specific child protection obligations for social media and other online platforms, including enhanced preservation requirements. It targets seven types of online harms: hate speech, terrorist content, incitement to violence, the sharing of non-consensual intimate images, child exploitation, cyberbullying, and inciting self-harm, and includes measures to crack down on non-consensual artificial intelligence pornography, deepfakes and require takedown provisions for what's become known as 'revenge porn'. Further, while the sources suggested there will be no new powers for law enforcement, multiple reports have indicated the bill will propose creating a new digital safety ombudsperson to field Canadians' concerns about platform decisions around content moderation.”

As explained in footnote 125 on page 84 of the House of Commons Procedure and Practice, third edition, on March 19, 2001: “Speaker Milliken ruled that the provision of information concerning legislation to the media without any effective measures to secure the rights of the House constituted a prima facie case of contempt.”

The subsequent report of the Standing Committee on Procedure and House Affairs concluded: “This case should serve as a warning that our House will insist on the full recognition of its constitutional function and historic privileges across the full spectrum of government.”

Sadly, Mr. Speaker, the warning has had to be sounded multiple times since. Following rulings by your predecessors finding similar prima facie contempts on October 15, 2001, April 19, 2016 and March 10, 2020, not to mention several other close-call rulings that fell short of the necessary threshold yet saw the Chair sound cautionary notes for future reference, a number of those close-call rulings occurred under the present government that would often answer questions of privilege with claims that no one could be certain who had leaked the bill or even when it had been leaked, citing advanced policy consultations with stakeholders.

Mr. Speaker, your immediate predecessor explained, on March 10, 2020, on page 1,892 of the Debates, the balancing act that must be observed. He said:

The rule on the confidentiality of bills on notice exists to ensure that members, in their role as legislators, are the first to know their content when they are introduced. Although it is completely legitimate to carry out consultations when developing a bill or to announce one’s intention to introduce a bill by referring to its public title available on the Notice Paper and Order Paper, it is forbidden to reveal specific measures contained in a bill at the time it is put on notice.

In the present circumstances, no such defence about stakeholders talking about their consultations can be offered. The two sources the CBC relied upon for its reporting were, according to the CBC itself, granted anonymity “because they were not authorized to speak publicly on the matter before the bill is tabled in Parliament.”

As for the CTV report, its senior government source “was not authorized to speak publicly about details yet to be made public.”

When similar comments were made by the Canadian Press in its report on the leak of the former Bill C-7 respecting medical assistance in dying, Mr. Speaker, your immediate predecessor had this to say when finding a prima facie contempt in his March 10, 2020 ruling:

Everything indicates that the act was deliberate. It is difficult to posit a misunderstanding or ignorance of the rules in this case.

Just as in 2020, the leakers knew what they were doing. They knew it was wrong and they knew why it was wrong. The House must stand up for its rights, especially against a government that appears happy to trample over them in the pursuit of legislating the curtailing of Canadians' rights.

Mr. Speaker, if you agree with me that there is a prima facie contempt, I am prepared to move the appropriate motion.

Criminal Code

[Lianne Rood, Conservative, Lambton—Kent—Middlesex, ON]

Mr. Speaker, I rise today to address a question of paramount importance and profound concern to many of my constituents in Lambton—Kent—Middlesex: Will Canada cross the Rubicon and expand access to assisted suicide for otherwise healthy individuals whose mental disorder is the sole underlying medical condition, or do we have enough common sense and moral clarity to stop this radical and dangerous expansion of MAID to mental health cases? The issue at hand stands at the juncture of ethics, medicine and our societal values. This is not merely a policy decision. It is a profound moral question that strikes at the heart of who we are and how we value life and respond to suffering.

The core concern here is the difficulty, if not the impossibility, of determining with certainty that mental disorders are irreversibly incurable. Unlike many physical ailments, the trajectory of mental illness is often unpredictable and can respond to treatment over time. The NDP-Liberal government's push toward expansion, despite substantial opposition from medical professionals and the public, raises serious questions. It reflects a troubling trend of policy-making that seems to prioritize ideological considerations over careful, evidence-based deliberation. How can we, in good conscience, move forward with a policy that many experts in psychiatry and mental health view with significant trepidation?

The opposition from the medical community, particularly from mental health professionals, is not just significant but deeply insightful. The expert panel on MAID and mental illness, the very panel established by the government to study this issue, acknowledged the complexities involved. It noted the difficulty in predicting the long-term prognosis of mental disorders, underscoring the near impossibility of determining with certainty whether a mental disorder is truly incurable.

Leading psychiatrists across Canada have expressed reservations. The Association of Chairs of Psychiatry in Canada, which includes the heads of the psychiatry departments of all 17 medical schools in the country, called for a delay in implementing MAID for patients with mental disorders as the only underlying medical condition. Its concerns centre on the challenges in assessing incurability and differentiating genuine MAID requests from suicidal ideation rooted in treatable mental health conditions.

Surveys conducted within the psychiatric community reflect this opposition. For instance, a significant majority of Manitoba psychiatrists have indicated that Canada is not ready for the implementation of assisted suicide for patients with mental disorder as the sole underlying medical condition. A similar sentiment was echoed in a survey conducted by the Ontario Medical Association, where a two-to-one majority of respondents opposed the availability of MAID for such cases. These results are in line with public opinion, which has consistently shown discomfort with this expansion. In fact, I have heard from hundreds of residents of Lambton—Kent—Middlesex who are opposed to this expansion, and polls such as those conducted by Angus Reid reveal substantial public reservations about MAID for mental illness.

If we ignore experts' warnings and the public sentiment and proceed with this expansion, we risk making irreversible decisions in cases where there might be potential for recovery and improvement with the appropriate treatment. The ethical implications of such a scenario are profound and disturbing. In our examination of this issue, we must not overlook the societal context in which decisions about MAID are being made.

The CEO of Food Banks Mississauga recently issued a stark warning that the inability to afford basic necessities is pushing people towards considering MAID. This is a harrowing indication that, for some, the choice to pursue assisted dying may be influenced more by socio-economic despair rather than by unimaginable physical or mental health conditions. This revelation is deeply troubling. It compels us to question whether we are addressing the root causes of such despair or merely offering a tragic and irreversible solution to what are fundamentally social and economic problems. This is particularly concerning in light of the ongoing mental health crisis that was exacerbated by the COVID-19 pandemic and the government's divisive response.

Additionally, we must also reflect on the alarming reports concerning our veterans. There have been stories of veterans being offered MAID. This raises profound concerns about the support and care that we provide to those who have served our country. These individuals, who have sacrificed so much, deserve better than an expedited path to assisted death. These stories underscore the need for robust mental health support and the dangers of expanding MAID without adequately addressing these needs first.

When the Liberal government has such a cavalier attitude toward assisted suicide, with a one-way slope toward access expansions and safeguard removals, is it any surprise that, according to the latest available numbers, the annual growth rate of MAID between 2021 and 2022 was 31.2%? Between 2016 and the end of 2022, 44,958 people died by MAID. That is more than the number of Canadians who died in military service during World War II.

My point is that Canada's current MAID access may already be the most discretionary in the world. That is before the proposed mental health expansion. We are the only country whose legal system does not see assisted suicide as a last resort. What can we expect to happen to the growth rate if the House enables the “treatment” of mental illness with assisted suicide? We would be past the slippery slope concern if that were to happen. Crossing the Rubicon here would put us closer to free fall.

Why are we debating the radical expansion of assisted suicide? Just four months ago, the hon. member for Abbotsford's bill, Bill C-314, was in the House. Conservatives urged the House not to give up on Canadians living with mental illness. Nevertheless, the government voted against the bill, sticking to its original plan, as per Bill C-7, to expand access to MAID to Canadians who are healthy except for their mental disorder.

If it were not for the Special Joint Committee on Medical Assistance in Dying's tabling, on January 29, 2024, its findings and recommendations, the unprecedented MAID expansion would have been implemented within two months. Thankfully the committee, after extensive consultations and a review of expert testimony, concluded that Canada is not ready for the expansion of MAID to include cases where a mental disorder is the sole underlying medical condition. The report highlights the unresolved issues in accurately assessing the irremediability of mental disorders and the challenges in distinguishing between genuine requests for MAID and those stemming from treatable mental health conditions. The report confirms what common-sense Conservatives have been saying for months: Expanding assisted suicide to those suffering from mental illness would result in the deaths of those who could have gotten better.

That is why, just like last year when the government introduced eleventh-hour legislation to put a temporary one-year pause on expanding assisted suicide to those suffering with mental illness, we are once again here at the eleventh hour. There is no question that there is an urgent need to pass Bill C-62 to delay until 2027 the implementation of MAID in cases where a mental disorder is the sole underlying cause and condition.

As highlighted by the report of the special joint committee and the voices of experts and Canadians alike, a mere delay may not suffice. What is required is a comprehensive re-evaluation of our approach to MAID, particularly in the context of mental health. The issues at stake are not just medical or legal but are deeply rooted in our societal values and the respect we need to afford the dignity of human life, especially in its most vulnerable forms.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, we have heard that a lot in this debate. We all want to be on the side of the angels. We all want to improve socio-economic conditions. The expert report does take structural vulnerabilities into account, and no assessor is authorized to grant a request for medical assistance in dying if there is any possibility that the request came about because of a structural vulnerability.

I paid close attention to my colleague's speech. Judging from the examples he gave, I gather he was in favour of Bill C‑14 for cases involving reasonably foreseeable death, but that he is against Bill C‑7 for people suffering from an incurable degenerative disease who are forced to cut their life short by suicide because their suffering has become intolerable. If Bill C‑7 is implemented, those people will be able to live until they reach the threshold of what they feel is tolerable.

Did I understand correctly that my colleague is against Bill C‑7 as it relates to degenerative diseases? I am curious, and I would like him to answer this question. He talked about it in his speech.

[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.

[Lisa Hepfner, Liberal, Parliamentary Secretary to the Minister for Women and Gender Equality and Youth]

Mr. Speaker, I will be sharing my time today with the member for Lac-Saint-Louis.

I am very pleased to have the opportunity to speak in this House today in support of Bill C-62, particularly after listening to some of the debate this morning and hearing some of the language used in this House today.

For example, the member for Abbotsford, throughout his speech today continually used the words “the mentally disorded” I believe in reference to people who are suffering from mental illness. A little later in the day, we then heard from the member for Leeds—Grenville—Thousand Islands and Rideau Lakes, who continually referred to people as “addicts” throughout his speech.

In this House, we are leaders. Our words are important and we should not be furthering the stigmatization of people who suffer mental illness. I would caution my colleagues across the way to be careful in their language and to please not further marginalize people who are already suffering.

I will turn back to Bill C-62. As the Minister of Health and the Minister of Justice have emphasized, the government believes an extension of three years is necessary to provide individual clinicians as well as provinces and territories the time they need to prepare for this change.

I also believe a three-year extension of the period of ineligibility to receive MAID on the basis of a mental illness alone is necessary. Although significant progress has been made, more time is needed to ensure the safe assessment and provision of MAID in these circumstances. I have heard from psychiatrists in my riding of Hamilton Mountain who have said these very things. They need more time to get the system ready.

My remarks today will focus on the progress that has been made in preparing the health care system, and also what more needs to be done.

In 2021, as required by former Bill C-7, an expert panel examined the issue of permitting MAID where the sole underlying condition is a mental illness. It concluded that the existing legal framework of eligibility criteria and safeguards is sufficient, providing that MAID assessors apply the existing framework appropriately with guidance, through the development of MAID practice standards and specialized training.

Our government understood the importance of the panel's findings. To that end, we have been working in collaboration with the provinces and territories and other health care partners to implement consistent standards across the country and support a highly trained workforce to undertake these complex assessments.

For example, we supported the development of a model practice standard for MAID by individuals with clinical, regulatory and legal expertise. A model practice standard for MAID was released in March 2023 and has been adopted, or is in the process of being adopted, by most regulators across the country as a basis for assessment for clinical decision-making. The standard also provides guidance for MAID clinicians as they navigate more complex MAID requests.

We also supported the development of the first national, fully accredited bilingual MAID curriculum, which was launched in August 2023. The curriculum consists of seven training modules addressing various topics related to the assessment and provision of MAID, including how to do a MAID assessment, how to assess capacity and vulnerability, how to manage complex chronic situations and how to assess requests involving a mental illness. Over 1,100 clinicians have registered for the curriculum since August of last year.

This progress is the result of leadership and collaboration among health system partners, including federal, provincial and territorial governments, health professional organizations, regulatory bodies, clinicians and organizations like the Canadian Association of MAID Assessors and Providers. This collaboration and progress will continue to make improvements in approaches to safety and quality in assessments and provisions of MAID.

In terms of the future, I want to briefly speak to the Regulations for the Monitoring of Medical Assistance in Dying, which outline the reporting requirements relating to MAID requests. These regulations came into force in November 2018, but were recently revised to facilitate enhanced data collection and reporting on MAID activity. Most notably, the regulations now allow for the collection of data based on race, indigenous identity and the self-reported presence of a disability, where a person consents to provide this information.

The revised regulations came into force on January 1, 2023, and information on MAID activity in 2023 will be released in Health Canada’s annual MAID report this year, in 2024. This information will provide valuable insight into who is requesting and receiving MAID, including those under track 2, whose natural death is not reasonably foreseeable.

Despite all this work, we have heard that the provinces and territories are at various stages of readiness for the lifting of the exclusion of eligibility and that they need more time to prepare their health care systems.

I know that the suffering caused by a mental illness can be just as severe as that caused by a physical illness, but I strongly believe that this extension is necessary to ensure that MAID can be safely assessed and provided on the basis of a mental illness alone. This extension does not question the capacity of people with mental illness to make health care decisions. It is about giving the health care system more time to adopt or implement some of these key resources to ensure that MAID practitioners are properly equipped to assess these complex requests, and that the provinces and territories have the necessary mechanisms in place to support them.

For example, both the expert panel that I referred to earlier and the special joint committee on MAID have emphasized the importance of case review and oversight of MAID, both to educate practitioners and to support accountability and public trust in the law. While the majority of cases of MAID, 90%, take place in provinces with formal oversight processes, other provinces do not have formal MAID case review and oversight processes in place beyond those already undertaken by professional regulatory bodies.

Work is being planned to explore best practices through a federal-provincial-territorial working group, with a view to encouraging more consistent and robust mechanisms across the country.

The expert panel and the special joint committee also identified engagement with indigenous partners as a priority. The Government of Canada has launched a two-year engagement process on MAID to hear the perspectives of first nations, Inuit and Métis, including urban indigenous people, indigenous people living off-reserve with or without status, indigenous people living with disabilities, and two-spirit, LGBTQQIA+ and gender-diverse indigenous people.

The proposed extension under Bill C-62 would provide the necessary time to have these discussions with indigenous partners. It is an essential process to appropriately inform implementation as well as guidance and training material for clinicians to support enhanced integration of cultural safety in MAID practices.

Health Canada will provide its first official update to Parliament on this work in March 2024, just next month.

In conclusion, the Government of Canada remains committed to ensuring that laws reflect the needs of people in Canada, protect those who may be vulnerable, and support autonomy and freedom of choice. While we have made significant progress in the study of MAID and mental illness, and in the development and dissemination of key resources, we are not yet ready. We need to act prudently and not rush this change without the necessary resources in place.

This decision is not an easy one, but I want to assure the House that we will continue to work collaboratively with our partners to improve the mental health of Canadians.

I thank all members for the opportunity to speak today as we debate this important bill.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, I am glad to be joining debate on Bill C-62. Off the top, I will mention that I will be voting for it. Like the shadow minister for justice on the Conservative side said, this is about protecting the vulnerable. Though the federal government has dropped the ball in this latest iteration of its legislation, these three years, I hope, will be taken to basically fix the mistakes that were made all the way back to Bill C-14. I want to talk a little about what brought us to this moment, and then refer to some constituents of mine who have emailed me over the last few months on the issue of assisted suicide.

I will also mention that I am sharing my time with the member for Mission—Matsqui—Fraser Canyon. I am sure he will add more to this debate.

To go back to the beginning, not too far to the beginning because I could get into Genesis, the Carter decision is what kicked off multiple debates that I have now been a part of. I have now seen this debate go from Bill C-14 to Bill C-7 to Bill C-62, and the attempts by my hon. colleague from Abbotsford, who, I think, tried to do right by vulnerable Canadians all across Canada to make sure that we would not see an expansion of the MAID provisions to those who are still suffering with mental health conditions.

The great thing about Hansard is that I was able to go all the way back and review what I had said on Bill C-14. I spent quite a bit of time complaining that the reasonably foreseeable clause would be knocked down by a court. It was knocked down by a court in the Truchon decision, because all our deaths are reasonably foreseeable; that is what living is all about. At the time, I had said that all of us who are born are born with one foot in our grave. One is assured one will die; one does not know just what it is, but it is reasonably foreseeable. I am just repeating it now. I know that it is morbid, but it is the truth. A lot of what we are dealing with here are issues of life and death and how one's death will happen. Therefore, at the time, this reasonably foreseeable clause would get knocked down, and it was knocked down in the Truchon decision.

My issues, just generally, are that, in a perfect world, this would not be necessary because people would not suffer. However, because this world is not perfect, people do suffer. People suffer in deep and different ways. Members know that I had a disabled daughter who passed away a few years ago. Had she lived longer, and I know at least one little girl in Calgary who has lived much longer with the same conditions my daughter had, she would be one of those vulnerable Canadians who would be facing the possibility that her physician, her specialist, might push for and might offer MAID.

I say “offer MAID”, but it seems so weird to say “offer MAID”, to offer something that I do not consider to be a medical service and to rush one's death sooner. Although we all die, as I said many Parliaments ago, the act of dying is not one that one does alone; it is done as a family, as a group of friends and with those loved ones around.

It is not something that happens in solitude. There are others who will miss one when one is gone. I know that it is difficult in a moment of suffering and a moment of great pain, or chronic pain, to believe it, to know it. A lot of the emails, the correspondence and the meetings I have had were with people who are worried about the assisted suicide MAID provisions, which the government has ineffectually dealt with through successive pieces of legislation. I think it was a grave error not to appeal the Truchon decision. I really do. I think it was a mistake. I said it to constituents at the time.

I have a Yiddish proverb, because I always do. They are great proverbs, and everybody should live by them and should know more of them. I just wish I could pronounce them in Yiddish: The truth never dies, but it is made to live as a beggar. This legislation is a beggar. This legislation should have been a permanent fix to the issues.

I think that Conservatives have suggested, both in committee and outside of committee, what some of those fixes would be. Although I disagree with an acronym, I will use RFND, reasonably foreseeable natural death. It should be limited to those who are terminally ill, where their death is foreseeable within the next six months, where there is a prognosis from a medical professional saying that one will indeed pass away.

For those most terrible conditions, I am thinking of a lot of cancers. My grandfather passed away from brain cancer in Canada, which brought my family to Canada. His death was very much reasonably foreseeable when it was terminal. There are others who have mental health conditions, which are caused by a physical condition. The mental health condition alone should not be the reason to seek assisted suicide.

Different Conservatives have mentioned, and I very much agree with this, that patients should be the ones requesting it. These are all things the government could have legislated into law. These are things that experts have said, and I want to read some of what the experts said in different committees.

Professor Trudo Lemmens and Mary Shariff persuasively rebutted a bunch of arguments that were made in Truchon. They noted again that reasonably foreseeable natural death applied to “all” persons, “not only to persons with disabilities”. “The judge in Truchon failed to appreciate how such a restriction reflects a constitutional duty to protect the equal value of the lives of all Canadians.”

I have read the Carter decision twice now. As many in the House know, this is something I take pride in saying that I am not a lawyer. I am not burdened with a legal education. I know the member for Fundy Royal is disappointed and that the member for St. Albert—Edmonton will be disappointed too, so I come to this as a layperson. Even the Carter decision did not say he had a right to die. It goes back to this idea, like I have said, that all of our deaths are reasonably foreseeable. It will happen; it is unavoidable in life.

These two experts said that the judge in Truchon made a mistake. This concept, this expertise, was then repeated in observations made by 72 disability rights organizations that penned a letter to the then justice minister. They said that reasonably foreseeable natural deaths are the ones where there is terminal illness that is coming up very quickly, and that this idea is an equalizing effect, guaranteeing a common thread among persons accessing MAID, assisted suicide, namely that they are dying within a very short time window. That is how I think this legislation should work. I am not saying there should be no MAID.

The Carter decision stands as a Supreme Court decision in Canada, so there has to be a provision of it in a method. It should be rare and should be restricted to the very few people for whom it was originally intended. I feel that Bill C-14 to Bill C-7 to the situation we are in today do not address that. That is why we have this legislation that is a beggar. It is not in the original form that it should be. The truth lies in abiding by what Carter decided.

Another one reads, “From a disability rights perspective, there is a grave concern that, if assisted dying is made available...regardless of whether they are close to death, a social assumption might follow (or be subtly reinforced) that it is better to be dead than to live with a disability.” That is a terrible message to send to persons with disabilities. I am thinking of my daughter, had she lived. That would have been a terrible message to send to her.

All three of my living kids have a chronic kidney condition. My boys will likely need a kidney transplants. What a terrible thing to tell them, that they are a burden on the medical situation and that maybe they should seek faster death. Is that what specialists are going to tell them when they are adults? I will not be in the room, but they will be in the room. Will that be pushed onto them? For those who are on dialysis, it is hard on their bodies to go three to four days a week to get dialysis in a hospital setting. I am not speaking of peritoneal dialysis that can be done in the home.

There have been lots of experts. The member for Fundy Royal explained a lot of what has been said on the issue. The government keeps erring in the wrong direction with more expansive legislation to allow more people to access something that was not the original intention of Carter. We should abide by Carter, as I mentioned before.

I have had constituents write to me. I just want to make sure that I read some of their thoughts into the record. Leanna wrote, “Please Halt the expansion of MAID to include those facing mental illness.” Catherine wrote, “As a parent who has seen my own children experience mental health challenges while in their teen years and early twenties, I am writing to express my deep concern about people with mental illness alone becoming eligible for medical assistance in dying. The move towards this will put countless vulnerable people at risk.”

Joe, in my riding, is a regular writer. I respond to most of his emails. I will send this to Joe just to make sure he knows I read his emails. His second and third points read, “By offering MAID for mental illness governments may put less money into treating mental illness.... Canadians may wish for MAID because of despair. They have not have been offered treatment for their mental illness.”

Cameron talked about a friend of his who is a nurse working in a mental health unit in Calgary. Mental health for him is all about seeing the intrinsic value of every human being, as celebrating the person not for what they contribute but for the beauty of their existence. He feels that once we stop seeing the dignity of one person, we will doubt our own worth and validity.

I know my time is running short, so I will not belabour this. I have heard comments from some members of the House who have tried to impugn a person's faith, religion or philosophical affiliations with whatever beliefs; although, all of us come to the House with our different beliefs. Some of them are sacred. Some of them are secular. It really does not matter where they come from, but all of us try to ascribe value to life, what that life is and what autonomy should be like.

To those members, I note that I did abstain from one vote that was specifically on advance directives because I have a constituent, Jim, who communicated with me over email that he and his spouse saw the experience of his mother, who passed away from Alzheimer's, and how terrible it was. In situations like that, it is incumbent upon the government to find a way to meet the requirements of the original Carter decision so that Jim and his spouse, when that time comes, can have their wishes met.

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, my colleague is quite right. With Bill C-7, but for the passage of Bill C-62, the impact would be profound on our health care system, on individuals suffering with mental illness and on the message we send Canadians suffering with mental illness. I can say only that the government has moved forward in this dangerous direction while ignoring at every turn the advice of experts, including, as I quoted extensively, the Society of Canadian Psychiatry, medical experts and legal experts, about the merits of moving forward. It is our job to debate these things, to consider them and to hear from experts. Unfortunately, because the government dropped the ball, it is up to us to pass the legislation before us to protect Canadians suffering with mental illness.

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, my hon. colleague is quite right. The government and the minister have been all too eager to lose. When they had a constitutional responsibility to defend their laws, they did not appeal decisions that would protect vulnerable Canadians, and when the then minister appeared at the justice committee on Bill C-7, which expanded medical assistance in dying, he assured us it was quite constitutional. Then, the next day, he was back, assuring us that without the expansion to those suffering from mental illness, it would be unconstitutional, so this was a minister who was all too eager to lead his government, and the government members did not stand up and push back.

Now we are in the situation we are in. We have already extended the coming into force for a year, and now we are debating a bill to extend it by three years. That is a clear indication that the government got it wrong, and we are going to do what needs to be done to protect Canadians.

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, Canadians would be forgiven for thinking they have seen this movie before, because they have. It was only last year that we debated Bill C-39, which provided an extension of the coming into force of this dangerous legislation. Now we are debating Bill C-62, which was introduced two weeks ago thanks to consistent pressure from Conservatives, advocates, experts, organizations and individuals from across the country who want to help individuals live with mental illness, not help them end their lives.

How did we get here? We got here because we have a justice minister, a Prime Minister and a government that have ignored the science, the legal experts, the courts and the pleas of the most vulnerable. They have ignored Canadians. They have plowed ahead with legislation to expand medical assistance in dying to Canadians who deserve help, Canadians who are suffering from mental illness.

I do not need to tell the House about some of the shocking headlines we have seen over the last year. Veterans suffering with PTSD are being told by employees of Veterans Affairs that they could consider MAID. Individuals without housing are considering MAID for economic reasons. Individuals, as we heard at our justice committee when we studied Bill C-7, who did not wish to have MAID were consistently pressured to considered it.

On this side of the aisle, Conservatives have chosen the path of hope rather than harm, and we will continue to do so, but across the way, just this week, we heard a government minister say it is not a matter of if this expansion takes place; it is a matter of when.

I mentioned ignoring the law. When we were at the justice committee studying Bill C-7, we consistently heard the government say that we have to do this because the courts told us we have to. Nothing could be further from the truth. First of all, there was a court decision, which the government did not appeal. That decision in no way directed the full expansion of accessibility to MAID to those suffering from mental illness. In fact, it was not in the original legislation.

What happened with Bill C-7, which we studied at justice committee, in no way, shape or form involved expansion of MAID to those suffering from mental illness. However, when the bill got to the unelected Senate, it was amended to include this provision, which we had not even studied. The minister at the time assured us his bill was charter-compliant. The previous justice minister was at committee.

I am holding today a letter signed by 32 leading experts on the law, professors from faculties of law around the country. The letter says, “We disagree as law professors that providing access to MAID for persons whose sole underlying medical condition is mental illness,” which is what we are talking about today, “is constitutionally required, and that Carter...created or confirmed a constitutional right to suicide, as [the Minister of Justice] has repeatedly stated. Our Supreme Court has never confirmed that there is a broad constitutional right to obtain help with suicide via health-care provider ending-of-life.”

Those are powerful words. If I had time, I would read the names of the 32 professors who signed the letter. People would recognize many of them. They would certainly recognize the different universities they represent.

With the letter in hand, I said to the minister of justice, “Minister, you have come here saying that, constitutionally, you have to do this, but these 32 experts are saying you do not. Who is right, you or these experts?". The minister said, “I'm right.”

That is the attitude we have seen consistently with the government as it has plowed ahead in spite of the evidence, in spite of the concerns and in spite of the pleas from disability groups, mental health experts and psychiatrists.

I have a brief from the Society of Canadian Psychiatry, which makes a number of conclusions. I do not have time to read them all, but I want to touch on a couple of the conclusions:

At this time, it is impossible to predict in any legitimate way that mental illness in individual cases is irremediable. A significant number of individuals receiving MAID for sole mental illness would have improved and recovered.

This is a finding of the Society of Canadian Psychiatry. I have already spoken about this a bit, but even they can see this. They go on to say:

The political process leading to the planned expansion of MAID for mental illness has not followed a robust and fulsome process, has not reflected the range of opinions and evidence-based concerns on the issue, and has been selectively guided by expansion activists.

If that does not send a shiver down one's spine, I do not know what would. When we are talking about Canadians at their most vulnerable place, they should be able to count on us. How many of us participate in, for example, Bell Let's Talk Day every year? We say to people, if they are suffering with mental illness, to reach out, that we are here to help and that they should talk to someone they trust and access mental health support. Now, in spite of all this, we have psychiatrists saying the government is moving in the wrong direction.

I turn to their recommendations:

The Board of the Society of Canadian Psychiatry recommends that the planned 2024 MAID for mental illness expansion be paused—

It's not for a year, not for three years and not for five years, but:

—indefinitely, without qualification and presupposition that such implementation can safely be introduced at any arbitrary pre-determined date.

What are we led to believe when a government will not listen to legal experts when it comes to the criminal law and will not listen to psychiatrists when it comes to mental illness? It begs the question of who it is listening to and why.

This is the second time, and Conservatives have warned all along that there would be a dangerous, slippery slope. Canada has leapt ahead of all other nations. Some nations were ahead of the curve on this compared to Canada. Now they look at us and ask what happened that we would even be discussing providing assisted death to someone who comes to Veterans Affairs or to one of the number of hospitals across our country, looking for help, and instead is offered medical assistance in dying.

I want to set the record straight that the Liberal government has not, in any way, been bound by the courts to expand MAID to those whose sole underlying condition is mental illness. This was a path it chose to take. We need to take this time to reflect on that path, to turn back and to give people hope.

We all know individuals who have been touched by mental illness in the health care system. We know the wait times can be extraordinary for people to get help. We also know the government has contributed to those wait times. After eight years, people are suffering.

I would urge members to support this bill and then to look at ways to provide support for those suffering with mental illness, not to offer them assistance in death.

I move:

That the question be now put.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I will start with an assertion whose veracity will become clear. With Bill C-62, the cowardly Liberal government brought forth a mouse.

If we are talking about Bill C‑62 today, it is because Bill C‑7 created the Special Joint Committee on Medical Assistance in Dying when it passed. The committee's mandate was to review the medical assistance in dying legislation, in particular as regards the issue of advance requests. Because we knew that the problem was more difficult in cases of mental illness, the government set up an expert panel to help MPs do their job. The panel was to issue a report to the special joint committee.

The expert panel was indeed set up. The problem is that, instead of putting everything in place following the adoption of Bill C‑7, the government decided to call an election in 2021. That delayed the process.

Immediately after the useless election, we would have expected the special joint committee to sit but, no, we had to wait. They took their sweet time. The committee was finally convened, but it had a huge mandate. Its mandate was so huge that Bill C‑39 on mental illness had to be introduced, delaying the committee's recommendation.

Since February 2023, the committee has been very clear on the issue of advance requests. In fact, that was its most widely held recommendation. During the entire debate on Bill C‑62 in the House, the government said that we needed to be cautious and proceed slowly. That is fine, but when caution involves making patients suffer, I cannot agree. I think we need to be diligent.

The government took its sweet time. Here we are in 2024, and it introduced legislation seeking to postpone the issue of mental illness. Fine, but what is happening with the main recommendation the committee made in February 2023? The government knew very well that Quebec was laying the groundwork on the issue of advance requests. It knew very well that Quebec would bring in its own law. Instead of taking inspiration from that and seeing what measures could be included in the regulation accompanying Canada's MAID legislation, it did nothing.

I have stood in the House many times to ask the Minister of Justice and the Minister of Health why the government did nothing. Why does the bill not include a component on advance requests, which should have been prepared over the past year? After all, the government introduced legislation enacting the special joint committee's February 2023 recommendation on mental illness. On the issue of advance requests, however, it did nothing, despite the majority recommendation.

Yesterday, I got my answer. The Minister of Health demonstrated in front of the whole committee that he was unfamiliar with the Quebec law, yet he rises in the House and says he has enormous respect for Quebec's process. The Liberals do not even know what they are talking about. The minister told me that the issue of advance requests is more difficult than the issue of mental illness because, for example, there might be family quarrels at the patient's bedside.

I realized that the minister had not read section 29.6 of the Quebec law, which stipulates that, as soon as patient is diagnosed, they can appoint a third party. The third party will not determine when the person can access medical assistance in dying, but will advocate for their wishes, which will be included in the advance request, or the person's criteria.

People in my riding have told me that, when they become incontinent and can no longer control their bowels, when they have reached the point where they no longer have any appetite and it becomes a chore for their caregivers to feed them, although they are well compensated for their troubles, when they are no longer able to recognize their friends and family members and when they can no longer maintain relationships, they would like to have access to medical assistance in dying. The third party in whom they have placed their trust will then ask the care team—because patients are indeed cared for by entire teams—to evaluate whether they are meeting the criteria, if they are there yet.

If people make advance requests, it is because they want to avoid shortening their life. They want to live as long as possible. We could be good to them and take care of them until they cross their tolerance threshold.

The minister does not even know what I am talking about right now. Do members think it is normal that people say they respect Quebec, that they have great admiration for Quebec's progress on this issue, but that they do not even know what is in Quebec's law?

It is no surprise that they come out with a bill like Bill C‑62, that does not address this at all. Then they have the gall to say that Quebec has made good progress, but that not all Canadians are ready for that, so they have to wait and watch their patients suffer. Quebec is not the only province that supports advance requests. According to an Ipsos survey, 85% of Canadians from coast to coast support advance requests.

The Conservatives claim that they want to do good, they want to take care of Canada's most vulnerable. I, too, want to take care of the most vulnerable, but who is more vulnerable than a patient who is about to cross their tolerance threshold, who is suffering and who is being told no by the government?

Some claim that there could be abuses, as if the Criminal Code did not provide for punishment of abuses. They seem to believe the medical system to be inherently evil. I heard my Conservative colleague earlier. Listening to the Conservatives, one would think everyone working in the health system wants vulnerable people euthanized. I heard another Conservative member say there is an opioid crisis, there are people in the streets, and we are going to euthanize them. That is absolutely false. It is really far-fetched. That kind of rhetoric is meant to scare people; it amounts to spreading misinformation on a crucial topic.

When we care, we do not infringe on individual autonomy. The role of the state is not to decide matters so personal as how someone wishes to cross their threshold of tolerance. It is not to tell patients what is right for them. It is to provide the conditions so they can make a free and informed choice.

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

Madam Speaker, I would like to say two things. First, there is unanimous consensus in Quebec. All parties in the Quebec National Assembly voted to pass a law, but it has no force or effect because it is being blocked. Quebec is asking that its law be aligned with the Criminal Code so it can come into effect in Quebec alone. That is what we are asking. It is not complicated. The government tells us this is very important, but it chose to do nothing and kick it down the road, even though we need to act quickly.

Second, the decision to delay all debate in the House for three years brings us to after the election. Projections indicate that the Liberals will not form a majority government. In all likelihood we will never discuss this again, we will never come back to this debate. I think that is irresponsible.

We first dealt with Bill C-7 in 2021. That is already three years ago. What has the government done in three years? It came up with the current bill, which says they will ensure the debate will never be over. We think that is irresponsible. I beg the government to at least try to harmonize the Criminal Code with the unanimous will of Quebec. It is a matter of dignity. My society and my nation are ready. However, they are being blocked by their neighbour, who is choosing not to act. I am asking them to act.

[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.

[Yasir Naqvi, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I am thankful for the opportunity to speak about Bill C-62 and the extremely important issue of medical assistance in dying, or MAID, and mental illness.

I think all members can agree that this is a highly complex, quite sensitive and emotional issue, that raises divergent and deeply held views from the medical community, experts and the public at large. The questions of whether, how and when to expand eligibility for MAID to persons whose sole underlying medical condition is a mental illness are difficult; they do not have easy answers.

The federal government believes that eligibility for MAID should be expanded to such persons. However, such an expansion should not be rushed and should not occur before the health care system is ready to safely provide MAID in all cases where it is requested on mental illness grounds. This is why we have introduced Bill C-62, which proposes to extend the temporary mental illness exclusion by three years, until March 17, 2027. The bill also includes a provision requiring a parliamentary review prior to that date.

As members will recall, in 2015, the Supreme Court of Canada concluded in the Carter case that the Criminal Code’s absolute prohibition on physician-assisted death was unconstitutional. The Supreme Court held that physician-assisted dying must be permitted in some circumstances, namely, for competent adults who clearly consent to the termination of life and who have a grievous and irremediable medical condition. This decision led to the legalization of MAID in Canada one year later, in 2016, through Parliament’s enactment of former Bill C-14. Our original MAID law limited eligibility for MAID to competent adults with an eligible medical condition whose natural death was reasonably foreseeable. Our MAID framework was added to the Criminal Code and was made up of a stringent set of eligibility criteria, as well as procedural safeguards to prevent error and abuse in the provision of MAID.

A few years later, the “reasonable foreseeability of natural death” eligibility criterion was challenged in Quebec; in 2019, it was declared to be unconstitutional by the Superior Court of Quebec in the Truchon decision. As this was a trial-level decision, it was only applicable in Quebec. Nevertheless, the Attorney General of Canada did not appeal the decision; instead, the federal government made the policy decision to expand eligibility for MAID. This led to Parliament’s enactment of former Bill C-7 in 2021, which expanded eligibility for MAID to persons whose natural death is not reasonably foreseeable. This resulted in the removal of the eligibility criterion that a person’s death be reasonably foreseeable and the creation of two sets of procedural safeguards for the lawful provision of MAID.

The first track of safeguards applies to persons whose natural death is reasonably foreseeable; the second, more robust, track applies to persons whose natural death is not reasonably foreseeable. This second set of safeguards was created in recognition of the fact that requests for MAID by persons who are not at end of life are more complex. This is why a minimum of 90 days must be taken to assess a person for eligibility for MAID when their natural death is not reasonably foreseeable. This is not a reflection period; it is a minimum assessment period. This safeguard aims to respond to the additional challenges and concerns that may arise in the context of MAID assessments for persons whose natural death is not reasonably foreseeable. This includes whether the person’s suffering is caused by factors other than their medical condition, as well as whether there are ways of addressing their suffering other than through MAID.

This second set of safeguards also requires that two practitioners be satisfied that the person meets all the eligibility criteria, and if neither of them has expertise in the medical condition causing the person suffering, one of them must consult with a practitioner who does. Involving a practitioner with the relevant expertise aims to ensure that all treatment options are identified and explored.

Practitioners are also required to inform the person of available counselling services, mental health and disability support services, community services and palliative care; to offer them consultations with the relevant professionals; and to ensure that the person has given serious consideration to such alternative means to alleviate their suffering. Although this does not require a person to undertake treatments that may be unacceptable to them, it requires that they fully explore and weigh the risks and benefits of available treatment options.

Former Bill C-7, as originally introduced, permanently excluded eligibility for MAID on the basis of a mental illness alone. This was not because of the incorrect and harmful assumption that individuals who have a mental illness lack decision-making capacity or because of a failure to appreciate the severity of the suffering a mental illness can cause. Rather, this was done because of concerns about the inherent risks and complexities of permitting MAID for individuals who suffer solely from mental illness.

During its consideration of the bill, the Senate made an amendment that added a sunset provision that would repeal the mental illness exclusion 18 months later. The House of Commons accepted the amendment in principle, but changed the date of repeal to two years; in other words, the provision of MAID based on a mental illness alone was set to become lawful on March 17, 2023.

The decision to temporarily maintain the exclusion of eligibility was based on the recognition that additional study would be required to address the risks and complexities of permitting MAID in these circumstances. This is why the former bill also included a requirement for an independent expert review respecting recommended protocols, guidance and safeguards to apply to such requests for MAID.

Former Bill C-7 also required the creation of a joint parliamentary committee tasked with conducting a comprehensive review of the Criminal Code's MAID provisions and other MAID-related issues, including MAID and mental illness. The committee undertook this important work, and its interim report, which focused on MAID and mental illness, was tabled in June 2022. It urged the federal government to collaborate with regulators, professional associations, institutional committees and the provinces and territories to ensure that the recommendations of the expert panel were implemented in a timely manner.

The committee's second report was tabled in February 2023. The majority view expressed was that eligibility for MAID on the basis of a mental illness alone should be permitted. However, the final report also raised a key concern that more time was needed for standards to be developed and training to be undertaken before the law should permit a mental illness to ground a request for MAID. The federal government recognized the significant progress that had been made by the provinces and territories, stakeholders and the medical community in preparing for the expansion. However, it ultimately concluded more time was needed.

This is why we introduced Bill C-39, and Parliament enacted it. It extended the exclusion by one year, until March 17, 2024. This extension aimed to provide additional time for the dissemination and uptake of key resources by the medical and nursing communities. We thought it essential to prepare for the safe assessment and provision of MAID in all cases where a mental illness grounds a request for MAID. The committee expressed support for the extension in its second report.

I want to take a moment to recognize the work that the federal government has done during this extension to support the fulfillment of some of the expert panel’s recommendations. For instance, we amended the regulations for the monitoring of MAID last year to ensure comprehensive data collection and reporting. Such changes allow for data collection related to race, indigenous identity and disability of persons requesting MAID. These changes came into force in January 2023, and the first set of data will be captured in Health Canada’s 2024 annual report on MAID.

Moreover, Health Canada convened an independent MAID practice standards task group to develop a practice standard for MAID. In March 2023, the model MAID practice standard and supporting documents that provide guidance to support complex MAID assessments were released. Finally, Health Canada supported the Canadian Association of MAiD Assessors and Providers in the development of a Canadian MAID curriculum, which was launched in September 2023.

In Canada, certain aspects of MAID fall under federal jurisdiction and others fall under provincial and territorial jurisdiction. The federal government is responsible for the criminal law aspect, whereas the provinces and territories are responsible for the implementation of MAID within their health care delivery systems. Impressive progress has been made in preparing for the expansion by the March 2024 deadline. However, the provinces and territories have all expressed that they are not yet ready. For this reason, we are proposing to extend the temporary mental illness exclusion for another three years, until March 17, 2027.

The extension would allow more time for the provinces and territories, and their partners, to prepare their health care systems by implementing regulatory guidance and developing additional resources for their medical and nurse practitioners. It would also provide more time for medical and nurse practitioners to become familiar with the available training and supports. Our ultimate goal is to help ensure that the necessary protections are in place to protect the interests of individuals who may seek MAID on the basis of a mental illness alone.

We believe that this issue should not be rushed. Eligibility for MAID should not be expanded until the health care system is ready to safely provide MAID in these complex circumstances. I urge all members to support the bill so our partners can get this right.

Government Business No. 34—Proceedings on Bill C-62

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

Madam Speaker, the New Democrats actually also voted against what I thought was an ill-advised Senate amendment to Bill C-7. There is plenty of blame to be thrown around. I understand that. I have done more than my fair share this week against the Liberals, but the fact of the matter is that we are at a moment right now when time is critical. We have about a week and a half left, in terms of sitting weeks, until the March 17 deadline. It is imperative that this bill gets passed through the House this week, so that it can go to the Senate.

I am glad to hear the member's support for that measure, but I am curious as to why, when we had a vote on time management of this motion, which is programming the bill, the Conservatives voted against it, knowing that it could have actually jeopardized the time we had available to us this week to get Bill C-62 passed.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Madam Speaker, it is possible that my colleague misunderstood me. What I said in my speech was that I voted for Bill C-14 because it was a reasonable response to what had to be addressed, which was the Carter decision. The reasonable foreseeability of death was a problem clause, and I thought so at the time. I thought it was awkward and perhaps not the best way to put it, so it was not a shock to me that it ended up being challenged on that basis. I think my colleague may have been overestimating my enthusiasm for Bill C-14, but I did support it, because something had to be done.

However, this reckless expansion that came after the Senate amendments to Bill C-7 goes way beyond this. No court was calling upon Parliament or forcing Parliament to expand the eligibility of MAID to those whose sole underlying health condition is mental illness.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Madam Speaker, it is quite difficult to follow the incredible words we just heard from the member for Cariboo—Prince George. Nevertheless, I am going to give it a try.

I am here tonight of course to speak to Bill C-62 and the self-inflicted debacle that has been unfolding in Parliament since it passed its radical expansion of legal medical assistance in dying to include persons for whom the sole underlying health condition is mental illness.

I will remind members of the House and my constituents that I supported and still support the principles of the 2016 bill, which was a necessary response to a 2015 Supreme Court ruling that struck down the blanket prohibition against MAID. That bill was not perfect, but it was a reasonable response to the Supreme Court's decision and was certainly better than the free-for-all on MAID that would have surely followed had there been no law.

It is my view that people who are suffering intolerably from a terminal disease without any hope of recovery or any prospect for improvement and are spiralling into a certain death as a result of illness or disease ought to be able to seek medical assistance in dying as long as they are not coerced, have received an option of proper palliative care, are not proactively offered MAID as an alternative to treatment, and most importantly, as long as the patient is a mentally competent adult.

Part of the criteria laid out in the original 2016 law was the reasonable foreseeability of death of the applicant. This clause was a problem from the start. It was challenged in court and struck down by the Quebec Superior Court. The Truchon case presented the Liberals with a decision point. The decisions the government has made since then have all been wrong.

The first thing the Liberals could have done, but did not, was defend their own existing law and appeal the Truchon decision to the Supreme Court. If they believed that their 2016 law was charter compliant, like they claimed it was during the debate in 2016, they should have stepped up and defended it. Not doing so was their first mistake.

The second mistake was that the then minister of justice was so eager to expand the law, they used the Truchon case as an opportunity to open up and expand access to medical assistance in dying and tabled Bill C-7 in the fall of 2020. That was their second mistake.

As I said before, I support MAID for competent adults who are grievously and irremediably ill and suffering cruelly from intolerable pain and anguish in the late stages of a terminal illness. I have consistently said there are important conditions for my support for legal access to MAID: the availability of quality palliative care as an option; the existence of robust safeguards for the vulnerable, especially minors, the disabled and the mentally ill; conscience protection for practitioners who oppose MAID; and any expansion of the availability of eligibility for MAID be well thought out, carefully considered and not rushed.

For these reasons, I voted to send Bill C-7 to committee, but voted against it at third reading because it failed on at least two, maybe three of my four conditions for support. I concluded that access to palliative care is not adequate in Canada. I have also become alarmed by the cracks in what should be the protections for vulnerable Canadians, as we have experienced in my own family. It was my view, even before the Senate amendment, that Bill C-7 was flawed and unworthy of support.

Then the House made a terrible decision when it passed the amendment that came back from the Senate. It was rightly opposed by all of my Conservative colleagues, who knew then that medical professionals cannot, with the certainty required for what is literally a life-and-death decision, determine irremediability of a patient in a case of mental illness. Conservatives opposed it, but it was passed nevertheless, and this expansion, which was not necessary to conform to any court decision, was to come into effect last year. The government had to introduce emergency legislation this time last year to give the medical system more time for this extraordinary change. That was the next mistake it made.

The Liberals could have used that opportunity to deal with this once and for all and simply strike this portion of what was then Bill C-7. However, they did not do it and here we are, another year later, and this country is no more ready for this expansion than it was this time last year. Here we are again in an eleventh-hour panic to kick this further down the road until after the next election; the next mistake.

Now, the Liberals could have tabled a bill that would have removed this from the bill that passed in 2021, but they have chosen not to and so said that the next government will have to deal this. However, the good news is that a Conservative government, which will surely be formed after the next election, will not recklessly expand the application of MAID to include vulnerable Canadians whose sole underlying health condition is a mental illness.

MAID is for people who cannot get better. It is for people who have no reason to hope that they can get better because they are in an irreversible, terminal state. It is for people capable of making a rational decision and not as a means of potentially fulfilling suicidal ideation.

The impossibility of creating a regime that could determine appropriate MAID for mentally ill but otherwise healthy people who are not in the final stages of a terminal illness seemed intuitive to me, but, of course, I am not a medical professional. However, I can also point to the clear message that was sent from the joint committee that studied this. Its recommendation to Parliament was very simple: Do not do it. It was the shortest list of recommendations I have ever read in a parliamentary report. It just said: Do not do it. That was the recommendation based on months and months of testimony from experts.

My recommendation to this government is to listen to the committee and strike it from the bill that passed. This time last year, the Liberals could have done that, but they kicked it ahead until this year, and nothing has changed. We find ourselves here where a full 80% of members of the Ontario Psychiatric Association do not believe that Canada can safely implement MAID for mental illness. Here we are just pushing this back a couple of years.

I want to share with the House the words of one of my constituents who met with me in November. She said in a letter to me, which I got before I met her, that, “Twenty-three years ago, age nineteen...I made the desperate decision to try and escape what appeared to me to be a dark world.... While taking a course in Pharmacology, I calculated the quantity of poison needed to arrest the heart of an adult male, multiplied it by three, and chose to ingest it.... I felt compassion for the suffering of others and the weight of constant, terrible news...though I formerly had the capacity to deal with this, the ingestion of a single pill coerced upon me by a well-intending physician inadvertently plummeted my thoughts into despair.”

What she told me later was that the side effect of the medication that she had been prescribed caused her to immediately become suicidal, and her survival was described as miraculous by the professionals who attended her.

She is now a wife and a mother and lives a productive, meaningful life. She is convinced that had MAID been available to her earlier in her life, she would have sought it and potentially have been granted it. She told me that the sufferings earlier in her life may well have been thought to be irremediable and thus would have made her eligible.

So, this government has failed to defend its original law. It failed to focus the new law on the narrow constraints of the Truchon decision. It used the Truchon decision in Quebec as an excuse for a reckless expansion of MAID. When it was obvious that it made a mistake, its members dithered instead of acting decisively and they are dithering now by pushing this two more years down the road. That is not leadership. This is just bizarre enthusiasm for the most radical expansion of MAID possible, which has now run amok.

So, I do support swift passage of the bill. Given the extensive debate that has already taken place, I was prepared to let it pass unanimously, but here we are. I had an opportunity to get some of my thoughts on the record, and I am happy to take questions.

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

Mr. Speaker, it seems to me that we have gotten ourselves into trouble with the use of arbitrary timelines. The Senate amendment to Bill C-7 kicked the can down the road two years. Last year's Bill C-39 added a year, and now Bill C-62 would add three years.

I just want the member to put that into the context of the fact that the health ministers of seven out of 10 provinces and all three territories have asked for an indefinite pause. The special joint committee, likewise, was very careful not to put a timeline in its recommendation for a pause.

How does the member reconcile this three-year pause with the fact that those institutions, those provincial governments, would rather put more of a qualitative benchmark than a timeline on it?

[Andréanne Larouche, Bloc, Shefford, QC]

Mr. Speaker, the member for Salaberry—Suroît is a tough act to follow. This is not easy, because we all have someone in mind when we talk about this. We have all lost loved ones over the past few months and years. We all have gone through different experiences. Some people request medical assistance in dying, others do not, but one thing is certain: this is a very sensitive topic. It is with great humility and sensitivity that I rise today to speak to Bill C-62, an act to amend An Act to amend the Criminal Code (medical assistance in dying), no. 2, something we have been talking about for a long time.

We must act by considering the fact that, currently, the Government of Quebec's Bill 11 does not include non-neurocognitive mental disorders as being eligible for medical assistance in dying and that Quebec wants to fill the administrative void surrounding the federal government's position on the subject of mental disorders relative to neurocognitive disorders. Therefore, I am not here to repeat my whip's testimony. I am here to provide some background and talk about Quebec's specificities. I will close by going into more detail about the Bloc's position.

First, in 2014, Quebec passed the Act Respecting End-of-Life care after five years of consultations and of working together across party lines. I want to emphasize that the work was non-partisan. In 2015, the Supreme Court ruling in Carter indicated that some provisions of the Criminal Code that prohibited medical assistance in dying contravened the Canadian Charter of Rights and Freedoms. In 2016, the Liberal government passed Bill C-14, in response to Carter. In 2019, the Quebec Superior Court ruled in favour of Nicole Gladu and Jean Truchon, who claimed that excluding people whose death was not reasonably foreseeable from eligibility for medical assistance in dying was discriminatory. As a result, the court ordered that federal and provincial laws be amended before December 18, 2020.

In 2021, after a pandemic-related delay, Parliament passed Bill C‑7, which created two pathways to medical assistance in dying: One for those whose death is reasonably foreseeable and one for those whose death is not reasonably foreseeable. Quebec simply chose to drop the end-of-life criterion. Bill C‑7 required that an expert panel be created to review MAID and mental illness. The Expert Panel on MAID and Mental Illness was formed in August 2021 and produced a final report containing 19 recommendations. Recognizing that the legislation was flawed and that issues related to medical assistance in dying remained unresolved, Bill C-7 created the Special Joint Committee on Medical Assistance in Dying, composed of members of the Senate and members of the House of Commons, which had a five-part mandate.

The joint committee tabled an interim report on June 22, 2022. There was not much time between the tabling of the joint committee's report, which was initially expected in 2022, and the March 17, 2023, deadline for excluding people from MAID for mental illness, so members postponed eligibility for one year to allow the committee to finish its work. The goal was to give the professions involved more time to develop standards of practice. At last, in February 2024, the joint committee produced its final report. The report contains only one recommendation. Bill C‑62 implements the report's recommendation by postponing eligibility for MAID MD-SUMC, for mental disorders, for three years and by forcing the creation of a joint committee one year before the report.

Sections 241.1 to 241.4 of the Criminal Code govern medical assistance in dying in Canada. What is more, under the law, the government is required to oversee the use of medical assistance in dying via the Regulations for the Monitoring of Medical Assistance in Dying. I am providing all of this background to illustrate that the government could have and should have taken action a long time ago.

Second, in Quebec, medical assistance in dying is governed by the Act Respecting End-of-Life Care. The activities surrounding medical assistance in dying are supervised by the select committee on end-of-life care. In June 2023, the National Assembly of Quebec passed Bill 11 to expand access to medical assistance in dying in Quebec and harmonize Quebec's legislation with the Criminal Code. There are some notable changes to Quebec's legislation. Minister Sonia Bélanger and her colleagues Roberge and Jolin‑Barette held a press conference on February 7 calling on the government to include a provision in the Criminal Code that would allow Quebec to move forward with advance requests, because, even though Quebec's legislation allows it, the Criminal Code does not.

Although doctors who choose to go ahead with advance requests are unlikely to be prosecuted by Quebec's attorney general, the risk of a civil lawsuit is still there, and that will make many doctors think twice about granting advance requests. Quebec's National Assembly has passed a unanimous motion demanding that the federal government legislate on the issue.

Third, the Bloc Québécois will vote for the bill on the condition that the postponement is for one year, not three. The Bloc Québécois believes that eligibility for people suffering from mental disorders must be postponed so that Quebec, the provinces and professional bodies can create a framework for their MAID practices. However, it should not be postponed indefinitely. The Bloc Québécois believes that postponing eligibility by three years will prolong the suffering of individuals who could be eligible for MAID and is contrary to their rights as guaranteed by the charters. The Bloc Québécois wishes to point out that the report of the Expert Panel on MAID and Mental Illness, as well as the Collège des médecins du Québec, emphasized that the safeguards—namely irremediability, severe physical or mental suffering, and free and informed consent—currently provided for in the Criminal Code are sufficient to allow access to MAID where mental disorder is the only underlying condition.

In our supplementary opinion attached to the report of the Special Joint Committee on Medical Assistance in Dying, the Bloc Québécois points out that, even though preparations on the ground for medical assistance in dying when a mental disorder is the sole underlying medical condition are not yet complete across Canada, this does not change the fact that several professional associations, including the Collège des médecins du Québec and the Association des médecins psychiatres du Québec, would still like it to be made available in the future.

The Bloc Québécois also acknowledges the requests made by several provinces to postpone eligibility. It should be noted that many countries have adopted policies on medical assistance in dying specifically for mental disorders.

The Bloc Québécois deplores the government's failure to be proactive and the Conservatives' obstruction on the issue of medical assistance in dying when a mental disorder is the sole underlying medical condition and on the issue of advance requests. We fear for the patients who will have to turn to the courts to assert their rights while also bearing the burden of their illness.

Finally, the Bloc Québécois condemns the fact that this bill does not distinguish between mental disorders and neurodegenerative diseases, such as Alzheimer's and Parkinson's. Quebec's law makes that distinction. It would allow people suffering from the latter category to access medical assistance in dying, as advocated by the Quebec government. In the Bloc's opinion, the social consensus on these illnesses is stronger, and it would have liked to see the Criminal Code brought into line with Quebec's end-of-life care law by allowing advance requests.

In his supplementary opinion on MAID, the member for Montcalm, whom I would like to congratulate for all his work on this issue, went into great detail on the reasons that justify MAID when a mental disorder is the sole underlying condition. The position of the Collège des médecins du Québec perfectly sums up the importance of allowing advance requests for medical assistance in dying, as well as medical assistance in dying when a mental disorder is the sole underlying condition. While admitting it needs more time to ensure its members are ready, the Collège des médecins du Québec has established five guidelines for assessing eligibility for medical assistance in dying.

In conclusion, the Bloc Québécois has a humanist view of medical assistance in dying that is grounded in philosophical principles and ethical arguments that reflect the evolution of Quebec society. Medical assistance in dying recognizes the right of individuals to choose for themselves, to determine the conditions for a healthy and dignified life. Medical advances allow us to sustain life, but that does not preclude the need and right of the individual to define what is an acceptable life. Section 1 of the Quebec Charter of Human Rights and Freedoms states that every human being has a “right to life, and to personal security, inviolability and freedom”.

Quebec society believes that the right to life includes the right to die. In that context, we need to see medical assistance in dying as a right that gives the individual the option of avoiding terminal suffering and medical paternalism in order to maintain their dignity. By allowing medical assistance in dying, we allow people to choose how, when and where they want to pass away.

Medical assistance in dying only makes sense if the person's free and informed consent is respected. The word “free” means voluntary and without constraint, and the word “informed” means with all the information needed to make such a decision. Meeting this condition is necessary for accessing medical assistance in dying.

The principles we stand for concerning medical assistance in dying are equally valid in cases of mental illness. Let us not forget that the possibility of access to MAID does not mean automatic eligibility. However, when the Quebec select committee was doing its work, it made a distinction between mental disorders and neurodegenerative diseases. The commission concluded that although there was no consensus on mental disorders, there was a consensus on neurodegenerative diseases. With that in mind, the Quebec government opened the door to advance requests. Advance requests allow an individual to determine the conditions under which MAID should be administered when they have lost the capacity to consent because of their illness.

In its second report, the Special Joint Committee on Medical Assistance in Dying expressed its support for advance requests. All parties, except the Conservatives, who are against any form of medical assistance in dying, voted in favour of the recommendations.

As a final point, the federal government therefore has no reason to drag its feet or to deny Quebec's request.

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

Mr. Speaker, on the situation we find ourselves in this week, and last year with Bill C-39, we can draw a direct line back to the Senate amendment that was placed on Bill C-7. The government did a complete 180. It came out with a charter statement explaining why it was excluding mental disorders, and it then went and accepted the Senate amendment.

Bill C-39 last year had to punt the ball down the road by a year. Now we have Bill C-62 trying to do that by another three years. It feels like everything we have been doing has been trying to play catch-up to that change in the law. The law was changed before we had done the work.

Does my hon. colleague regret voting for that Senate amendment, given all he knows now and all of the catch-up we have been trying to do on this very important and sensitive issue?

[Yasir Naqvi, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I appreciate being recognized to speak to a very sensitive and emotional issue.

Today, I am pleased to be speaking to Bill C-62. This bill proposes extending the temporary exclusion from MAID for people whose sole underlying medical condition is mental illness.

We are proposing that the exclusion be extended by three years. To understand why an extension of this exclusion is so important right now, we need to look at how we got to this point in the legislative process.

As members know, former Bill C-7 was enacted in response to the Quebec Superior Court Truchon ruling. The ruling found that the original MAID legislation, which required a person's natural death to be reasonably foreseeable, contravened the Charter of Rights and Freedoms.

The former Bill C-7 received royal assent and became law on March 17, 2021. This law included a temporary two-year exclusion of eligibility for individuals suffering solely from mental illness, which meant that such persons would become eligible to receive MAID starting March 17, 2023, if they met all other eligibility criteria. The intent of this two-year delay was to allow an expert panel to undertake an independent review and to provide recommendations respecting any protocols, guidance and safeguards that should apply to requests for MAID by persons with a mental illness.

I will be sharing my time with the member for Richmond Hill.

On May 13, 2022, the “Final Report of the Expert Panel on MAiD and Mental Illness” was tabled in Parliament and released publicly. The expert panel noted that MAID clinicians are already assessing very complex cases and concluded that certain assessment challenges, such as determining incurability or assessing decision-making capacity, are not unique to MAID requests from persons with a mental disorder, nor are they applicable to every requester who has a mental disorder. The expert panel also concluded that the existing MAID eligibility criteria and safeguards in the legislation provide an adequate structure for MAID where a mental disorder is the sole underlying medical condition, as long as they are interpreted and applied appropriately.

The expert panel's recommendations provide guidance to support complex MAID assessments. In its final report, the expert panel made 19 recommendations, laying out a broad set of principles that could structure the practice of MAID not only for persons with a mental disorder but also for those with other conditions where concerns may arise related to incurability, irreversibility, decision-making capacity, suicidality and/or the impact of structural vulnerability, regardless of the person's diagnosis.

The government supports the insights and general advice emerging from the panel's work. Let me take a few minutes to highlight some of the key achievements.

The expert panel report recommended the development of national practice standards on MAID for mental disorders and other complex cases. Practice standards help regulatory bodies evaluate the appropriateness of the clinical decisions of health professionals who assess and provide MAID. They also provide clarity to MAID clinicians regarding their professional obligations. In March 2023, a model practice standard for MAID was released along with a companion document of advice to the profession, which provides a series of questions and answers that elaborate upon specific clinical questions raised by the model standard.

That is not all we have done to help prepare a safe approach to providing medical assistance in dying across Canada.

We are providing $4.9 million to the Canadian Association of MAiD Assessors and Providers to develop and deliver an accredited, Canadian-made curriculum to support practitioners. This consists of seven training modules that address various topics related to the assessment and provision of MAID, including guidance in how to assess capacity and vulnerability, how to navigate more complex cases and how to assess MAID requests with mental illness as the sole underlying condition. The MAID curriculum was launched in August 2023. Over 1,100 clinicians have registered for it.

From when MAID legislation was enacted in 2016 to the end of 2022, over 44,000 Canadians received MAID. The vast majority of these individuals were at the end of their life. In fact, numbers from 2022 show that 96.5% of individuals accessing MAID were terminally ill, and two-thirds had a cancer diagnosis. Many more requested MAID but were ruled ineligible based on the strict eligibility criteria and safeguards, withdrew their requests or died before receiving MAID. This is not unexpected.

The government recognizes that public reporting is critical to ensuring transparency and public trust in the legislation. Both the original MAID legislation of 2016 and the amended law passed in 2021 set out obligations for the collection of data and public reporting on important aspects of MAID. As of January 1, 2023, we have expanded our collection of information on MAID.

I would like to take this opportunity to highlight the achievements of the provinces and territories, as well as key partners in the system, such as health care professionals, who are working to safely implement MAID within their health care systems.

We have come a long way, but we have heard clearly that there is more work to be done. More preparations are required within the provincial and territorial health care systems to support the wraparound activities that may be necessary for the management and assessment of MAID requests where mental illness is the driver.

We also know that some Canadians and members of the medical community are concerned about expanding eligibility for MAID to people suffering solely from mental disorders.

We will continue the work with the provinces, territories and key health system partners to support the safe implementation and delivery of Canada's framework for MAID, while protecting those who may be vulnerable. The expert panel also recommended consultations with first nations, Inuit and Métis people. We recognize the importance of meaningful engagement and ongoing dialogue with indigenous peoples to support the culturally safe implementation of MAID.

Working in partnership with indigenous communities, we have developed an extensive plan for indigenous engagement. Our approach involves both indigenous-led community engagement and federally supported activities, such as an online tool, which has already been launched, and knowledge-exchange round tables, which will be taking place this February to April. We are working closely with indigenous partners to design a process with them at their pace.

I recognize that there is a lot of hard work being done in order to show that MAID is accessible to people who need it, with appropriate safeguards in place. However, we need to make sure that we do not rush into that decision. This is why it is really important that we extend the application of this particular bill, as it relates to people with mental disorders, by at least three years; as a result, all provinces and territories can have the appropriate training and assessment tools ready.

A year ago, we extended the exclusion period for one year, until this March. As we approach that date, we have heard unanimously from all provinces and territories that their health care systems are at various stages of readiness, and there is more to be done.

The decisions we are making about MAID are not easy to make, nor should they be.

These are life-and-death decisions and we must get this right.

In Bill C‑62, the government has put forward a three-year extension of the exclusion from eligibility for MAID for people suffering solely from mental illness.

I urge all members of this House to support Bill C-62.

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

Mr. Speaker, I agree with many points my hon. colleague made in her speech. It is why I voted against the Senate amendment to Bill C-7 in the previous Parliament. It is why I voted for the member for Abbotsford's bill, Bill C-314. It is why I agree with the recommendation that came out of the special joint committee.

There is more than enough blame to be assigned to the Liberals, but we are dealing with a March 17 deadline. This is a time the House collectively has to stand up and get this bill through because we also have the Senate to deal with.

Why, with that context upon us right now, did the Conservatives vote the way they did this morning when it is imperative that this bill get passed before March 17?

We do not yet know what is actually going to happen in the Senate. We can only really say for certain what is going to happen in the House, but this is a critically important bill to pass before March 17.

[Branden Leslie, Conservative, Portage—Lisgar, MB]

Madam Speaker, before I give my speech on this very important topic, I would like to quickly comment on the horrific incident we faced in southern Manitoba over the weekend with the tragic loss of life of two young women and three children. As a father, it is tough to fathom the loss of a child and the impacts it would have on that family's loved ones and friends. It would impact everyone in their lives and, frankly, the broader community.

My heart goes out to those of Carman and the surrounding area, and to the friends, families and loved ones of the victims of this horrific incident. It is devastating news for a small community like that, where folks know their neighbours and look out for each other, so I pray for strength during a very dark and incredibly difficult time for our community.

To the issue at hand, we are more than a month away from the Liberal government implementing medical assistance in dying for those who suffer from a mental illness. I believe this is heartless, reckless and immoral. Every Canadian has worth, and I, for one, will never give up on those who need help.

Never have I seen a government mismanage an issue as critical as this, and while it may be unpleasant for my Liberal colleagues to hear, I believe they must be held to account. Due to the incredibly serious nature of this issue, there is a lot to be answered for. How could the Prime Minister let this happen and let it get to this point? How could the government be so irresponsible and negligent?

From day one, our Conservative team in Parliament has been sounding the alarm bell, but we were ignored, and we now find ourselves in an emergency. I believe it is ludicrous that it took the outcry of countless medical professionals to get the Liberals to reverse course on this matter. Witness after witness testified to the Special Joint Committee on Medical Assistance in Dying about the dangers of pressing ahead with this plan.

Why did the Prime Minister accept the last-minute amendments put forward by the Senate that dramatically changed the legislative framework for MAID? There was no parliamentary study. There was no consultation with experts or affected groups and no evidence that MAID for mental illness could be implemented safely and appropriately. When the Liberals' original bill, Bill C-7, was put before MPs, at no time did it contain any language about creating a pathway for MAID for those with mental illnesses. In fact, it explicitly ruled that out in its entirety.

The original proposed amendment to the Criminal Code specified that “persons whose sole underlying medical condition is a mental illness are not eligible for medical assistance in dying”. The then Minister of Justice said, “there is no consensus among experts on whether and how to proceed with MAID on the basis of mental illness alone.” The minister then did a 180° and became a proponent of this disastrous course. Due to his actions, and the Prime Minister's rubber-stamping of the those Senate amendments, we are where we are today.

This is now the second time the Liberals have had to delay the implementation of their reckless legislation. There will never be a consensus from mental health experts that the government should implement MAID for those who are suffering from a mental illness, and if the Liberals will not listen to me, I implore them to listen to their own expert panel on MAID and mental illness, when it said it is implausible to determine whether a mental disorder is incurable.

The panel's report said, “There is limited knowledge about the long-term prognosis for many conditions, and it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient.” That was echoed by the heads of psychiatry departments of all 17 medical schools, who called on the Liberals to stop this plan from being implemented on March 17.

I completely agree with these experts, but not only should we pause this law from being implemented, we need to permanently end it once and for all. Let me be perfectly clear. Instead of delaying, the government needs to introduce a bill to ensure that it never happens.

When I ran to become a member of Parliament, this was a key plank of my platform. I pledged to do everything I could to stop the Liberals from ever implementing this dangerous idea, and the sad reality is that the Prime Minister—

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

Madam Speaker, I appreciate the opportunity to speak to this. Having been in this place for all the debates we have had, I have been trying to figure out the best way to explain to Canadians, if there is an argument here, why it is not between Liberals and Conservatives, or between Greens and NDP and Conservatives and the Bloc. It has actually been, from the very beginning, a struggle for Parliament to actually deal with an issue we have been kicking down the road for too long.

I mentioned earlier in debate, as the member for Saanich—Gulf Islands, the quiet and extraordinary courage of a single woman, Sue Rodriguez, who took her irremediable medical condition of suffering all the way to the Supreme Court of Canada and was denied the opportunity for what is generally called death with dignity. She had the procedure illegally. Those who were with her at the time would have been subject to criminal penalty as well, including my friend Svend Robinson, who at the time was member of Parliament in a different party from a different place.

It was a very fraught time, and the issue of medical assistance in dying kept coming back to me from constituents who were heartbroken that their parents or loved ones had to go through suffering. Quite often people would say to me they would not let a family pet go through this kind of suffering so why do we allow our moms and our dads to go through this when there is no prospect they are going to recover.

This finally went back to the Supreme Court of Canada for a different decision that came out of the Carter case. The Carter case, back in 2015, said that refusing to allow someone the legal option to seek medical assistance from their doctor in a situation where their illness is terminal is really a violation of section 7 charter rights. I only mention this because that was also with a deadline. We have to take action on this; we cannot just leave the matter. The Supreme Court of Canada has said that this provision of the Criminal Code is actually a charter violation. That means one cannot let it just sit there anymore.

It would take too much time, and my colleagues will be relieved to know I will not go through this chapter and verse, but it is a tough, tough issue for parliamentarians. At the time, as we started debating the first iteration of allowing for death with dignity, in Bill C-14, our first Minister of Justice to deal with this was the very honourable Jody Wilson-Raybould. She had to struggle with this. Our Minister of Health at the time, also very honourable, Jane Philpott, was struggling with this.

It occurred to me as the debate went on that what we had in Canada on this issue was essentially a professional dispute. The lawyers in Canada wanted to make sure that the charter was respected. The doctors in Canada said they did not want to be asked to figure out what “irremediable” meant and were not exactly ready for that. Therefore, subsequent revisions kept happening because, after all, in our first attempt to get medical assistance in dying right, we did not allow for advance directives. Therefore, we had subsequent court cases where people who had terminal cancer could not access MAID because they decided they better ask for it now, which was maybe months before death would occur naturally and months before a doctor could say, “Okay, you're ready now. Nod.” One had to be able to physically sign; the day of, one had to confirm one's procedure.

Again, I better not go back through all of this, but essentially the professional views of doctors pleading with parliamentarians outweighed the lawyers dealing with parliamentarians to say that we were probably still going to have charter violations, but it is better that we listen to the doctors and that they are ready. All of this ended up taking us back to fixing medical assistance in dying again to try to make it more humane, to try to respond to the concerns of Canadians from coast to coast that they wanted to be able to access an advance directive in a situation that fit the MAID template. This brought us to Bill C-7.

To some of the comments that were made in this place earlier today, the government and Parliament were under a deadline that was court imposed, not politically imposed, to oblige ourselves, as parliamentarians, to meet what the Supreme Court of Canada said the charter required us to do. We had a very tight timeline, and then the Senate did something I do not think anyone in the House expected.

Again, we had a professional dispute going on here. Doctors were saying they were not ready to extend this to people whose sole irremediable condition is mental illness. Public health professionals in addiction and mental health were saying they were not ready. However, with strong pressure and strong professional advice from the psychiatric community, the Senate decided we should extend MAID to those with an underlying condition that is only, and I do not say “only” as if it is a marginal or trivial matter, a crushingly painful and life-ending threat from mental illness.

We are walking this fine line. The line is even finer when we start realizing who is more likely to not be able to access mental health supports; they are the marginalized and the poor. Who is more likely to not be able to imagine continuing on in life with a crushing mental illness? It is again the marginalized communities. The disability community spoke with a loud voice saying not to extend MAID as they were worried enough that it was a slippery slope when Bill C-14 first came in, and now Bill C-7.

Here we are again with a court-imposed deadline. Let us be clear to Canadians watching today. Certainly, the provinces and many doctors and mental health professionals have spoken with one voice. If we do not act quickly to pass this legislation and if the Senate does not act quickly to get it to royal assent come March 17, then as a matter of reality, we are up against March 17, and medical assistance in dying would become available to people where mental illness is the sole underlying condition.

Is it irremediable? We are told by the experts that no one really knows how to answer that question. Yes, some of the psychiatric community says the safeguards are there and if three psychiatrists say that it is irremediable, then that is enough. However, we are all asking where the mental health supports are, particularly for those who are marginalized. Where is the access?

This is one that particularly perturbs me. I have had many people come to me from a community that has experience with using psilocybin, conventionally known as magic mushrooms, as a way to alleviate a mental health condition, which might otherwise be irremediable, with remarkable results. We know that Health Canada is currently accelerating trials on psilocybin. It strikes me as beyond a catch-22 that the authorities would say to those people and to their doctors, who think psilocybin could help them, when the alternative is that they are more likely to commit suicide, or if we do not act by March 17, they will have access to legal medical assistance in dying, and it would be too dangerous to let them try psilocybin, but the alternative is death. It seems to me that any medical risks from psilocybin pale in comparison to the irreversible reality of death. How can we let this happen? We cannot.

I think we need to discuss another thing in this place, which is societal assistance in living. We know what medical assistance in dying looks like, but what does societal assistance in living look like? It means ending poverty and bringing in a guaranteed livable income for all. It means access to mental health services in this country. It means a compassionate and caring approach that says to every Canadian, whether in the disability community, the indigenous communities or the youth who are struggling with addictions, that we hear them and will not fail them. That means, no matter how members feel about it, we have to pass this legislation expeditiously.

[James Maloney, Liberal, Etobicoke—Lakeshore, ON]

Madam Speaker, I think it is my assistant calling me, telling me it is time to speak. She is very efficient.

As I was saying, the bill proposes to extend the temporary mental illness exclusion, so that the provision of medical assistance in dying, or MAID, on the basis of mental illness alone would remain prohibited until March 17, 2027. In my remarks today, I will be addressing some of the concerns that have been expressed about allowing MAID for mental illness and the importance of ensuring that our health care system is ready before legalizing this practice.

As members know, Bill C-7 temporarily excluded MAID for mental illness until March 2023. Parliament extended the exclusion for an additional year after organizations such as the Association of Chairs of Psychiatry in Canada and the Centre for Addiction and Mental Health expressed a need for additional time. The Special Joint Committee on Medical Assistance in Dying, or AMAD, also supported the extension.

At the outset of my remarks, I want to emphasize that the government recognizes that mental suffering may be as severe as physical suffering. We know that not all individuals with a mental illness lack decision-making capacity. The extension of the temporary exclusion of eligibility for MAID is not based on these stigmatizing stereotypes.

I also want to announce my profound sympathy for anyone in Canada who is intolerably suffering because of a health disorder. My thoughts are with them.

While the federal government believes that MAID eligibility should be expanded to those whose sole condition is a mental illness, this process cannot be rushed. Over the past year, important progress has been made to prepare for the expansion, but provinces and territories are at varying stages of readiness. The federal government has listened to its partners and introduced this bill as a direct response to their concerns.

A cautious, deliberate and rigorous framework is essential to ensure the safe provision of MAID where a mental illness grounds a request for MAID. Debate about the parameters of the MAID regime has been taking place since before the Supreme Court of Canada's 2015 decision in Carter, in which it held that the absolute prohibition on physician-assisted dying was unconstitutional. This is a sign of a healthy democracy.

Most recently, the Special Joint Committee on MAID witnessed the diversity of views and expertise first-hand. Some witnesses who testified, such as Dr. Trudo Lemmens, chair in health law and policy at the University of Toronto, expressed concerns about permitting MAID where the sole underlying condition is a mental illness. Others, including the members of the Canadian Association of MAID Assessors and Providers, thought the country was ready for the current March 17, 2024 deadline.

Still others supported expanding MAID for mental illness, or accepted that it would become legal but recommended a delay. This recommendation came from Dr. Jitender Sareen of the University of Manitoba on behalf of eight chairs of psychiatry departments in Canada. The chairs of psychiatry outlined several reasons, including concerns about a need for further safeguards and accepted definitions of irremediability in mental disorders, before moving forward.

I would like to acknowledge the important contributions that have been made on this topic. While not everyone agrees, it is clear that we all care deeply about the well-being of those seeking MAID and the protection of the vulnerable.

Let me now get into some of the specific concerns that have been raised. Members will recall that certain eligibility criteria need to be met to qualify for MAID. This includes having a grievous and irremediable medical condition, which requires that a person be in an advanced state of irreversible decline.

Some doctors, such as Dr. Sonu Gaind, chief of psychiatry at Sunnybrook Health Sciences Centre, have said it is impossible to predict which patients with a mental illness will get better; in other words, we cannot determine whether their illness is irremediable. However, other experts, including members of the expert panel on MAID and mental illness, suggest that the evolution of the illness and the response to past interventions can be used to assess irremediability, as is done with some physical conditions such as chronic pain.

Concerns have also been raised, by Dr. Sareen and others, that it is too difficult to distinguish between suicidality and a rational request for MAID when the request is based on a mental illness alone, because suicidality may be a symptom of the mental illness itself. Dr. Stefanie Green acknowledged that this can be complicated, but testified before the MAID committee that clinicians have a duty to assess every patient for suicidality. It is something that doctors do regularly in clinical practice. In addition, MAID assessments may involve suicide prevention efforts where warranted.

Another concern expressed by Dr. Tarek Rajji, the chair of the medical advisory committee at the Centre for Addiction and Mental Health, is that there was no consensus within the medical community about whether MAID should be available for persons whose sole underlying medical condition is a mental illness. However, others, including Dr. Green, note that the lack of consensus in the medical community is not unique to MAID.

A last concern that I want to address is that individuals are requesting MAID due to a structural and systemic vulnerability, such as lack of income and social supports. I want to be clear that the law requires that the suffering be due to illness, disease or disability, not poverty or unmet needs.

Our government is confident that the existing safeguards will ensure that only those who meet the eligibility criteria receive MAID. We are also determined to invest in social programs that can alleviate non-medical suffering and bolster social supports. Our MAID framework contains two sets of safeguards, one for requests where natural death is reasonably foreseeable and the other, more robust set for requests where natural death is not reasonably foreseeable.

The second set of safeguards would apply to cases where a mental illness is the basis of a MAID request. These include a requirement for a doctor or nurse practitioner with expertise in the condition to be involved in the assessment, a longer assessment period of 90 days, a requirement that the patient has been informed of the means available to relieve their suffering and has been offered consultations with relevant professionals, and a requirement that both assessors and patient agree that the patient has given serious consideration to the reasonable and available means of relieving their suffering.

In addition to these stringent safeguards, there is other guidance for doctors, nurse practitioners and regulators, including a model practice standard. Implementation of robust regulatory guidance and additional resources is ongoing, as is uptake of the nationally accredited bilingual MAID curriculum.

We are confident that, with more time, we can achieve readiness to ensure the safe provision of MAID in circumstances in which a mental illness grounds the request for MAID. We have made important strides, but work remains to be done to prepare health care systems and for more doctors and nurse practitioners to benefit from the available training and supports.

Our government thinks that three years is enough time to complete this work, so that our health care system is prepared when MAID for mental illness is permitted. In addition, we are proposing to add a requirement for a parliamentary review by a joint committee of both Houses of Parliament, to start within two years of this bill's receiving royal assent.

The committee will have six months to submit a report, including a statement of any recommended Criminal Code changes. This review will inform government action and ensure that they move forward only once the Canadian health care systems are ready.

With the March 17, 2024 deadline fast approaching, I urge everyone to work together to see that this bill is adopted before that date.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, my colleague participated in all three sessions on the issue. When Quebec tabled its report and when we voted on Bill C-7 in 2021, I was very reluctant to consider opening up MAID to mental disorders. However, I worked my way through the experts' report and I invite my colleague to read it again.

My colleague says there is nothing in the legislation. However, it does not have to be in the legislation. The regulations can set out the “how to”. Recommendations 10 and 16 are important safeguards.

Let us assume I am not questioning anything in my colleague's speech; the fact remains that, today, as I speak, there are people who are suffering irreversibly and intolerably.

What solution does my colleague have for those people?

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Mr. Speaker, I joined the latest edition of the Special Joint Committee on Medical Assistance in Dying, which was mandated to deal specifically with the question of the health system's readiness for an extension of MAID to cases of severe mental illness, out of a sense of duty as this is a deeply serious matter for Canadian society, one on which I received correspondence from a great many concerned constituents.

At first, I humbly questioned my qualifications to sit on the committee. I am not a psychiatrist. I am not a medical doctor. I do not have expertise or experience in this area. However, in a democracy, not all is left to the experts. The people, through their elected representatives, set legal parameters in areas of public interest by way of legislation and regulations. In fact, that is what has been happening since 2016 on the issue of MAID.

That said, it is important to carefully listen to and consult the experts out of respect for the authority of knowledge and experience. This is the opposite, I might add, of the new populism.

I agree with the committee's recommendation that we should indefinitely postpone MAID where the sole underlying condition is mental illness, also known as MD-SUMC. The central issue in MD-SUMC is irremediability; that is the question of whether there is the possibility that a person with severe mental illness can be cured of their terrible suffering, a suffering not different from physical suffering.

Under the law, for a person to be deemed eligible for MAID, the illness must be irremediable; grievous and irremediable. The problem when we move from somatic, that is physical, illness to psychiatric illness is that irremediability becomes more difficult to establish. In the case of psychiatric illness, an accurate prognosis is infinitely more difficult to produce.

Because of the difficulty, in cases of mental illness, of offering a reasonably certain prognosis, the determination of irremediability will necessarily have to be based on a retrospective view; that is on an assessment of the extent of a patient's past treatments and whether the patient exhausted all treatment possibilities in a quest to be relieved of their suffering. The problem is that the MAID assessors will most likely not have been involved in past treatments, which makes it difficult to ascertain the quality of those treatments. When it comes to establishing irremediability in cases of mental illness, evidence has shown accuracy is poor. It is less than 50%, a coin toss.

To quote Dr. Sonu Gaind, one of the experts who appeared before the committee, “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.”

It should be pointed out that under our MAID law, clinical certainty about irremediability is not actually required. Here it is important to highlight the distinction between legal irremediability and irremediability in clinical medicine.

In the MAID law, “grievous and irremediable” has a different meaning than in medicine. It is defined as incurability, “be in an advanced state of irreversible decline” and “enduring...physical or psychological suffering” that is intolerable to the person and cannot be relieved “under conditions the person considers acceptable.”

In law, therefore, it is not necessary to establish irremediability with a degree of clinical certainty. Rather, both patient and assessor must come to the shared understanding based, among other things, on the assessor's analysis of the history of past treatments. There is an element of subjectivity on the part of both patient and assessor. Naturally, the assessor will bring their own philosophical biases, values and ethics to this subjective equation.

As Dr. Gaind suggested to committee members, “Try those mental gymnastics on your constituents. Convince them it was okay that their loved ones with mental illness got MAID, not because of a clinical assessment based in medicine or science, but because of the ethics of the particular assessor.”

An important issue in determining eligibility for MD-SUMC is being able to separate suicidal ideation from a considered request for MAID. It bears keeping in mind that suicide attempts are not always rash and impulsive, the product of a panicked state. This, in some ways, is a stereotype. Psychiatrists will say that some suicides are not frenetic but carefully planned in advance.

Dr. Tarek Rajji, chair of the medical advisory committee at the Centre for Addiction and Mental Health, told the committee, “There is no clear way to separate suicidal ideation or a suicide plan from requests for MAID.”

To again quote, Dr. Gaind:

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.

In the Netherlands, an assessment by an independent physician is required for MAID, and in the case of psychiatric suffering, a third assessment by an independent psychiatrist, preferably one with specific expertise regarding the patient's disorder.

The problem with Canada's law, as it stands, is that there is no requirement for one of the assessors of MAID eligibility to be a psychiatrist, yet psychiatric issues are exceedingly complex. Often a patient has more than one illness. It is said that 71% to 79% of psychiatric patients who died through MAID in the Netherlands had more than one psychiatric disorder.

We humans are not self-directed, rational atoms exercising unencumbered clear-eyed autonomy. We are not as free as we think. We are born into families and communities, and influenced by the opportunities they offer, and alternatively, by the constraints they impose on us.

I sometimes wonder if we are not in the process of turning personal autonomy into ideology. I say “wonder” because as a liberal, I have not been bestowed the gift of absolutism that has blessed ideologues.

Requests for MAID can be influenced by, even driven by, extraneous factors like poverty and isolation, that is by psychosocial factors. According to Dr. Gaind, “those with mental illness...have higher rates of psychosocial suffering.”

This all means that MAID assessors will be wrong over half the time when predicting irremediability, will wrongly believe they are filtering out suicidality and still, instead, provide death to marginalized suicidal Canadians who could have improved.

Archibald Kaiser, Professor at the Schulich School of Law and Department of Psychiatry, Faculty of Medicine at Dalhousie University added that “The Supreme Court concluded in 1991 that people with mental illness have historically been the subjects of abuse, neglect and discrimination.”

Dr. Gaind further underscored that “Suffering is cumulative, and life suffering unfortunately fuels much of the suffering of those with mental illness, even more so for marginalized populations.”

There is, in fact, the possibility that gender-based marginalization can influence requests for MD-SUMC. We know that in countries that allow MAID for severe mental illness, the ratio of women to men who seek MD-SUMC is two to one.

For their part, indigenous representatives have expressed serious reservations about expanding MAID to include mental illness. According to Professor Kaiser:

In February 2021...many distinguished indigenous signatories wrote to Parliament that the consultation ... has not been adequate and “has not taken into account the existing health disparities...we face compared to non-Indigenous people.” They said, “our population is vulnerable to discrimination and coercion...and should be protected against unsolicited counsel.”

We know there is systemic racism in the health care system. Ask the family of Joyce Echaquan. How would systemic racism influence the rate of acceptance of MAID requests of indigenous and other racialized peoples? That is a pertinent question.

As Dr. Lisa Richardson, Strategic Lead, Centre for Wise Practices in Indigenous Health, Women's College Hospital, told a Senate committee on February 3, 2021:

In an environment where both systemic and interpersonal racism exists, I don’t trust that Indigenous people will be safe. I don’t trust that anti-Indigenous prejudice and bias will not affect the decision making and counselling about MAID for Indigenous people, no matter how much education is given.

Indigenous communities, many of which have felt the scourge of high suicide rates, especially among youth, may have concerns about possible contagion effects of MD-SUMC on suicidality.

Then, there is the basic question of the ability of the health care system in Canada, already stretched to the limit, to handle an expansion of MAID.

According to Dr. Eleanor Gittens of the Canadian Psychological Association, as a country we have not yet established parity between available physical and mental care. To quote her, “Care and treatment of mental illness are not covered by medicare, nor is it readily accessible.”

We do not really know how many people would request MD-SUMC, and thus whether we have enough qualified assessors. By some estimates, we would have well over 2,000 patients a year getting MD-SUMC with countless more requesting eligibility assessments. I know there is dispute around that number.

Just because there is a published Health Canada standard for MD-SUMC and a training module does not mean the system is ready. A building built on a soft foundation is not ready for occupancy, no matter the level of completion of its structure. There are today no safeguards preventing poverty, housing insecurity, loneliness, etc., that is psychosocial factors, from significantly fuelling MAID requests of those suffering from mental illness.

I will quote Dr. Rajji: “The standards document itself, the one developed by the expert panel, states that these are not clinical guidelines, and this is what is missing to ensure quality.” According, again, to Dr. Gaind, “it is a legal fiction that determinations of the eligibility of MAID are based on objective clinical judgment. In fact, I regularly witness practitioners' values influencing the interpretation of the current MAID eligibility criteria and safeguards.”

As per an article in the review Impact Ethics, “The few jurisdictions allowing MAiD for [sole] mental illness have safeguards Canada lacks, notably (unlike Canada) requirement of due care and no reasonable alternative, or treatment futility, prior to MAiD eligibility.”

In Canada, a patient would be able to qualify for MD-SUMC even if they refuse treatment. Often a psychiatric patient will refuse additional treatment owing to treatment fatigue. While treatment fatigue has been studied in the context of HIV and type 1 diabetes, with the goal of developing strategies to help overcome it, treatment fatigue has not yet received attention in psychiatry. A better understanding of treatment fatigue could lead to alternatives to MAID, such as palliative or recovery-oriented treatments.

I respect the Senate. I value the Senate. Senators bring more than just sober second thought; they bring expertise in fields crucial to good public policy making, but senators are not elected. They are not the voice of the people. It was never the government's intention to extend MAID to those suffering from mental illness.

The government was running out of runway to meet the court-imposed deadline in the Truchon decision for amending the law to remove the requirement that death be foreseeable to qualify for MAID. It could not afford a back-and-forth game of procedural ping-pong with the Senate over its last-minute amendment to remove the mental illness exclusion from Bill C-7. It had to accept the Senate's amendment to get the bill across the finish line.

In my view, we are not ready for MD-SUMC. We cannot ascertain irremediability with any acceptable degree of certainty and objectivity. We cannot sufficiently distinguish an unfettered request for MAID on the grounds of mental illness from suicidal ideation. We are not able to separate out psychosocial factors that might drive MD-SUMC. We have not properly consulted racialized communities to take account of their views, concerns and fears, notably those of indigenous communities, and we have not built proper safeguards into the law.

We do not require the involvement of a psychiatrist in assessment nor require that a person have reasonably exhausted available treatments before making a request for MD-SUMC. The few other jurisdictions that allow MD-SUMC have this requirement.

We have not studied and understood treatment fatigue such that we can develop strategies that can possibly lead a patient to other non-lethal treatment options, and finally, we have allowed an unelected body, the Senate, to drive this agenda.

[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.

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

Mr. Speaker, it is an honour to rise today on the unceded lands of Tseshaht and Hupacasath on Vancouver Island in Nuu-chah-nulth territory to speak to Bill C-62, which is calling for the extension of the temporary exclusion of eligibility for medical assistance in dying for persons suffering solely from a mental illness by three years, until March 17, 2027.

Clearly, without an intervention by Parliament, this expansion would come into effect on March 17, 2024, in just one month. New Democrats agree with the majority decision made by the Special Joint Committee on Medical Assistance in Dying, also known as the AMAD committee, which I will refer to it as in my speech. It reported that Canada is not adequately prepared to deliver medical assistance in dying to individuals whose sole underlying medical condition is a mental disorder.

The bill would allow more time to implement the necessary safeguards and address the capacity concerns that are expected to be the result of the expansion of medical assistance in dying for those with the sole underlying medical condition of a mental disorder. It would give medical practitioners more time to become familiar with available training and supports, while providing time for the public to become more aware of the robust safeguards and processes in place. I know this is a very sensitive and very personal matter to so many people around this country. Especially in my riding of Courtenay—Alberni, I have heard from many people about this.

We also need to ensure that we have the understanding and compassion to respect the right of an individual's choice of dignity when they have deep, prolonged and ongoing suffering. I will speak to that. Suffering from mental illness is extremely serious, and it is just as real as suffering from a physical illness. In our health care system, we clearly do not have parity when it comes to mental and physical health, and I will speak to that as well.

We must also affirm and protect the most vulnerable when we do any sort of decision-making on such a serious piece of legislation as expanding medical assistance in dying. This additional delay is necessary and needed right now to ensure that we have a health care system in place that can safely provide medical assistance in dying for those whose sole underlying medical condition is a mental disorder.

We know how we got here. The Liberal government made an ill-advised decision and did a complete 180° by accepting the Senate's amendment to Bill C-7 in the 43rd Parliament. That is what got us here. The government changed the law before any kind of comprehensive review had been conducted, and we have been trying to play catch-up ever since. I am going to speak about the important work that needs to be done, and I want us to be thoughtful in our approach to expanding medical assistance in dying.

As New Democrats, we take people's concerns and feedback very seriously. We are committed to helping find the best possible solution for Canadians in the policy of medical assistance in dying to ensure that it does what it was always intended to do. One of the biggest concerns New Democrats have with the expansion of medical assistance in dying is with the barriers that many Canadians face when they reach out for mental health treatment. Because of the Liberals, and the Conservatives before them, the chronic underfunding of our health care system has become even more apparent. It is now more than ever, as we see the disparity between mental and physical health and how people are taken care of.

We heard the Prime Minister promise to implement a new mental health transfer of $4.5 billion over five years, but he has still not done that. Even with the bilateral agreements, the Liberals are falling far short, and that would not even be enough. Everyone should be able to access mental health supports when they need it, but under the Liberal government, and that of the Conservatives before it, this has not been the reality. It is the same with all provinces and territories.

New Democrats wholeheartedly support the delay in expanding medical assistance in dying for those who have a mental disorder as the sole underlying condition, but the Liberal government needs to ensure that proper consultation happens between now and the expansion date, or it would need to be extended again. It needs to ensure that people will be protected while respecting their individual choice.

The Liberals cannot just delay the expansion either. They need to fund adequate supports and treatment options for people dealing with mental illness. Members have heard me say this repeatedly, but we need a pathway, a road map, to how we are going to achieve parity for mental and physical health and ensure people get the timely help they need when they need it.

Seven of the provinces and all three territories have said that they are not ready and have signed a joint letter to that effect, including my home province of British Columbia. That was signed by the ministers of health in those provinces and territories. They are calling for an indefinite pause on the expansion for individuals whose sole underlying medical condition is a mental disorder. That is what those ministers identified.

As New Democrats, we want to see a MAID regime where guardrails are in place to protect vulnerable populations while still allowing for personal bodily autonomy and end-of-life choices. We must make sure that people do not request medical assistance in dying because they do not have access to treatments, supports and services. This has to be absolute. The Liberals need to make sure everybody can access mental health supports. However, after nine years of carrying forward with the Conservative cuts to health care, this is where we are at right now right across the country. Help is out of reach for many people. This needs to change before medical assistance in dying can be expanded.

We know that the housing, toxic drug and mental health crises that are happening are not being addressed. I see that I do not have a lot of time left, but I want to ensure I outline that the AMAD committee heard from plenty of witnesses who cautioned the committee on expanding MAID in cases of persons suffering solely from a mental illness. I want to share what a couple of those experts had to say.

Professor Brian Mishara, who is with the Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices at Université du Québec à Montréal, said, “The expert panel report on MAID and mental illness states that there are no specific criteria for knowing that a mental illness is irremediable”, and that there is absolutely no “evidence that anyone can reliably determine if an individual suffering from a mental illness will not improve.” He warned us that “any attempt at identifying who should have access to MAID will make large numbers of mistakes, and people who would have experienced improvements in their symptoms and no longer wish to die will die by [medical assistance in dying].”

We heard from many experts. The CAMH raised similar concerns.

Because I see that I only have a couple of minutes left here, I want to talk a bit about the system and the lack of access. We are talking about a crisis going on from coast to coast to coast, according to a poll done just a year ago. The Mental Health Commission of Canada and the Canadian Centre on Substance Use and Addiction released a report talking about postpandemic findings. It cited that 35% of respondents reported moderate to severe mental health concerns.

This is alarming. It should also be alarming to all parliamentarians that it found that fewer than one in three people with current mental health concerns accessed services. The report identified key barriers to accessing services as financial constraints and help not being readily available. We know that right now we are in a financial crisis, and I am sure those numbers have only gone up. It identified that one of the top stressors was between income and unemployment with mental health concerns.

We need to create a system of parity with mental and physical health. The government has not delivered when it comes to a plan, a road map, on how we achieve parity with physical and mental health. I hope in this budget, it is going to release funding on top of the bilateral agreements directly to community-based organizations as a COVID emergency recovery response because, post-COVID, we know some people are struggling financially, but the biggest concern right now and the biggest epidemic post-COVID is in mental health. I hope the government is hearing that.

I see that I have run out of time. I have a lot to say on this matter. I look forward to taking questions from my colleagues.

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

Madam Speaker, I would like to inform the you that I will be splitting my time.

Today, we are not debating Bill C-62; we are actually debating Motion No. 34, which is a programming motion to get the bill through the House of Commons. We are having to resort to a tactic that I do not often like to use, but time is forcing us to do this.

If the House of Commons, the Senate and Governor General do not act and we do not have this bill into royal assent by March 17, the law is going to change. Essentially, many experts have expressed an extreme amount of discomfort with that. There is a lot of professional discomfort. We have seen also from our provinces and territories that they are very uncomfortable with the pace of change that is going on.

What Bill C-62 would do is delay the implementation of MAID for persons who are suffering from a mental disorder as a sole underlying condition. The bill would further kick that can down the road until 2027. It also has a legislative requirement that the Special Joint Committee on Medical Assistance in Dying be reconvened in advance of that date. Hopefully, that committee would have the time necessary.

As parliamentarians, we have to step up to the moment. I am particularly saying this for my hon. colleagues in the House of Commons. There is plenty of blame to be assigned to the Liberals, and, trust me, I have given my fair share. We are in this situation because of an ill-advised 11th hour amendment to Bill C-7 in the previous Parliament, a bill that the government's original charter statement had presented as a reasonable argument against the expansion of MAID to people who had mental disorders. Then that bill went to the Senate and it inexplicably accepted a consequential amendment that brought us to where we are today.

Last year, we had to quickly pass Bill C-39, because, again, we were not ready for the deadline then. That kicked the can further down the road by one year. Now we find ourselves in the exact same position. I am suffering déjà vu, like a lot of my hon. colleagues are, where we now have to force this legislation to kick the can down the road another three years. I feel like I am caught between two forces right now: the ineptitude of the governing Liberals for putting us in this position and a Conservative Party that seems to just want to cause chaos in this final week.

This is a moment when the adults in the room need to step up to the plate. There is plenty of blame to be assigned, but we cannot work around the deadline and the fact that we have only two sitting weeks left to us. We are still at the second reading stage of this bill, and that is why this programming motion is necessary. That is why we need to step up to the plate and ensure that Bill C-62 is through the House of Commons by the end of this week. It still has to run the gauntlet in the Senate, and who knows what is going to happen in the red chamber. That is something for the government members to figure out.

One thing that is really good about this motion is that there is a requirement that the Standing Committee on Health be convened on Wednesday. That will allow members of that committee to question either the Minister of Health or the Minister of Justice and also have two hours to speak to witnesses. Honestly, we need to come together as a Parliament and ensure that we get this through.

It is further bolstered by the fact that seven out of 10 provinces and all three territories sent a letter to the federal government asking for an indefinite delay. These are signatures of ministers of health and ministers responsible for mental health and addiction, which are essentially the departments that are responsible for oversight of the whole medical assistance in dying regime. We have to listen to those incredibly important voices. We have to listen to their expertise. We have to honour what they are requesting in this letter.

I ask my hon. colleagues to step up to the plate and be the adults in the room. Let us get Bill C-62 passed through the House of Commons this week.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, let us try to calm down a bit.

In this debate, the government is basing itself on the Special Joint Committee on Medical Assistance in Dying for its amendment to Bill C‑62.

The Bloc Québécois would have liked to lend its support. The problem is that we believe that we should not indefinitely delay the possibility of medical assistance in dying for people with an irremediable mental disorder, when no psychiatrist worth their salt has been able to treat them or relieve their suffering. After 10, 20 or 30 years of suffering, the decision whether or not to request MAID should not lie with this person, who is supposed to determine whether the patient is eligible.

We asked for an amendment to the bill. Why take three years when, last year, we were told that it would take a year to make sure that MAID for people with mental disorders could be set up in a safe and appropriate manner? The main issue we have is that, in 2015, there was an election, but there was also the Carter decision. The government and this Parliament passed terrible legislation, similar to the one Quebec adopted a year earlier.

Quebec passed a law that only covers end-of-life cases, people who are terminally ill. I want to reiterate that, in the terminal phase of life, the process of dying has begun and is irreversible. People can be well taken care of in palliative care. Good palliative care, as described by Cicely Saunders at the time, is full, comprehensive, holistic support for people as they are dying. It involves adequately managing the person's pain and suffering, both physical and emotional, and supporting their family. All of this should be done in an environment that resembles a normal environment as much as possible. However, it is possible that, all of a sudden, in the midst of this process, the patient, who is slowly dying, will request MAID because, one day, they are feeling at peace and ready to let go. That is not a failure, in my opinion. It can be seen as successful palliative care. When my colleagues are about to depart this life, I hope that they will be calm and at peace. That is what I would wish for everyone.

So Quebec had taken those steps. Then in Parliament came the Carter decision, which stated that Ms. Carter was not at the end of her life, but she was suffering a great deal. It was therefore decided that depriving her of medical assistance in dying impinged on her right to life. Why? She was being forced to end her life prematurely, when the fact is that letting her decide what happened next would empower her. It was up to her to define when her suffering became intolerable.

It was a bad law. Bill C‑7 had to be introduced. When we began studying Bill C‑7, there was another factor that had to be considered; that was in 2021.

The Carter decision states that there cannot be an absolute prohibition on MAID simply because people belong to a particular group, one that is vulnerable. It must be assessed on a case-by-case basis.

The reality is that people can and do struggle with irremediable mental disorders. Irremediability is established through a rigorous process. During that process, practitioners must be certain that the person has never refused treatment that we know would have absolutely improved their situation.

There are indeed people whose mental disorders cause intolerable suffering, and psychiatry does not help them. If anyone here wants to claim otherwise, I would say that they lack intellectual integrity. Psychiatrists cannot cure everyone; it is impossible. That said, psychiatry is rife with medical paternalism.

That being said, what we wanted was for the government, whose Bill C‑62 is based on the work of the Special Joint Committee on Medical Assistance in Dying, to plan ahead for when it might have to introduce Bill C‑62 and include another key recommendation of the special joint committee in the bill. That recommendation was presented a year ago and was the subject of a consensus. One Conservative member even joined the majority. There is a consensus in favour of advance requests.

Why was that not included in the bill? It should have been anticipated. The government knew that the date would have to be pushed back. It had a year to introduce a measure in the House that would have also covered people suffering from dementia and Alzheimer's. Why did the government not do that? We asked the government why it was not doing so when it had the chance. Quebec drafted its own legislation. It is structured, rigorous and unanimously supported in Quebec.

An Ipsos poll shows that 85% of the Canadian population supports advance requests. In British Columbia, 84% supports advance requests. In Alberta, it is 84%; in Saskatchewan and Manitoba, it is 81%; in Ontario, it is 84%, in Quebec, it is 87%; in Atlantic Canada, it is 81%. I could go on. There are other figures. They vary. The results are based on a sample of 3,500 people. That is not nothing. When will the government take action? Why has it not heard this request? Why has it not spoken with Quebec, who has worked on this issue? Why did it not hear the unanimous will of the National Assembly, just last week? Why is it afraid of its own shadow? Why do the Liberals lack courage so?

The last time they lacked courage, we ended up with Bill C‑14. What is the problem with Bill C‑14? The real problem with Bill C‑14 is not a legal problem. The problem is for a patient who is suffering, who, to satisfy the reasonably foreseeable natural death criterion, has to go on a hunger strike. We have seen that. The problem is for people who, like Ms. Gladu and Mr. Truchon, have to fight for their constitutional rights in court. When I say there is a lack of courage, that is what I mean.

My only viewpoint is the viewpoint of patients who are suffering. The only thing I am standing for here is the suffering patients' right to self-determination. Patients had to fight an uphill battle against medical paternalism when it comes to MAID.

As I mentioned last week, there was a time when the palliative care that is so dear to the heart of my Conservative friends and that I personally consider to be very important was called passive euthanasia. Doctors obstinately used aggressive life-support measures because their duty was to save their patients. As we know, every doctor thought that they could save every patient back then. It was actually doctors suffering from cancer who started to assert their right to refuse treatment. Today, cessation and refusal of treatment are part of what are considered to be good medical practices.

Why are we not studying the bill today? The government is imposing a gag order. We will not be overly critical of this decision. I understand that this has to be done before March 17. We are not getting too worked up about this, but still, we have not consented and will not consent to this. Why not? It is because we wanted a bill that was based on the recommendations from the Special Joint Committee on Medical Assistance in Dying. I want answers from the government in that regard.

Why the delay in expanding medical assistance in dying to people with mental health issues? We did what the committee asked. Bill C‑62 even provides for the Special Joint Committee on Medical Assistance in Dying to reconvene in order to determine whether the groundwork has been laid. That is what we are doing. We basically took the recommendation and inserted it into the bill. Then, there is the issue of advance requests. There is a consensus on that across the country, but the government lacks the courage of its convictions.

The Liberals are afraid of demagoguery because there has been a lot of it on this issue. They are lumping everything together. However, at some point, they need to be consistent in their approach. The Liberals are well aware that the state's role is not to decide for the patient what is best for them when it comes to a decision as personal as one's own death. The state or the patient's neighbour is not the one who is going to die. The state's role is to determine the proper conditions and ensure that they are put in place so that patients can make a free and informed choice. If people are worried about abuse or the slippery slope when it comes to advance requests, then they should look at Quebec's law, which is a model to follow.

The government could have easily inserted elements of the Quebec law into its regulations. It is all well and good to say that the law is a little vague, but the amendment we are making to the medical assistance in dying legislation, expanding section 241 of the Criminal Code, is followed by a procedure, regulations on enforcing regulations. That is where the various safeguards are put in place.

There are standards of practice when it comes to mental disorders. A year ago, a committee began looking at standards of practice, and they will be sent to the regulatory bodies in each province, namely the colleges of physicians. Once we have clear guidelines and standards of practice and the criteria I was talking about earlier are met, someone in a suicidal crisis will not have access to medical assistance in dying.

It bears repeating, because I am hearing a lot of confusion over this. A suicidal person is not eligible for medical assistance in dying, even if they suffer from a mental disorder and are in suicidal crisis, and even if they have recently been admitted to care and diagnosed. I have often asked psychiatrists if they thought that giving access to medical assistance in dying to people with mental disorders could also provide an opportunity for prevention. Some people commit suicide and no one sees it coming. No one knows those individuals today, no physician took them on.

For example, knowing that MAID is an option, a person might come forward because they are suffering and want to exercise that option. Well, that person would not qualify. However, they would then be taken care of and get the treatment they need, since suicidal ideation is reversible. There is no question about that. However, it is not about those patients. When we asked the chair of the expert panel, psychiatrist Mona Gupta, how many patients in her practice would have been eligible, she told us of two or three patients over her entire practice. Still, these are people who are suffering.

When people talk about the fact that the resources are not there—the resources in terms of someone to assess capacity, for an independent psychiatrist to look at a case—I would point out that right now, the decision-making capacity of a person struggling with a mental disorder, but who has cancer, for example, is verified. Psychiatrists are currently assessing the decision-making capacity of people with a mental disorder and a comorbidity. Depending on their condition, practitioners are able to determine the decision-making capacity of these people who have a mental disorder.

The Supreme Court was clear: Not allowing these people to access MAID creates stigma. Not only does it stigmatize them, it discriminates against them. Why infantilize and weaponize people who have a mental disorder and who, in their entire existence, have not found treatment that can alleviate their suffering?

I rather like having discussions and debating with my Conservative colleagues. They have a sense of conviction, but there are some Conservatives who use scare tactics and conflate everything. It is not enough to repeat some 20 times that someone came to say that irremediability is hard to address. Everyone agrees. Even the expert panel starts with that. They did not hide that fact. In fact, they say that because irremediability is hard to establish there must be safeguards and precautionary principles put in place.

I therefore move the following amendment:

That the motion be amended in subparagraph (b)(ii):

(a) by adding after the words “be deemed referred to a committee of the whole,” the words “that an instruction be deemed to have been given to the committee granting it the power to expand the scope of the bill so as to take into account provincial medical assistance in dying frameworks for advance requests from persons who have an illness that could deprive them of the capacity to consent to care,”;

(b) by replacing the words “deemed reported without amendment” with the following: “deemed reported with the following amendments:

That the bill be amended by adding the following new section 241.21 to the Criminal Code:

New section 241.21

Medical assistance in dying eligibility criteria for advance requests

“241.21 The government of a province may establish a medical assistance in dying framework for advance requests from persons who have an illness that could deprive them of the capacity to consent to care, in accordance with the laws of that province.””; and

(c) by replacing the words “deemed concurred in at report stage” with the following: “deemed concurred in at report stage, as amended”.

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

Madam Speaker, the member for Cumberland—Colchester had a couple of factual errors in his speech. The NDP voted against Bill C-7's amendment that brought this in. We supported the member for Abbotsford's bill, Bill C-314, and we support the majority report. We have never been for the expansion; let us put that on the record.

We are at a moment in time this week, with an impending deadline, when we can throw blame at the Liberals, and they are well deserving of it, or we can rise to the occasion and be the adults in the room, given that there are only two sitting weeks left before March 17. Which are the Conservatives going to choose? Are they going to be on the side of getting the bill through the House to the Senate in the correct amount of time?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, in the question previous to that of the member, the government was accused of being too slow. Now my New Democratic friend is saying that we were too quick when it came to Bill C-7. In saying that we did not do enough background work, he implied that we were too quick.

The Government of Canada, when we look at the broader picture of the Supreme Court decision back in 2015, brought forward very difficult legislation. As has been demonstrated, it was not perfect legislation. Given the very nature of it, one would be naive to think there was never going to be a need to make changes. That is why standing committees were mandated to meet on the legislation. It was because it was the first time we had substantive legislation of this nature.

Criminal Code

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I appreciate the comments of my colleague, who always speaks very calmly and moderately. It is a pleasure to serve with him.

The NDP voted against Bill C‑14, which did not address the Carter decision's requirements at all. Bill C‑7 met the Carter decision's requirements with additional changes that required hard work, to clarify the issue.

Is the NDP saying no to the idea of one day moving forward on mental disorders, or would it rather put the subject off indefinitely?

We could start working on this tomorrow morning, and I am convinced that within a year, we could come up with something very promising.

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

Madam Speaker, honestly, I do not know.

I was here for Bill C-7. I thought the government's original position with respect to that bill was quite clear. For some reason, the Liberals did a complete 180 when it came to the Senate's amending the bill. To this day, I do not think I—

[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.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, that is an excellent question. In the supplementary report that I tabled, I note that, if we had had more time, we could have engaged with these people. By engaging with these people, we could have understood exactly what their concerns were.

A certain number of associations did tell us that everything was ready for us to do this. The member knows that. For example, the Association of Medical Assistance in Dying Assessors and Providers came and told us after Bill C‑14 and Bill C‑7 were introduced that not all doctors were trained to be MAID providers. There was only a small number and they would be able to meet the demand. When it comes to mental disorders, we are talking about an even smaller number still. The people from this association felt that they were able to do this safely. There was also the Canadian Psychiatric Association, the Canadian Bar Association, the Association des médecins psychiatres du Québec, the Federation of Medical Regulatory Authorities of Canada, the Nova Scotia department of health, and so on.

It comes down to the way people followed the debate and the way they debated within the governments because they sometimes have other concerns. I would have liked to hear them. The government did not call on us as soon as Parliament returned so that we could do a review and ask all of the questions we had. We could have even gone out into the community to see what was missing, but we were unable to.

Here is what I think: We could do it right now, in the next year. We need to work together, get out there and explain it, see what is going on, and share the guidelines. Then, if we need another year, we can take it. Waiting until 2027 to do this is definitely not a progressive way of going about it.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, that is an interesting question.

I would like to point out to my colleague that the committee had very little time to assess whether the system was ready. We had two or three meetings to determine that and the deadline was ridiculous. However, many people came and told us that the system was ready.

The Quebec National Assembly took a stand in 2021. Bill C‑7 was passed after that, after a lot of work had been done and brought to a halt in Quebec. The Quebec college of physicians said that it still needed a little more time. However, there is a big difference between needing a little more time to ensure that everything is done safely and properly and putting off indefinitely the need to deal with the suffering of people with serious mental disorders.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I never thought I would end up debating medical assistance in dying in the House again, or reliving what we went through when we passed Bill C‑14, a bad law. I never expected that the Liberals would again be in the same position, or show the same lack of courage they did with Bill C‑14, which was prescribed by the Carter-Taylor decision.

Quebec passed its legislation on end-of-life care before the Carter decision. In the Carter decision, the court ruled that Quebec had to revise its legislation to include more than end-of-life issues only. The Parliament of Canada, which had never considered this before, was also told that it had to address not only end-of-life issues, but also degenerative diseases like those afflicting Ms. Carter and Ms. Taylor. Ms. Carter had spinal stenosis and Ms. Taylor had amyotrophic lateral sclerosis. In its decision, the court ruled that Parliament had to legislate because both women's right to life was being infringed.

Why was their right to life being infringed? The right to life is not a minor right. This should be of interest to the Conservatives, who are pro-life. I am too, in that sense. The right to life was being infringed because these people had to shorten their lives when they would have liked to live until their suffering became intolerable.

As members of Parliament, as representatives of the state and the people, our duty is not to decide what the patient needs when it comes to an issue as personal as their death. The role of the state is to ensure the conditions needed for them to exercise free will, so that they can make a free and informed decision. That is the role of the state. Otherwise, we get into government paternalism.

I invite my Conservative colleague to do some reading in clinical ethics and not to limit himself to what psychiatrists in Ontario are saying. We know that psychiatrists are divided on the issue. In fact, if there is one discipline in which medical paternalism continues to reign, it is psychiatry. We would never have seen the progress that we have seen in clinical ethics if medical paternalism in general still ruled supreme.

What happened for patients to be given back control over their end of life? We find the answer to that question in the bioethics literature. In the past, some doctors who had cancer said they did not want treatment. Now, we have good medical practices, whereas in the past, aggressive treatment was the standard. The doctors said that they wanted to live the two years they had left without undergoing treatment that would leave them bedridden. They claimed that they wanted to spend quality time with their loved ones. It took doctors with cancer demanding that option for patients to be able to discuss these sorts of things with their own doctor. In the 1960s, there were patients who only found out that they were dying of an incurable disease and were in fact at the end of their life when the priest came to their room to administer the last rites. They were not even told that they were terminally ill. That was medical paternalism.

Over time, the right to die was granted. Patients were granted the right to die and the opportunity to refuse aggressive treatment. That is when we began providing the palliative care that is so important to my Conservative friends. Before that, palliative care was called passive euthanasia, and it was not allowed.

Medical paternalism has been gradually set aside. What has this led to?

It has led to the right to refuse life-saving treatment, to stop treatment. These are all rights we have today.

We have before us a bill that perpetuates suffering indefinitely for people with a severe mental disorder who have been unable to relieve their suffering through treatment. That is no mean feat. They have spent 10, 20, 30 years suffering, trying multiple treatments and being stigmatized by the society in which they live.

We are able to establish the decision-making capacity of people living with a severe mental disorder. For those capable of making decisions, the court told us that it would be discriminatory and stigmatizing if, just because they have a severe mental disorder causing suffering that psychiatry is unable to properly change or relieve, they were told what was best for them and that they should continue to suffer forever, while psychiatry need only provide a palliative care option until the end. That is what we are discussing today.

I will calm down. It is just that I heard some nonsense earlier.

Then what happens? There was Bill C‑7, which was rather cautious. It set a two-year deadline for creating an expert panel. Who read the report of the expert panel in the House? Who read it before voting? This is the second vote we are having on this subject. We have to read the report of the expert panel. Indeed, the irremediable aspect is something that is hard to implement. Admittedly, there is an additional difficulty, but the expert report does set out guidelines. That is what this is about.

Then the Liberals show up today with a clause they added that says we are going to work with an expert panel for two years and create a joint committee. The problem is that the joint committees have always been set up at the last minute, too close to the deadline.

When we submitted our report the last time, we were forced to admit that, before moving forward with the issue of mental disorders, we needed to assess the situation in the field. Even though I think the group that was supposed to work on it had developed important guidelines and standards of practice, it was obvious to me that there was still not quite enough time. Everyone told us so, including the Collège des médecins du Québec—I will have more to say later about its criteria and guidelines for proceeding that I find useful.

How is it that, a year ago, the government gave itself a one-year deadline and thought that would be enough time? A lot of work has been done in that year, yet the government is saying we should put it off until 2027.

We heard what the Conservatives just said. We can forget about MAID if they form government; they will put it off indefinitely. That means that people will continue to suffer indefinitely, and that suffering will be intolerable because psychiatry is unable to provide relief other than by rendering them virtually incapacitated. Somehow, people find that morally acceptable. I honestly do not know where the morality lies in that. Some people have very flexible morals. In any case, it has nothing to do with suffering.

When people claim that someone living with depression could have access to medical assistance in dying, it is simply not true. Just because someone applies for MAID does not mean they will be able to access it. The assessors will do their job. Stefanie Green was saying that a person in a suicidal crisis is not eligible for medical assistance in dying. Someone who raises their hand and says that they want MAID simply because we allow mental disorders to be eligible grounds for MAID would not have access to it because they have not received proper care.

However, there would be an opportunity for prevention, because we could provide treatment at that time. It is wrong to say that 90% of people who have suicidal ideation and commit suicide received proper care. No, they did not receive proper care. Very often, when people commit suicide, no one saw it coming at all.

What are we going to do? What are the Conservatives going to to with people who are desperate and suffering and who currently still have hope that we are going to consider their suffering and find a solution so that things are done properly and by the law? What do they think those individuals are going to do in their despair? Is suicide morally acceptable? Suicide attests to the failure of our system and our society. I will never, ever accept suicide. That is why, when we talk about medical assistance in dying, we are not in the same page at all.

A person who is feeling suicidal is not eligible. Someone who has just been taken into care and diagnosed is not eligible. Applications take structural vulnerabilities into account. Just because someone is poor and does not have access to care does not mean that they will be eligible for medical assistance in dying. They would not be eligible, because they would have to have tried every possible treatment. Someone who unjustifiably refuses treatment that could improve their condition will not be eligible. If accessible and effective treatments are available and the person refuses them, they are ineligible. If the assessors cannot agree that the criteria have been met, the person is not eligible either.

The Collège des médecins du Québec told us that it remains at the discussion stage, that it has established its guidelines and it still needs time in order to eventually get there. Personally, I think one year would have been enough, otherwise we might give up. We could end up being hypocritical and leave it to chance. We might as well flip a coin.

The Liberals need to work hard if they want to win the election. If not, they are going to be leaving the fate of those who are suffering in the hands of people who just told us today that this will not happen on their watch, that they support suffering for life everlasting, and that they know what is moral and right for these people.

The Quebec college of physicians said, and I quote, “the decision to grant MAID to someone with a mental disorder should not be viewed solely as an episode of care. Rather, the decision should be made following a fair and comprehensive assessment of the patient's situation.” We are talking about taking the time to establish the chronicity of the condition.

The college of physicians also set out a second condition. It said, and I quote, “the patient must not exhibit suicidal ideation, as with major depressive disorders”. It might be a good idea for the members of the Special Joint Committee on Medical Assistance in Dying to hear that, although they are on the same committee as I am and that was said in committee.

That is a far cry from the grandstanding Leader of the Opposition who stands up in the House and asks the Prime Minister, in prime time, whether medical assistance in dying is the only thing he has to offer those who are depressed and having a hard time making ends meet. That is a bit much.

The third criterion laid out by the college of physicians states that the patient must “experience intense and prolonged psychological suffering, as confirmed by severe symptoms and overall functional impairment, over a long period of time, leaving them with no hope that the weight of their situation will ease. This prevents them from being fulfilled and causes them to see their existence as devoid of meaning.”

The experts tell us that they cannot apply irremediability and suffering metrics to mental health, and that prevents them from creating a category as a grounds for MAID. It has to be done on a case-by-case basis. All questions of clinical ethics, in terms of clinical assessment, are examined on a case-by-case basis. Some seem to think that going on a case-by-case basis is hell and that it is not a rigorous process. It is very rigorous.

The fourth condition states, “the patient must have been receiving care and appropriate follow-up over an extensive period of time.” Access to care must have been available. Otherwise, no access to medical assistance in dying will be provided for mental disorders. It seems to me that we heard the same thing in committee. We heard the same criteria.

At some point, we have to have the courage of our convictions. I believe that we have to offer relief to people experiencing intolerable suffering, who have reached their limit. I also believe that we must not make decisions about their life or quality of life for them. They alone can decide what is tolerable or intolerable.

When people talk to me about a slippery slope, they seem to be working on the assumption that all health care workers are evil. However, people who work in health care need to be kind. As far as I know, gaining admission to medical school is not easy. I imagine that the selection criteria are quite strict and challenging. The same goes for nursing.

The fifth condition states, “requests [from social workers] must undergo a multidisciplinary assessment, including by the physician or specialized nurse practitioner in the field of mental health who has treated the individual”. This is in the case of a follow-up assessment, not in the midst an episode. A person cannot get medical assistance in dying simply by saying that their life no longer has any meaning. Making a request does not mean one is eligible.

The Collège des médecins du Québec concluded by saying, “Under these conditions, it would be possible, in the CMQ's view, to provide individuals suffering from a grievous and irreversible mental disorder with access to MAID. It is important to prevent situations where individuals opt for MAID out of desperation, because they do not have access to proper care or do not consider the care available to be acceptable, such as an extended stay in a facility without the prospect of gaining more autonomy.”

That is the exact opposite of the nonsense we heard earlier. We were told that this was like a house of horrors, that we were dealing with experts and doctors who simply wanted to harm people's physical integrity. We have to be careful.

To access MAID, the individual must first make a request, which is then followed by informed consent. When it comes to mental disorders, doctors currently perform a daily assessment of a person's decision-making capacity if they have a mental disorder and a comorbidity, an additional illness that is hastening their death. Everyone agrees that these people are capable of choosing and consenting to medical assistance in dying. MAID practitioners have long been determining the decision-making capacity of people with a mental disorder. Just because someone has a mental disorder does not mean that their right to self-determination and to make decisions should be violated. That is discrimination and stigmatization.

When people tell me they want to protect the vulnerable, I wonder who could be more vulnerable than someone who has suffered for decades with a mental disorder and has tried every treatment. Who could be more vulnerable than someone grappling with a paternalistic psychiatrist—I am choosing my words carefully—who thinks he knows better than his patient what treatment they need, then chains them to a palliative care pathway and throws away the key because he cannot bring himself to admit that he is unable to provide relief to his patient?

At committee, I put the question to some psychiatrists who told us we were on the wrong track. They admitted that, in 25 or 30 years of practice, they had seen some patients fall through the cracks. Indeed, it is for this small group of people who fall through the cracks in psychiatry that this expansion is necessary. We need to show a little humanity here in the House.

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

Madam Speaker, if the member is referring to the Truchon decision, that was not what the Truchon decision provided for.

That was outside the scope of the Truchon decision. Evidenced by that is the fact that when the Liberals responded to Truchon by introducing Bill C-7, mental illness as the sole underlying condition was expressly excluded from the legislation.

This is a political decision brought on by the Liberals.

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

Madam Speaker, as my colleague knows, I have been on the Special Joint Committee on Medical Assistance in Dying from the get-go.

If he will recall, in the 43rd Parliament, when this House was dealing with Bill C-7, the government's original charter statement, which provided its rationale for excluding mental disorders as the sole underlying medical condition, was fairly well reasoned, and explained that section 7 and section 15 of the charter can be involved here. However, we have to remember section 1. Sometimes we may need to limit rights.

For me, personally, I am big believer in the charter, but I struggled through this whole process in how to find that balance between an individual's charter-protected rights but also the need of society to sometimes step in and protect the most vulnerable.

Could the member tell us how he personally approached finding that balance, and to also put it in the context that so many people in Canada, whether they are in rural or remote communities or in our urban centres, are marginalized and do not have access to the proper mental health care supports they so desperately need?

[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 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.

[Ya'ara Saks, Liberal, York Centre, ON]

moved that Bill C-62, an act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2, be read the second time and referred to a committee.

Mr. Speaker, I am pleased to have the opportunity to speak today about Bill C-62. This is a sensitive and very personal subject for so many around the country.

We have debated many of the core issues, but today we are talking about the legislation that proposes to extend the temporary exclusion of eligibility for medical assistance in dying for persons suffering solely from a mental illness by three years, until March 17, 2027.

I want to be clear: The question we are debating today is not whether mental illness can cause irremediable and intolerable suffering on par with that of physical illnesses. We know that it can, and that is not up for debate. We must proceed cautiously and we must get this right. We must ensure that the appropriate measures are in place across this country to affirm and protect our most vulnerable.

We have heard significant concerns from partners, provinces and territories and the medical community, regarding health care system preparedness. In its latest report, tabled on January 29 of this year, the Special Joint Committee on Medical Assistance in Dying found that while considerable progress has been made in preparing for the expansion of eligibility for persons suffering solely from a mental illness, an additional delay is needed to ensure that the health care system can safely provide MAID in these types of complex cases.

These concerns must be addressed before we can move forward with extending eligibility to persons whose sole underlying condition is mental illness. While that critical work is happening, we must also take action to ensure that vulnerable people are protected. Unless Bill C-62 is passed by March 17, 2024, the exclusion of eligibility for MAID will be automatically repealed. That means that individuals suffering solely from mental illness could be eligible to receive MAID as of that date, without the system being ready.

Although progress has been made to support the safe assessment and provision of MAID in complex cases, now is not the time to extend the exclusion, as highlighted by the letter we received from provinces and territories.

Over the past few years, the Government of Canada has been collaborating closely and carefully with partners to support the implementation of MAID. We have taken a compassionate and careful approach to this in our support of the safe assessment of MAID in complex cases, including where the sole and underlying medical condition is a mental illness.

I would like to take a few minutes to highlight some of the key areas of progress that have been made. As required under former Bill C-7, we appointed an independent expert panel with a mandate to provide recommendations on protocol, guidance and safeguards to apply to requests for MAID made by persons whose medical condition is a mental illness.

The final report, tabled by the expert panel in the spring of 2022, included 19 recommendations for governments and health system partners to support the safe expansion of MAID for persons suffering only from a mental illness. The panel noted that the recommendations would benefit all complex track 2 MAID assessments and provisions, even those where mental illness was not a factor. At the same time, the Special Joint Committee on Medical Assistance in Dying was also studying the question, and concluded that, at that time, they believed additional work was needed before moving ahead.

Both the reports by the Special Joint Committee on Medical Assistance in Dying and the expert panel highlighted the importance of education and training, consistent professional guidance, enhanced data and analysis, meaningful indigenous engagement and strong oversight. The government has taken these recommendations very seriously and has worked diligently to advance them.

In September 2022, Health Canada convened an independent task group made up of clinical, legal and regulatory experts to develop model MAID practice standards based on the expert panel's recommendations. Its mandate was to create resources that could be used by regulators to operationalize the expert panel's guidance with respect to complex MAID cases, including those based on a mental illness alone. The task group's efforts resulted in a model practice standard for MAID and a companion document, “Advice to the Profession,” which were both published in March 2023.

To date, the majority of provinces and territories have indicated that their practice standards for MAID have been updated or are in the process of being reviewed using these materials as a guide. The supporting “Advice to the Profession” document is being used to support and inform regulatory bodies, public authorities and health professional organizations, and is intended to support a consistent and safe approach to MAID practice across Canada.

In addition, Health Canada has been working closely with the Canadian Association of MAiD Assessors and Providers, also known as CAMAP, on a number of key activities to support preparedness among practitioners. Among them include funding the development of a nationally accredited bilingual MAID curriculum to support access to high-quality MAID training and a standardized approach to care across the country, while recognizing that differences in the delivery of health care services among provinces and territories do exist. As of the end of January, more than 1,100 clinicians have already registered with CAMAP to take the training.

We supported a knowledge exchange workshop on MAID and mental disorders that took place in June 2023. The workshop brought together MAID assessors and providers, as well as psychiatrists, from across the country to discuss the assessment of MAID requests based on mental illness alone, to build a network for ongoing knowledge exchange and to inform future practice. Additional knowledge exchange sessions are being planned for May 2024 and 2025 to support ongoing interjurisdictional lesson sharing and clinical guidance for complex case assessment, including for mental illness as the sole underlying condition.

When it comes to the question of eligibility criteria for MAID, we must consider all situations and all outcomes. While important work has indeed been done, we have heard clearly from our partners that they need to have sufficient time to implement safeguards and address capacity concerns that are expected to result from the expansion. As my hon. colleague, the Minister of Justice, has pointed out, we are trying to calibrate two fundamental ideas: the autonomy of the individual in terms of dignified decisions about the timing of their own passing, coupled with protecting vulnerable communities and individuals.

As the deadline to lift the exclusion of eligibility for mental illness approaches, calls to further extend the deadline have grown louder. We understand from our engagement and outreach with health stakeholders that there are varying levels of readiness to manage and assess requests for MAID where the sole medical condition is a mental illness. All provinces and territories have indicated that they are not yet ready to move forward. More work needs to be done.

On January 29, the Special Joint Committee on Medical Assistance in Dying tabled its most recent report examining the degree of preparedness for the safe application of MAID for persons whose sole underlying condition is a mental illness. While recognizing the considerable progress that has been made in preparing for the expected expansion of eligibility, the committee recommended an additional delay to ensure that the health care system can safely provide MAID in these types of complex cases.

I want to be clear: I understand that suffering from mental illness is just as real and just as serious as suffering from a physical illness. That is why we provided a clear timeline of three years before the lifting of the exclusion, which the provinces and territories and our health care partners can continue to work toward, and a firm commitment for parliamentarians to evaluate the progress after two years. That work will continue in earnest, and we can be assured that all the necessary measures are in place to move forward safely.

I understand there will be people who have suffered over many years without finding relief, and for whom MAID may be a serious consideration based on deep and personal reflection. This new development may truly be distressing for them. I want to say to them that we are committed to moving forward. However, we must do so in the most compassionate, responsible and prudent way possible. The system needs to be ready, and we need to get this right. It is clear from the conversations we have had that the system, at this time, is not ready. As I have said, we have worked hard to make sure that the necessary supports are in place for practitioners and our provincial and territorial partners to permit the expansion of the MAID eligibility to people whose sole condition is a mental illness. However, they have also been clear that more time is needed to prepare; that is why we are proposing a three-year extension.

The availability of nationally accredited training modules for MAID assessors and providers would help ensure that providers were clear on the requirements of the legislation and good clinical practice. However, it is going to take some time for individual physicians and nurse practitioners to integrate and internalize these practice standards.

Provincial and territorial regulatory bodies need to complete the work associated with updating standards. They need to ensure that health care clinicians have the training to ensure a safe and consistent assessment before the MAID eligibility is expanded through the lifting of mental illness as an exclusion. Existing assessment and support mechanisms also need to be examined and revised to ensure that the robust measures needed for these types of complex requests are in place. On that point, we are committed to continuing to support the provinces and territories and help system partners to further strengthen and improve mental health care services and supports, as well as data collection, to better understand who is requesting MAID and why, and appropriate support and oversight for practitioners.

While the management and delivery of health services, including MAID, is an area of provincial and territorial responsibility, the provinces and territories have been regularly engaged through a working group to facilitate information sharing and collaboration on MAID implementation. Through this group, provinces and territories have been and continue to be engaged in the work on the federally led model practice standards and are working collaboratively with all of us on all aspects of MAID.

The government has also made significant investments to support the provinces and territories in the delivery of mental health services. Budget 2023 confirmed the government's commitment to invest close to $200 billion over 10 years, starting in 2023-24, to improve health care for all Canadians. This includes $25 billion to provinces and territories through tailored bilateral agreements, focused on four key priorities, including improving access to mental health and substance use services and the integration of these services in all other priorities. This is in addition to the $5 billion committed in 2017 to support mental health and substance use services.

Our government has also invested more than $175 million to support the implementation and operation of 988, which will provide people across the country with access to immediate and safe support for suicide prevention and emotional distress.

As MAID continues to evolve, we need to ensure that accurate information is available to the public by providing clear information. We also take the concerns raised by those who might face systematic disadvantages very seriously. That is why we have expanded data collection on MAID to provide a better understanding of who is accessing MAID and why, including the collection of data on race, indigenous identity and disability. We can only address potential risks if we can uncover them.

We are continuing to engage with indigenous peoples through both indigenous-led and government-led activities to better understand their perspectives on MAID. This will culminate in a “what we heard” report in 2025. This will support transparency, provide insight into how the legislation is working, and maintain public trust in how MAID is accessed and delivered in Canada.

Finally, both the expert panel on MAID and mental illness and the special joint parliamentary committee highlighted the importance of case review mechanisms and oversight to support the safe assessment and provision of MAID. Most provinces and territories already have systems in place to do this work, but we understand that more can be done. We are working with the provinces and territories to explore enhanced models of case review and oversight, and, in particular, for more complex MAID requests, to support consistency and quality assurance across the country.

I understand that medical assistance in dying is a complex issue about which there are deeply held beliefs and opinions. I understand the concerns that have been raised with regard to the expansion of eligibility for MAID to include circumstances where the person's sole underlying medical condition is a mental illness. This would give medical practitioners more time to become familiar with available training and supports while providing time for the public to become more aware of the robust safeguards and processes in place.

The Government of Canada has also committed to a joint parliamentary committee to undertake a comprehensive review within two years after the act receives royal assent. This measure would further serve to examine progress made by provinces, territories and partners in achieving overall health care system readiness.

In the meantime, our government will continue to work with the provinces and territories to support ongoing improvements of the system to continue to ensure our laws protect those who may be vulnerable, reflect the needs of the people of Canada, and support autonomy and freedom of choice. That is why, after much deliberation, we have introduced Bill C-62 to extend the temporary exclusion of eligibility for MAID for persons suffering solely from a mental illness to March 17, 2027.

To put it simply, we need more time to get this right. I urge all members of the House to support Bill C-62.

[Ed Fast, Conservative, Abbotsford, BC]

Mr. Speaker, medical assistance in dying will soon be expanded to include those with mental illness, including depression. My bill, Bill C-314, would reverse this terrible decision. My bill is very narrow and would not repeal the other provisions of Canada's medical assistance in dying laws.

There is no national consensus on expanding MAID to include mental disorders, none. The most recent Angus Reid poll found that a very small number of Canadians actually favour expanding assisted suicide to the mentally ill, somewhere around 28%.

The mental health community has raised significant concerns. A recent letter to government from the heads of seven Canadian psychiatry schools implored decision-makers to hold off on expanding assisted suicide to the mentally ill. Similarly, the Canadian Psychiatric Association does not support the expansion of MAID due to the many ethical and clinical concerns that have not been resolved. They argue that mental illness is often highly treatable and that patients should be provided with the treatment they need to manage their symptoms and lead fulfilling lives.

Stakeholders have deplored the lack of social and economic supports for persons with mental illness and how this can lead people to consider MAID. They have pointed to the fact that the federal government has not fulfilled its promise to deliver dedicated mental health and palliative care funding to the provinces, leaving Canadians without access to the support that would lead them to choose life rather than death.

Many others have joined the chorus. They note that the issues of suicidal ideation, irremediability and competency have not been resolved, ensuring that Canadians will needlessly die because we have rushed ahead with expanding MAID.

At greatest risk are those suffering from depression, veterans suffering from PTSD, the opioid addicted on our streets, our indigenous communities and those seeking to escape a life of poverty. The government has even signalled its openness to allowing children to access assisted suicide, presumably without their parents' consent.

Last year, in my home town of Abbotsford, Donna Duncan was swiftly approved for assisted suicide after failing to receive proper treatment for chronic mental health issues. Her assisted death happened so quickly and so totally blindsided her daughters, Alicia and Christie, that they referred the case to the RCMP. Is this the dystopian world we are leaving behind?

Has anyone consulted with our first nations? Meaghan Walker-Williams of the Cowichan Tribe recently wrote in the National Post:

As a Sixties Scoop survivor, my lifelong personal journey back to my community of Cowichan has also been marked by the painful consequences of policies that didn’t respect or understand Indigenous cultures. Another policy, blind to my culture, may soon join them: assisted suicide for mental illness.

She concludes by saying, “it's crucial that the narrative remains firmly rooted in upholding the sanctity of life—a cornerstone of Coast Salish teachings.”

I note that the government originally excluded the mentally ill from its MAID regime and went to great lengths to explain why that was necessary. It was only after the unelected Senate included the mentally ill in Bill C-7 that the government suddenly enthusiastically embraced the idea.

The question is this: Should Canadians be able to trust their government to act in a way that values the life of every Canadian, or do we give up on the most vulnerable among us? Someday, all of us will have to give an account.

A famous world leader by the name of Moses once challenged his own people with a choice and a promise: “I have set before you life and death, blessing and curse. Therefore choose life, that you and your offspring may live”. I want my descendants to live, to prosper, to thrive, and I want the same for our mentally ill, our Indigenous peoples and indeed all Canadians. It is time to end this experiment. With so much uncertainty, surely we should err on the side of life, not death.

I respectfully ask members to support Bill C-314.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Mr. Speaker, it is a pleasure to rise and speak on an issue that has been fairly extensively debated over the last number of years. Members will recall that the reason we are having today's debate goes back to 2015, when a Supreme Court of Canada decision ultimately obligated parliamentarians here in the House to develop and pass a law that took into consideration the ruling made by the Supreme Court, with the necessity for the government to provide a framework.

It was not a very easy challenge when that decision was ultimately made. I do not know how best to put it, but the Government of Canada, at the time run by Stephen Harper, ultimately sat on the issue until there was an election. That election saw a change in government, and it was one of the first orders of business that the Government of Canada, under the current Prime Minister, had to deal with.

Over the years, I have been engaged in many different types of debates on all forms of legislation. When I am talking to young people who are trying to get a sense of what we do here in Parliament, I talk about legislation, and I will often make reference to Bill C-7. For Bill C-7, a very passionate debate took place on the floor of the House of Commons back in Centre Block. I can recall it vividly because of all the different emotions that were being expressed on the floor and all the discussions that took place.

It was not taken lightly. If we take a look over the years at the number of Canadians who have been consulted in one form or another with regard to medical assistance in dying, we are not talking about tens of thousands. We are talking about hundreds of thousands of Canadians from coast to coast to coast, in many different forms. They came together to voice opinions and concerns. In fact, we had a standing committee that did an incredible number of consultations, not only with individuals in our communities but with many different stakeholders.

In the debates that I have seen, I do not think we referenced our health care professionals and the important role they played in the debates. I want to start off by talking about that, because I think it is really important that, as Bill C-314 will ultimately be voted on, we understand and appreciate the number of discussions and the amount of effort that took place for the current legislation we have, which was amended.

As we saw, there were some issues that ultimately came out of Bill C-7, which caused another government bill to come to the floor. Again, a lot of repeat discussions took place and it ultimately passed. I think that is why the member has made the decision to propose his private member's bill. The changes that were made in what I think was Bill C-39, although I am not 100% sure and the member can correct me if I am wrong in his closing comments, are what might have brought forward this particular piece of legislation.

To be clear on what Bill C-314 does, it proposes to permanently exclude the eligibility to receive medical assistance in dying on the basis of a mental disorder alone. Wording is really important. I know that in the original debates with all the different stakeholders, and I made reference in particular to our health care professionals, the quality of the presentations and the understanding of the serious nature of the issue were, I would suggest, second to no other out of the debates I have witnessed, in particular given some of the things we heard coming out of committees.

As I reflect on that debate, I think that, in good part throughout the process, we saw many members of Parliament put their party position to the side and reflect in terms of what each believed as a parliamentarian. Maybe it was a crossover of personal beliefs versus the canvassing that many people no doubt had in terms of their constituents and wanting to reflect the general will of their constituents.

At the end of the day, when we think of medical assistance in dying and the issue of a mental disorder, I do not think that we want to try to simplify the message. As we all know, I am not a medical professional, but I have an immense amount of respect for what our medical professionals have to go through in order to be put into a position, because it is not just any and every doctor or nurse practitioner; there is a whole lot more that is involved. Towards the end of the debate, particularly on the second piece of legislation dealing with this particular issue, we had members who stood up and said, “Well, just put in your order”, almost as if someone were going through a drive-through and then it is done. We all know that is, by far, not the case.

I will fall back on the fine work that our standing committees have done. I am going to fall back on the issues and how they were explained, in good part, by the different stakeholders. I am going to stand by what the health care professionals brought forward to us. I will look at the information that was provided and ultimately reflect on what I believe in this particular situation and what a vast majority of the constituents I represent would want me to say on this particular issue. I will do this with very much a sympathetic heart, understanding the difficult situation that, unfortunately, far too many people have to face.

We can have as much sympathy as we want for those individuals who are looking at the possibility of getting medical assistance in dying, but it is one thing to sympathize and it is another thing to empathize. Based on everything I have looked at and listened to over the last number of years, I have not been convinced that this is, in fact, the direction that we should be going with regard to Bill C-314. I am just not convinced.

I think that what we ultimately need to do is continue to monitor and look at ways in which we can ensure that there is no abuse of the MAID legislation. We need to continue to show compassion in every way we can. We need to continue to listen to what the experts, individuals and stakeholders are telling us and try to build more value to the legislation so there is a higher sense of comfort in the broader community, which I believe there is today. The mechanisms are there, and there are opportunities to continue to be able to review.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Madam Speaker, as always, it is an honour and a great privilege to speak on behalf of my community of Peterborough—Kawartha.

Tonight, I am speaking on my colleague from Abbotsford's private member's bill, Bill C-314. I have explained this before, but I will do so again. A private member's bill is something a member puts forward for the House to decide on. This is an important private member's bill, as they all are, really, because they come from a place of passion, but this is Bill C-314, an act to amend the Criminal Code, medical assistance in dying, which many of us know as MAID.

The summary states, “This enactment amends the Criminal Code to provide that a mental disorder is not a grievous and irremediable medical condition for which a person could receive medical assistance in dying.”

The preamble states:

Whereas Parliament considers it a priority to ensure that adequate supports are in place for the mental health of Canadians;

Whereas Parliament considers that vulnerable Canadians should receive suicide prevention counselling rather than access medical assistance in dying;

Whereas Parliament considers that Canada’s medical assistance in dying regime risks normalizing assisted dying as a solution

The fact that we need a private member's bill to say this feels outrageous. I have listened to other members in the House tonight, and I want to be very mindful of my tone. This is an interesting and emotional debate, but I really urge the members opposite who have said they are not going to support the bill to consider getting it to committee. There is so much more we need to study.

My question is how this is not already in legislation. I will tell members why. In December of 2021, the Senate added an amendment to Bill C-7, without any consultation, study or discussion, to add people with mental illness as eligible for MAID. This private member's bill is currently the only way we can protect those suffering from mental illness. It is the only way for us as parliamentarians to say to those watching that we believe their lives matter and that it is our job to ensure we fight for them. Today might be awful, but none of us know what tomorrow will bring, as no one knows what is out there for them.

The MAID committee was created after the amendment was added. How backward is that? It heard testimony from many experts, and I want everyone to listen to the following quote because it is the essence of this discussion.

Dr. John Maher, clinical psychiatrist and medical ethicist, stated, “Psychiatrists don't know and can't know who will get better and live decades of good life. Brain diseases are not liver diseases.” Anyone who has dealt with somebody who has a mental illness or disorder knows that we have not even scratched the surface of what we know. We do not know.

I want to read this letter from a constituent who has been following the slippery slope of the Liberal government's extension of MAID into the record. I have her permission.

She writes:

“Dear Michelle...,

“My name is Kayla...I am going to be sending this letter to several MPs, but as you are [my] MP...I thought I should send this to you first. I am very troubled by something that is going to be happening very soon in this country, and I hope you will listen to what I have to say.

“Overall, I am a very healthy individual. I have a mental health condition, but it is my sole medical condition. However, I was mortified to discover last month, that Medical Assistance in Dying (MAiD...) will be available to people whose sole health condition is a mental health condition as of March 17, 2023.”

We have since voted in the House and that date has been extended one year to March 17, 2024. However, this is still in place, and this letter is very pertinent. She goes on to say:

“Persons who suffer from mental health conditions suffer horribly. I know that. I have suffered with mine for nearly 12 years. Perhaps the most appalling things of all are that 'The law no longer requires a person's natural death to be reasonably foreseeable as an eligibility criterion for MAID,' (Government of Canada, 2021) and 'There is no obligation for a person or their healthcare practitioners to inform family members if that person has requested or received MAiD.' (CAMH, 2022)...

“I think you see this for what it is...I will be eligible to end my own life on the basis that I have an incurable mental illness.

“Let me give you a bit more background: I have 2 university degrees in Biology and Environmental Science. I have a job that I love and have held since a little while after I graduated. I have NEVER failed to pay taxes, nor have I ever taken extended leave or gone on El due to my mental illness, no matter how hard it gets. I have a family and friends that I love dearly, and they love me too. And yet now my own government has deemed my life not worth living. This isn't just unfair. This is monstrous.

“But it gets worse. What about those people who are in the same boat that I am medically, but are much, much worse off. They cannot pay their taxes because they cannot work. They have a substance addiction. They are veterans with PTSD. They are homeless because they cannot seem to fight off their demons. These are some of the most vulnerable people in our society. To say nothing of the 'mature minors' (whatever on Earth that means) that will be able to access MAiD in the future if this doesn't stop. Make no mistake. This thing, that we dress up with the nice name MAiD, is euthanasia of our most vulnerable people because they cannot 'contribute to society' like others can. The fact that the government would offer to 'get them out of the way'...in this way, just because the systems that the government put in place are failing them is an unspeakable evil.”

She put in brackets, “convince them that they should die”. These are her words.

She continues, “I hope, Michelle, that you will do everything in your power as an MP as I will do everything in my power as a citizen, to abolish this law. I understand the federal government is seeking to push back the timing”, which it did, as I said. She says this is “likely because it has received so much criticism. I understand that it likely wasn't you that made any of the decisions for this law to go ahead. But I also understand that you are in more of a position to do something about it than many people are. I hope you will respond after reading this letter.

“Sincerely,

“Kayla.”

I did respond to Kayla and we had a very powerful conversation. She gave me permission to share this letter.

I think one letter like this is enough reasonable doubt that we need to take this private member's bill very seriously. It is everything we need to know to consider and urge everyone in the House. I have heard people say, on the Bloc side, that people should have the right to choose. The reality is that people who are in such a state of mental disorder do not have that capacity. We have to help them.

I want to leave us with this. This woman's name is Elyse. She is a young university student. She said that she is so worried about this legislation to extend MAID to those with mental illness. She has struggled with mental illness, and she knows with certainty that, if someone had offered that to her during her times of illness, she would not be here today. She would not be getting her university degree. She would not be in a happy, healthy relationship, and she would not know that her life was worth living.

If one is watching at home, if one has a loved one suffering, if one is suffering, one's life matters and it is worth living. It is our job to study this to the depths to determine whether we can do this. This private member's bill is the only thing that would protect those with mental illness and mental disorder from accessing MAID. I urge every member in the House to at least pass it to committee.

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

Madam Speaker, today we are revisiting a subject that never seems to leave me in this place, which is medical assistance in dying. It has come up repeatedly: in the 42nd Parliament, in the 43rd Parliament and again in the 44th Parliament. I think it underlines the gravity of the nature of this subject matter.

I want to thank the member for Abbotsford for bringing forward this bill and for giving us as parliamentarians an opportunity to discuss this incredibly important subject.

What Bill C-314 is essentially going to do, for the constituents of Cowichan—Malahat—Langford who are watching this debate, is amend the Criminal Code to reverse what was done with Bill C-7 and specify that a mental disorder is not a grievous and irremediable medical condition for which a person could receive medical assistance in dying.

It is important to mention Bill C-7, because it is an important part of why we are here today. Bill C-7 was originally introduced in the 43rd Parliament. The government is, of course, required by law to issue a charter statement with its main pieces of legislation. In that charter statement, the Minister of Justice went to lengths to make people understand why the government had specifically excluded in the first draft of the bill why a person with a mental disorder as a sole underlying medical condition could not be eligible to receive medical assistance in dying.

The charter statement did say that the exclusion was not “based on a failure to appreciate the severity of the suffering that mental illness can produce”. Rather, as the statement took pains to say, it was “based on the inherent risks and complexity that the availability of MAID would present for individuals who suffer solely from mental illness.” It is important to understand we are not using the term “mental illness” anymore. Every text is now recommending that we use the term “mental disorder”.

There were three primary reasons given in the charter statement at that time. First, the charter statement said, “evidence suggests that screening for decision-making capacity is particularly difficult, and subject to a high degree of error”.

The charter statement went on to say, secondly, “mental illness is generally less predictable than physical illness in terms of the course the illness will take over time.” I think a lot of people can understand that. Someone may receive a diagnosis for a physical illness like cancer, which is particularly well known. We know a lot about cancer these days, and based on what part of the body it strikes, we can predict with a fairly certain amount of accuracy what a person's ability to survive it is based on how far it has progressed and so on. It is the same with other physical ailments. With mental disorders, on the other hand, there still are, indeed, a lot of unknowns.

Finally, that same charter statement went on to explain that the recent experience in the few countries that do allow it, and it did mention Belgium, Netherlands and Luxembourg, “has raised concerns”.

That was the charter statement at the time with the first draft of Bill C-7. Of course, When Bill C-7 went to the Senate, the Senate amended that part of the bill to allow a person with a mental disorder as a sole underlying medical condition to access MAID. There was some back-and-forth between the government and the Senate to establish a sunset clause so that it would not come into effect until March 17 of this year.

At the time, the New Democrats decided to vote against the Senate amendment because the requirements of the earlier Bill C-14 had not yet been met. We had not yet had a parliamentary committee to delve into these issues, and we felt that, despite the government having gone to all those lengths through its charter statement to explain its position, accepting an eleventh-hour Senate amendment without having done that important work was very much akin to putting the cart before the horse.

There was also Bill C-39, which was introduced earlier this year because we found that more time was needed. Whatever anyone's feelings are in this House with regard to people with mental disorders being able to access MAID, there was agreement that more time was needed. Therefore, Bill C-39 was passed in very short order in both Houses, and that delayed the implementation of it until March 17, 2024. That is the timeline we are on now.

I am rising to speak to this particular bill because of my experience with this file. Both in the 43rd Parliament and in this Parliament, I was the New Democratic member on the Special Joint Committee on Medical Assistance in Dying.

It was not an easy committee to be on. Let me just say that. For me personally, I constantly wrestled with two concepts: How do we as parliamentarians, with the power we have to change Canada's laws, find a way to honour the personal rights, capacity and autonomy of the individual versus the need of society to step up and protect the most vulnerable? Those were two great themes that were constantly a struggle for me personally when listening to all of the witnesses who came before the special joint committee on the five thematic areas we were charged with by this House and the Senate.

I would encourage people, if they have not done so already, to look at the good work done by the special joint committee, both the interim report, which specifically focused on this area, and the final report, which was tabled earlier this year and completed the committee's mandate. I also want to draw people's attention to the executive summary of the final report of the expert panel on medical assistance in dying and mental illness because there was some incredibly good work done in that as well. We did recognize the authors of that report. The report states:

That MAiD requests may mask profound unmet needs or conversely, that such requests may not be received with the seriousness they deserve, has been raised with respect to several historically marginalized populations (e.g., racialized groups, Indigenous peoples, persons living with disabilities, and sexual orientation and gender minorities). In the course of assessing a request for MAiD—regardless of the requester’s diagnoses—a clinician must carefully consider whether the person’s circumstances are a function of systemic inequality.

That is the warning sign that I think much of the medical community is struggling with.

People with mental disorders qualifying for MAID will be under track two of the MAID regime, because death is not a naturally foreseeable outcome. I would remind people that track two has safeguards in place:

request for MAID must be made in writing....

two independent doctors or nurse practitioners must provide an assessment and confirm that all of the eligibility requirements are met....

the person must be informed that they can withdraw their request at any time....

the person must be informed of available and appropriate means to relieve their suffering, including counselling services, mental health and disability support services, community services, and palliative care....

I want to underline that last point. They have to be informed of the available and appropriate means, but we know that for a lot of marginalized populations, those are not always available.

I want to recognize my colleague from Courtenay—Alberni, who has called on the government to urgently fulfill its promise to establish a Canada mental health transfer. This is a very great need in our country. We can see it from coast to coast to coast. I can see it in my community of Cowichan—Malahat—Langford.

The question of Bill C-314 and the state of mental health care in Canada are two things weighing on me quite a bit. I am certainly going to take a lot of time to think about which way I want to go with this bill, but I appreciate the member for Abbotsford for bringing it forward and giving parliamentarians an opportunity to read the report and consider what this bill seeks to do.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I heard the member for Abbotsford say right out of the gate that his bill seeks to reaffirm the dignity and worth of each and every human life. Who could be against that?

The dignity of every human life, as I was trying to say to him earlier, depends on autonomy and respect for a person's self-determination. We may have good intentions, but if we claim to know what is good for a so-called vulnerable person because we think we know better than they do about what is good for them, because we mistake sympathy for compassion, if we decide through some sort of state or medical paternalism what is supposedly good for them, without considering the person's suffering at all, if we take away a person's self-determination, then we undermine their dignity. That is what I wanted to say, but my colleague did not understand.

That is the very foundation of our position. It is called ethical and political philosophy, not theology or any sort of religious ideology.

The preamble to the bill sets out its intentions: “Whereas Parliament considers it a priority to ensure that adequate supports are in place for the mental health of Canadians”. Who could be against that?

I see no problem with that, but it has nothing to do with the purpose of the bill. This can be done without saying that the mental disorder considered as a serious and irremediable medical condition is excluded. I will come back to that.

The second paragraph of the preamble states, “Whereas Parliament considers that vulnerable Canadians should receive suicide prevention counselling rather than access medical assistance in dying”. This really shows a lack of rigour.

All the experts spoke about this and we can even read it in the literature. It is a little twisted to associate suicide with medical assistance in dying. I heard the leader of the opposition make that link a few times during oral question period, but conceptually that is false. Medical assistance in dying is initiated when an individual expresses that that is what they want. It is not imposed. Above all, it is for situations where the person's condition is irreversible. As far as I know, no witness at committee told us that a suicidal state is not reversible. Furthermore, witnesses also told us that we should not conflate the two. This is not getting off to a good start.

When a request for medical assistance in dying cites a mental disorder as the reason, the first step is to establish whether the person suffering has been struggling with the mental disorder for 10, 20 or 30 years of their life. In the experts' report, which I hope my colleague has read, it says that a person exhibiting suicidal ideation would not be eligible. It is one thing to want or to request medical assistance in dying, and another to meet the eligibility criteria. This is essential.

A person who is depressed or in crisis will not necessarily receive medical assistance in dying. Moreover, the experts say that an assessor would never consider a request for medical assistance in dying from a person in a state of crisis. The patient would have to first exhaust all available treatments for alleviating their suffering, without refusing a single treatment capable of restoring their health.

As Dr. Black said, “One study estimated suicidal thinking as an 8% lifetime risk for adults in the Netherlands, yet 65 or 0.0004% of adults in the Netherlands have died of MAID in any given year due to psychiatric reasons.”

Now we have members talking about a potential slippery slope, citing Bill C-14 and ignoring the obligation given to us by the courts to proceed with passing Bill C-7. Bill C‑14 was a bad bill that confused the public. Is it respectful of human dignity to force people to go on a hunger strike to reach the standard of likely and reasonably foreseeable natural death? I think there is something a bit inhumane about that.

In order to reach a criterion that was unworkable for some, people had to actually go on a hunger strike. Others, like Ms. Gladu and Mr. Truchon, had to assert their rights in court. Members say they want to protect the vulnerable. They should start by not treating these people like children and not exploiting them for any purpose. They should instead think about their well-being.

Who is more vulnerable than someone who is suffering intolerably and is close to their tolerance threshold? Who are we to decide for them what their tolerance threshold should be? That is essentially what this is all about.

People want to live as long as possible. The court determined that these individuals' right to life was being infringed upon. I am sure the Conservatives have a lot to say about the right to life. The court found that by denying these individuals the right to medical assistance in dying, their ability to live as long as possible is being taken away. This prevents them from living until they reach their tolerance threshold. That is when we could provide care to them and proceed.

Without this assurance, what do many of these individuals do? They commit suicide prematurely, and this infringes on their right to life. This is indisputable, and it could not be considered reasonable in a free and democratic society, even if it went to the Supreme Court.

Some people always want to go to court. However, right now, people are suffering. While we are procrastinating, people are suffering. We have to put things into perspective.

The committee that considered the issue of mental illness as the sole underlying medical condition made a recommendation. That is why I think that Bill C-314 is premature, at the very least, if not irrelevant at this time.

I will read the committee's recommendation. It states, and I quote: “That, five months prior to the coming into force of eligibility for MAID where a mental disorder is the sole underlying medical condition, a Special Joint Committee on Medical Assistance in Dying be re-established by the House of Commons and the Senate in order to verify the degree of preparedness attained for a safe and adequate application of MAID (in MD-SUMC situations). Following this assessment, the Special Joint Committee will make its final recommendation to the House of Commons and the Senate.”

At the very least, I would have expected a debate to take place following the work of that committee. That is the least that could have been done. I invite my colleague from Abbotsford to read the report of the Special Joint Committee on Medical Assistance in Dying and especially the expert panel's report. The recommendations set out in the expert panel's report include criteria and guidelines that do not exist for other forms of MAID practice. He should feel reassured after reading those recommendations, and I am sure he will never talk about a slippery slope again.

[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.

[Ed Fast, Conservative, Abbotsford, BC]

moved that Bill C-314, an act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

Mr. Speaker, I am pleased to speak to my private member's bill, Bill C-314, the mental health protection act.

In its very essence, this bill is about reaffirming the dignity and worth of each and every human life. It is about recognizing that it is the most vulnerable among us, the disabled and the mentally ill, to whom we owe the greatest duty: to defend and protect their lives and to provide them with every possible opportunity to live life to the fullest.

Medically assisted suicide was legalized in Canada in 2015 by the Supreme Court's Carter decision and later under the Liberal government's Bill C-14. Under this legislation, medical assistance in dying, or MAID, as it is commonly called, was strictly limited to those consenting adults who had an incurable disease that caused enduring, intolerable suffering that could not be alleviated, and where natural death was reasonably foreseeable, which they call the foreseeability test.

At the time, the government and its supportive stakeholders assured Canadians that this was not a slippery slope, where the scope of MAID would continually be expanded to include more and more vulnerable Canadians. However, not surprisingly, in the intervening eight years since the Carter decision, the government has begun to expand Canada's MAID regime to include more and more defenceless Canadians, most particularly those living with disabilities.

In late 2019, a Quebec lower court judge in the Truchon case ruled that the foreseeability test I just mentioned was unconstitutional, requiring Parliament to respond with additional legislation. Sadly, the Liberal government chose not to appeal the Truchon case to the Supreme Court of Canada, presumably because the decision lined up with the Prime Minister's intent to dramatically expand assisted suicide to other vulnerable Canadians. This leaves us with the perverse situation in which the Supreme Court of Canada, the highest court in the country, has never been allowed to opine on whether the reasonable foreseeability test is constitutional.

In any event, the Liberal government responded to Truchon by tabling Bill C-7, which initially eliminated the foreseeability test but expressly excluded mentally ill persons from being caught up in its MAID regime. Here is what the justice minister said at the time:

The fact that there would be risk of ending the life of a person whose symptoms would have improved...is, in part, why we are of the view that it is safest not to permit MAID on the sole basis of mental illness.... There is also ongoing uncertainty and disagreement as to the potential impact on suicide prevention if MAID were made available to this group.

He went on to say:

...there is no consensus among experts on whether and how to proceed with MAID on the basis of mental illness alone. On a question of such importance and with so much uncertainty and expert disagreement, it is incumbent upon us to proceed with caution and prudence.

Those were our justice minister’s views until the unelected Senate suddenly introduced an amendment that expanded MAID to those Canadians whose sole underlying condition is mental illness. Sadly, the justice minister and the government accepted the amendment without protest and, overnight, became zealous proponents of assisted death for the mentally ill. What happened to the caution and prudence the minister was preaching? What about the impact on suicide prevention the minister was so concerned about? What happened to his view that it was safest not to permit MAID on the sole basis of mental illness?

I agree with the Minister of Justice on one thing, which is that, as he has said, this is indeed a complex issue and is deeply personal. It is deeply personal because it involves life, a precious human life.

I would remind the minister and his government that the issue is also profoundly simple; that is, the principle that all life, all human life is precious and worthy of defence and protection, especially for those who do not have the ability to speak for themselves and have no one to speak for them.

One of the primary functions of government is to protect its citizens, to protect life. In fact, the right to life is expressly enshrined in section 7 of our Charter of Rights. Sadly, the government's Bill C-7 fails to protect the lives of our most vulnerable. It removes the critical safeguards that the original euthanasia legislation included in response to the Carter decision. Removing those safeguards will have irreversible consequences for those who suffer from mental illnesses like depression.

What is equally disturbing is that the Liberal government has also signalled its intention to extend the so-called “treatment option” to minor children. That would arguably make Canada the most expansive, most liberal, assisted suicide jurisdiction in the world. Clearly we are on the slippery slope many of us warned about. Canadians have a right to conclude that the Liberal government has gone too far and too fast in its zeal to implement and expand the scope of assisted death.

My bill will reverse this momentum and repeal the government's decision to extend MAID to the mentally ill. It will put a full stop to the expansion of assisted suicide to mentally disordered persons. Let me be clear. My bill does not in any way reverse the rest of Canada’s MAID regime. Assisted death will remain available for those suffering from irremediable, incurable and intolerable illnesses and diseases. My bill is simply focused on reversing the government’s actions in expanding assisted suicide to include the mentally ill. It would arrest Canada’s slide into normalizing assisted death as an alternative treatment option, something so many of us had predicted would happen.

The evidence from mental health experts is very clear. Contrary to what our justice minister is now saying, there is absolutely no consensus in Canada that the mentally ill should be covered by Canada’s medically assisted death regime. In fact, here is what experts and other stakeholders in the mental health community are saying. John Maher, psychiatrist with Canadian Mental Health Association, states that:

Inducement to suicide while simultaneously denying mental health care to two-thirds of Canadians who urgently need it is an unconscionable failing.

Directly undermining suicide prevention efforts is an insidious and ablest perversion of our mental health care duty.

Drs. Ramona Coelho and Catherine Ferrier, co-founders of Physicians Together with Vulnerable Canadian, penned a statement that was endorsed by over 1,000 physicians. This is part of what it said, “Given that there is no medical evidence to reliably predict which patients with a mental illness will not get better, MAID for mental illness will end the lives of patients who would have recovered…Medicine …would fail in its mission if it were to deliberately end the lives of patients living with mental illness… Legislators must work towards safeguarding the lives of the most vulnerable including those placed at a greater disadvantage because of mental illness.”

Dr. Sonu Gaind, chief of the Department of Psychiatry at Sunnybrook Hospital, Toronto, stated, “The Ministers have provided false reassurances that we can somehow separate people who are suicidal from those who are seeking psychiatric euthanasia. That is simply not true. In my opinion, that is dangerous misinformation coming from our federal Minister of Justice and our federal Minister of Mental Health and Addictions providing a false sense of safety that does not exist.”

Trudo Lemmens, professor and chair in health law at the University of Toronto, said, “I urge Parliament to take very seriously how offering MAID for mental illness deprives disabled persons, particularly those with mental illness, from equal protection against premature death. Persons experiencing mental illness deserve to be protected against premature death by an unreserved focus on ensuring access to all required health care and social support services. Facilitating their death does exactly the opposite.”

Finally, Sephora Tang, psychiatrist and assistant professor in the Department of Psychiatry at University of Ottawa, said, “One cannot prevent suicide while at the same time facilitating it. Placing expectations upon mental health professionals to do both undermines the effective delivery of recovery-oriented mental health care. Canadians deserve to live in a country that is committed to safeguarding the right to life and security of every person. Current MAID legislation fails to achieve this overarching social good.”

Even Canada's justice minister has publicly acknowledged the fact that issues such as irremediability, competency and suicidality are not anywhere close to being resolved to justify such a major policy shift in favour of death. Furthermore, medically assisted death flies in the face of the government’s own promotion of suicide prevention programs, including the recent creation of a national 988 suicide hotline.

It cannot be both ways. It cannot claim, as the Liberal government has, that it wants to prevent suicide deaths on the one hand, when it actively promotes assisted suicide for the mentally ill on the other. Over the last eight years, many of us have expressed our concern and expectation that the Carter decision and BillC-14 would be expanded by future court decisions, and that these decisions would leave more and more vulnerable populations exposed to the reach of medically assisted suicide.

Our concerns were pooh-poohed. We were accused of fearmongering and of misrepresenting the intentions of this Liberal government. Yet, today, the Truchon decision and the travesty of Bill C-7 bear out our concerns. That is why more and more disability groups have set the alarm bells ringing and are vehemently opposing this legislation. They argue that this legislation amounts to a deadly form of discrimination, making it easier for persons with disabilities to die than to live.

We are hearing more and more reports of the poor and homeless approaching food banks to ask for assisted death, not because they are suffering from a grievous illness but because they do not want to go hungry and homeless. The headline in the British magazine The Spectator asked last year, “Why is Canada euthanising the poor?”

The response from some bioethicists appears to be, “Well, why not?” In fact, a new paper by two bioethicists at the University of Toronto makes the case that euthanizing the poor should be socially acceptable. That is indicative of the path on which our country finds itself. It is terrifying.

We also have verified reports of veterans suffering from PTSD who are being counselled by the Liberal government to consider medical assistance in dying rather than being provided with the treatment and supports they need to recover.

These are the vulnerable that the Liberal government promised to protect. Canadians have the right to ask whether this government is exercising the requisite caution and care to avoid unnecessary overreach and ensure that MAID is not abused or misapplied.

Let me conclude. My private member's bill, Bill C-314 gives all of us parliamentarians an opportunity to take a deep breath and reconsider the perilous road we have embarked upon. As I mentioned, my bill simply reverses the expansion of Canada’s assisted death laws to the mentally ill. At the very least, I would ask my colleagues to allow my bill, at second reading, to go to committee where there could be more discussion.

Have we gone too far and too fast with Canada's assisted suicide program? Will we evolve into a culture of death as the preferred option for those who suffer from mental illness or will we choose life?

I implore my colleagues to choose life. I wish them much wisdom as they make that choice.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

Madam Speaker, we do not have a charter statement and we should. It is my understanding that, even when a bill is revised, there should be a charter statement. With Bill C-7, we had an initial charter statement. It came back from the Senate, and there is no new charter statement. The charter statement we are left with is pre-amendment. That is a problem, and if we couple that with the lack of a charter statement in the House, we are left with a huge problem.

In my view, the law is to be followed and there should be a charter statement. We should be following that. I wish we had it. We should have it.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

Madam Speaker, the member for Kingston and the Islands commended me for my honesty. I appreciate that. I like to think I am always honest in this place.

In 1993, if memory serves, we had the Rodriguez case. I am probably simplifying this, but that was a question on the right to die. It was a five-four split, but the Supreme Court of Canada said that there was no charter basis for that decision. It has been a while since I reviewed that in depth, but that is my recollection.

We fast-forward 22 years to the Carter decision in 2015, which came to the opposite conclusion. That case, I believe, was a per curiam decision for the court, which means that all nine justices found that the prohibition did offend the charter. The question that often comes to the House after that occurs is how Parliament should respond. I was not here then. I got here in 2021. Being here has been 18 of the best months of my life.

I can say that, from 2015 to 2023, we have seen a dramatic shift in what seemed to be envisioned both in the legal community and in the Canadian community at large, that change from medical assistance in dying for people who had irremediability, a terminal condition or a condition that was not going to get better, with death being foreseeable. My understanding when I was growing up, and it was an issue when I was in high school and university, was that this was really at the crux of the issue. Should somebody who is terminally ill have a right to euthanasia? That is how we framed it.

I am going to go to the minister's charter statement, dated October 21, 2020. I am going to note that I am not sure whether or not a charter statement has been provided for Bill C-39. I was with the minister at committee yesterday and no charter statement had been provided, so here we are debating a bill on a very serious issue, and we do not have a charter statement.

I am looking at everybody on the government benches. There are a couple of people here on the opposition benches as well. I hope we can all agree that not having a charter statement, which is supposed to accompany legislation like this, is a problem. What is adding to that problem is that, when the minister was asked about that by one of my colleagues yesterday, there was no definitive answer. He was asked where the charter statement is and when it is coming.

We are being asked to decide on this issue inside of what I would call a legal vacuum, where we do not even know what department officials think about this proposed legislation. I would hope, and I would think, that all of my colleagues believe that to be a problem.

The charter statement on Bill C-7 was tabled on October 21, 2020. This was before the legislation was amended by the Senate. On page 7 of 18, the charter statement says, “While expanding eligibility for MAID to include people whose natural death is not reasonably foreseeable, the Bill would exclude individuals whose sole medical condition is a mental illness.” On the next page it continues, “In particular, the exclusion would apply only to mental illness”.

Further on, it says:

The exclusion is not based on the assumption that individuals who suffer from mental illness lack decision-making capacity and would not disqualify such individuals from eligibility...if they otherwise meet the requirements, for example, if they have another medical condition that is considered to be a serious and incurable illness, disease or disability. Nor is the exclusion based on a failure to appreciate the severity of the suffering that mental illness can produce.

This is the key part:

Rather, it is based on the inherent risks and complexity that the availability of MAID would present for individuals who suffer solely from mental illness. First, evidence suggests that screening for decision-making capacity is particularly difficult, and subject to a high degree of error.... Second, mental illness is generally less predictable than physical illness in terms of the course the illness will take over time.

These are static points, and by that I mean these things will not change with time. It is not like in 2020 there were inherent risks and complexity of judging MAID for people who suffer from mental illness, but now it has changed. We asked the minister about this, as I recall, yesterday. In any event, the minister has not articulated, and the government has not articulated, what changed. Either the charter statement was wrong, or something changed.

Neither has been put forward before the House. How is that possible? Was the charter statement wrong, or have the inherent risks and complexity changed? Has the predictability of mental illness over the course of time changed, or was the charter statement wrong? These are questions that, in my view, the minister has to answer.

One of the more difficult things we discussed yesterday at committee with the minister happened when one of my hon. colleagues asked him about a letter that was written by 32 academics. These are not insignificant people. I know some of these 32 law professors. The minister was asked flat out by the member for Fundy Royal if the professors were right, or if the minister was right. The minister said he was right.

I am going to list a few of these 32 professors, because the hon. minister has said that they are wrong. There is Archibald Kaiser, professor of law in the department of psychiatry at Dalhousie; Tess Sheldon, from the faculty of law at the University of Windsor; Elizabeth Sheehy; Brandon Trask; Brian Bird, a friend of mine who clerked at the Supreme Court of Canada and did his thesis on conscience rights for a Ph.D. in law; Janine Benedet, who I have heard speak to issues that relate to sexual assault; and one of my very good friends, Dr. Ruby Dhand. I am going to give her a few props here. She had five degrees by her 34th birthday. Professor Dhand is one of the smartest and most brilliant people I know.

The minister told us yesterday that he is right and these people are wrong. They wrote a letter saying that what the government is saying is the case with MAID, that it is rooted in Canadian law, is just simply not accurate. That is what they said. Who is wrong: them or him?

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Madam Speaker, I want my constituents to know that I am staying in the riding to take care of my newborn, but I am happy to participate, in hybrid fashion, on their behalf on this very important subject.

Bill C-39, an act to amend the Criminal Code regarding medical assistance in dying, seeks to delay the expansion of medically assisted death to individuals whose sole condition is a mental illness. We are here today because of previous legislation in the last Parliament, Bill C-7, that responded to the Truchon decision and the justice minister's interpretation of it by removing critical safeguards to accessing MAID, particularly that death must be reasonably foreseeable. However, Bill C-7 contained an arbitrary deadline of March 17, 2023, to expand MAID to those whose sole condition is a mental illness, and now the government is seeking to delay that arbitrary deadline another year down the road.

As I do not want MAID to be offered to those who are solely suffering from a mental health issue, I will be supporting the bill, but I do so in the context of very big and life-altering concerns regarding the direction the Government of Canada has taken since the debate on MAID commenced in 2016.

The Conservatives believe that we should never give up on those experiencing mental illness and should always be focused on offering help and treatment rather than assisted death. The Conservatives will bring forward alternative proposals to support those with mental illness instead of the government's approach.

Going back to 2016, the preamble of Bill C-14 spoke about the vulnerability of persons. It states:

Whereas vulnerable persons must be protected from being induced, in moments of weakness, to end their lives

It also states:

Whereas suicide is a significant public health issue that can have lasting and harmful effects on individuals, families and communities

Man, have we seen a lot of change in the last seven years.

Conservative members at the time, despite these assurances in Bill C-14, observed that the approach of the government was going down a slippery slope. The member for Selkirk—Interlake—Eastman highlighted a concern that has sadly now become a reality in Canada. He stated, “many believe that the policy will be used prematurely to end the lives of those who have become a burden to their families, society, or the medical system.”

At the time, because of big public concerns, many Liberal members were careful when it came to speaking about expanding MAID in the future. The former justice minister, Jody Wilson-Raybould, said, “In terms of eligibility, the policy choice made by the government was to focus on persons who are in an advanced state of irreversible decline and whose natural deaths have become reasonably foreseeable.” The current member for Lac-Saint-Louis said, “Bill C-14 would not normalize medically assisted dying as perhaps has occurred in Belgium and the Netherlands, the two most often cited examples of the slippery slope.”

In the last Parliament, in his charter considerations on Bill C-7, which expanded MAID to include those without a reasonably foreseeable death, the current Minister of Justice cited inherent risks and complexity as a reason not to expand MAID to those with mental illness as a sole condition. However, the Minister of Justice, unfortunately, as we find today, is speaking on both sides of this issue very irresponsibly. On the one hand, he communicated in the Bill C-7 charter consideration that due to the complexity and inherent risks, we should not be expanding MAID to those with mental illness as a sole condition. On the other hand, in the same bill, he included a sunset clause to expand MAID to these Canadians and said that his hands were tied by a Quebec court decision. However, not only has the government refused to challenge it at the Supreme Court, but leading legal experts in our country have stated that his interpretation of the decision is flawed.

After telling Canadians time and again that the legalization of MAID would not lead to a slippery slope by allowing death on demand for any citizen whenever they may want it, the government seems set on expanding MAID to anyone.

I plead with the backbench members of the Liberal Party to stand up against the justice minister today. You have more influence than any Canadians right now to stop what he is trying to do.

Do not forget that in 2016, on Bill C-14, he voted against the—

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, I am glad to be joining this debate at this late hour. I understand this is an issue that is very close to many people's hearts, and a lot of members wanted to rise. I wanted to make sure I caught your eye on this one.

“The Lord rewards a good deed but maybe not right away.” That is a Yiddish proverb I have often heard. I have heard it in Polish. I love Yiddish proverbs, as many members know. Growing up in my family, my grandmother used to say them. She said them in Polish. It turns out that nearly all of them are Yiddish in their origin. That was something humorous I would talk to her about.

In this case, some members of the public think we have actually voted through things that we have not voted through. All we are doing here, directly in the summary of this legislation, is delaying making a final decision until March 17, 2024, on the repeal of the exclusion from eligibility for receiving medical assistance in dying in circumstances where the sole, the only, underlying medical condition identified in support of the request for medical assistance in dying is a mental illness.

I am prepared to speak on this piece of legislation as I have done in past Parliaments. I have been here since the 42nd Parliament, so I have been through the debate on Bill C-7, and the debate on Bill C-14.

Bill C-7 was originally the response to the Carter decision rendered by the Supreme Court of Canada. In it, the Supreme Court found that there was a constitutional right to seek an assisted suicide from a medical professional. It is an exemption to a part of the Criminal Code, but do not ask me to quote which section of the Criminal Code. I have, fortunately, not been burdened with a legal education, so I come at this with a layperson's eyes.

It provided an exemption. Sometimes, when I have a back-and-forth with constituents back home, I raise that point. It is an exclusion to that particular section of the Criminal Code. Then, it becomes incumbent on the federal government to put in place some measures to protect the vulnerable in society.

There were a few people who emailed me over the last few months to talk about that vulnerability, people from different sectors of our society, and how they would be affected. This is not a unanimity in my riding, but the vast majority of the people who contacted me are opposed to the extension of medical assistance in dying, or assisted suicide, for people with a mental illness, when it is the sole condition that they have. They have been very clear on this. Some of the emails are quite emotional. Some of them are a dissertation of what has happened to their family, essentially, and they give particular cases.

I want to do them justice by reading some of their thoughts without using their full names, just to protect their anonymity in the emails. I was also here for the debate on Bill C-14. I remember this debate quite vividly, because Bill C-14 came after the Truchon decision. In that decision, the court found that there was a wording we had used, irremediable or unforeseeable deaths. I remember debating in a previous Parliament and saying this would likely be struck down by the court. It was such a broad term that it could mean anything. It went beyond what the Carter decision said. It was struck down by a court. Let that be said to my friends who are lawyers. I am occasionally right on the law and about what the courts would do. They did strike it down in Bill C-14.

Now we are going back again. I understand that, today, the special committee on medical assistance in dying, which was struck by the House, finished its review and tabled the report. I have not yet had the time to completely review that report. To the constituents in my riding who have emailed me over the last few months as this issue has gained more traction, I want to read a part from Allison.

Allison wrote to me, “A family member with complex health conditions said she was asked so many times about it,...” it being medical assistance in dying, “...she wondered if her Dr. would get a commission for the procedure!! Where are the safeguards and regulations? Who protects vulnerable patients from being coerced by subtle suggestions?”

She goes on, “To be human is to experience pain, suffering and vulnerability. In my family, we have had people that have struggled with mental illness and recovered to live productive, healthy lives, thanks to support from family and community.” She is saying, “let us help you live better” should be the message we send people who are suffering from a mental health condition or a mental illness of some sort. I have known people in my life, around me, who have gone through that as well.

Lisa in my riding emailed me in December and said, “As a citizen who is deeply invested in the going ons with MAID and disability services in this country I keep current in what is happening and research.” She started off by saying that she is the mother of a child with a disability. Her son has no siblings and no close family to look out for him and advocate for him. She mentioned that once she and her husband are no longer alive, she is worried what type of country will be left behind for her son.

She uses some pretty harsh language, but it is parliamentary; I checked. She went on to say, “The way in which Canada has expanded MAID is nothing short of predatory, opportunistic and ableist.” Those are the words she uses. She asked some questions, and I do not have easy answers for her, but I will ask them openly here: “Why are they not being offered better mental health and physical health supports? Why is the government expanding MAID without first expanding holistic supports to our disabled people?”

She then says, “As a mother of a vulnerable child who one day will be left alone who may be exceptionally impressionable and dependant on our broken system I am deeply concerned about the expansion of MAID and its possible implications.” She implores us, “Do better Canada!” That was from Lisa in my riding.

Bev in my riding is very concerned about MAID being expanded to adolescents. I know that debate is going on concurrently. It is not directly in Bill C-39, because we are just talking about delaying for a year the approval of mental illnesses and mental health issues as the sole underlying conditions for applying for medical assistance in dying. However, in her email to me, she noted how vehemently opposed she is to MAID being expanded to adolescents or children and to making this expansion permanent in the law. She went on a bit, but some of it is not entirely parliamentary, so I will avoid violating the rules of the House.

Joe in my riding mentions the following: “We have already had someone in the Department of Veterans Affairs advocating Maid for those with PTSD. What terrible advice to give our veterans. Please do not proceed with eliminating those whose only problem is that they are mentally ill.” I have talked to Joe many times. He is what I would call one of my regulars, as he emails me quite often. He is very passionate about public education, I will add.

Cindy in my riding said, “At no point does a healthy family or community decide that one of its dearly beloved members is better dead than alive. The veneer of compassion is easily seen through.” She went on to make a point that really struck me:

It is indeed a slippery slope to offer MAID to the mentally ill, depressed, bipolar, and any other non-detectable illness—especially when removing the requirement that death be considered reasonably soon.

By expanding MAID in this way, the floodgates are opened for Canadians to easily choose despair over meaning in their lives.

This is the wrong direction for Canada, and an embarrassment on the international stage.

The last one I will read is from Shirley, which is very simple. She said, “Has the world gone mad?” She talks about expanding MAID to those who have a mental illness, expanding it to young people, and on and on.

Those are the types of emails I have been receiving, on top of phone calls, and those are the worries I wanted to express on the floor of the House.

Some are suffering and going through difficult times, and some are diagnosed with really serious chronic conditions that are essentially terminal, conditions like Alzheimer's and Lou Gehrig's disease. The original foundational decision that Carter was gripped with was what to do about ALS, an awful condition. It is degenerative, chronic and pretty much incurable. There are many therapies out there to delay the condition. There was a member in the 42nd Parliament, an honorary chair occupant for a day, Mauril Bélanger, who passed away from it. Since then, I have met others whose family members have passed away. What I think the judges and the court were trying get at is that these are the people we should be looking after.

I want to lay this before the House. When a doctor gives up on someone, they are much more likely to give up on themselves. I have seen this time and time again. I have also experienced it myself when my disabled daughter was so sick that the four doctors in the room termed the condition “not conducive to life”. There is nothing like being told this by physicians who are supposed to look after a child, and seeing, essentially, the gentle and subtle push that my constituents talked about, which is repeated over and over. There is also the consumption of resources. That will lead to more people using the system when they have other options. Resisting the urge to just give up is difficult to do at the best of times, and people need community and family support all around them.

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

Madam Speaker, certainly as the debate has continued through this evening, I think there is a remarkable amount of non-partisan agreement, with areas of difference. I think one of the areas of difference, and I am hoping the hon. member for Foothills will agree, is that it is better not to try to suggest that people have a motivation in this place.

We all agree, I think, that the pace at which MAID extended from irremediable medical conditions to mental health conditions took a lot of us by surprise. I voted for Bill C-7 because I wanted to see the advance directives being made available to people who were suffering with a terminal medical illness. The mental health conditions were suddenly before us.

We welcome the chance to have an additional year's delay, but what could we do in that time? I ask the hon. member for Foothills what he would recommend in this next year to make a difference and have the precautions and protocols in place.

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

Mr. Speaker, I am thankful for the opportunity this evening to speak to Bill C-39.

At the outset, I believe it is important, first of all, that my constituents know that this bill is not a complicated one. It does not propose anything new to Canada’s euthanasia laws, nor does it propose to appeal laws that are currently in place. This is a simple bill that delays the expansion of medical assistance in dying to those living with mental illness by 12 months, one year. On those grounds, Conservatives support its swift passage, but only as a temporary solution.

However, this bill is what happens when a government moves too fast, too aggressively, and fails to take into account the pleas of experts and everyday Canadians living with mental illness and family members living with them. These Canadians include our family members, our friends, our neighbours and our co-workers. They live with mental illness that, to them, should not be a death sentence. They see the provision of MAID for their illness as yet another step along the road to devaluing life in this country. They know it is not going to accomplish anything to end stigma around mental illness, and they know that it puts vulnerable Canadians from all walks of life with illness seen and unseen at risk.

That is why this bill is little comfort to me and to Canadians at large. The extension of assisted death to mental illness must not just be delayed; it must be scrapped completely.

Assisted death has been a highly emotional issue since this place first considered its legalization in 2016. It was the first bill that I debated in this House. Debate has been passionate due to our personal experiences, personal beliefs and convictions on what constitutes dignity in end-of-life decisions. However, today’s debate takes on an even greater heaviness in that respect.

Statistics indicate that one in two Canadians by age 40 has or has had a mental illness. The chances are even greater for young people, and among those who have answered surveys on the topic, respondents report that they would be three times less likely to disclose a mental illness than a physical one, like cancer. The numbers are grim but paint a realistic picture of mental health as it relates to all Canadians. It is universal. No one is immune to life’s difficulties, whether in the short or the long term. That is precisely why stakeholders are asking the government to show true compassion by reconsidering an expansion of MAID to those with wounds that are largely unseen.

The Canadian Mental Health Association points to socio-demographic factors beyond age, education and income levels as driving forces behind a request for MAID. Racism, poverty, homelessness and gender-based violence have harmful effects on mental health and symptoms of mental illness. Over these past couple of years, we can tell too that isolation, persecution for one's beliefs and hopelessness impact our mental health.

The Ontario Hospital Association is clear that these complex issues must be addressed through appropriate legal safeguards, coupled with societal supports, before assisted death expansion is considered. On the other hand, I believe that we must consider the realities of mental health in Canada among certain groups close to my heart and why expansion must never be entertained.

This summer, Canadians were shocked to learn that a Canadian Armed Forces veteran struggling with PTSD and a brain injury was repeatedly advised of MAID as a solution to his suffering by a Veterans Affairs Canada employee. The veteran had never inquired about MAID, but even after asking the VAC employee to stop pressuring him over and over again, the employee persisted. We know that veterans face a greater risk of suicide compared to the average population. It is truly frightening to know that instead of facilitating the most appropriate care available, this public servant chose to repeatedly suggest MAID as a solution to suffering. This frightens me to know, and I wonder how often this kind of advice has led to tragic consequences.

Debbie Lowther of VETS Canada said that it is like planting a seed within someone who is already struggling with their mental health or may even be contemplating suicide. No matter how isolated the Veterans Affairs issue may be purported to be, and I do not believe it is, it is clearly a result of the government’s attempts to muddy the waters on suicide. It did a lot to draw Canadians’ attention to the normalization of assisted death in this country and just how rapidly it is becoming a “fix-all” solution, not just for end-of-life issues but for treatable illnesses among vulnerable people. When accessing an assisted death takes less time than accessing disability benefits for our veterans, we are completely failing them. Sadly, veterans are not alone in this respect.

Some Ontarians, for example, face multi-year wait times for special mental health care. That is years of living with mental health issues when they could be receiving treatment. Why are they not? We need to ask ourselves that question. Disability advocates have been crystal clear with this government for years that Canadians do not have access to all the supports that they need and deserve and are even available.

In a piece in the Hill Times this past week, Spencer van Vloten of BC Disability is correct when he states that, “too much time is spent considering who should die, rather than how to help people live.” He goes on to note all-time highs in wait times, nearly 30 weeks, for those seeking mental health treatment.

To paraphrase one disability rights advocate, those living with treatable illnesses likely would not put MAID anywhere near the top of their list if they had unimpeded access to support and treatment.

Indigenous Canadians also face an increased risk of preventable harm as MAID becomes more accessible. Tyler White, CEO of Siksika Health Services noted that, “Indigenous elders work hard to tell young people that suicide should not be an option, and the medical assistance in dying (MAID) bill [Bill C-7 in this case] says the opposite.”

Many indigenous Canadians can speak to negative experiences with the health care system, including procedures that were done against their will. It is my belief that an assisted death regime, with ever-expanding boundaries and ever-diminishing safeguards, will not help to heal mistrust. It will only worsen it for our indigenous people, our veterans and those with disabilities.

It comes down to this simple fact: The same majority of Canadians who desire empowerment in their end-of-life decisions want Parliament to carefully weigh the risks of MAID for those living with mental health issues, such as depression. Sixty-nine percent fear that depressed individuals could see MAID as a means to escape dealing with the underlying causes of their condition. The experts say they can, over time, deal with those conditions.

The slippery slope does exist, and Canada is spinning out of control. We have to apply the brakes here. We are not only listening to those who will personally be affected by these laws, but we also need to take lessons. I know this government says, “We take no lesson”. Well, do not take them from us then, take them from jurisdictions with a long-standing MAID regime for mental illness.

In Belgium and the Netherlands, MAID laws once limited to mentally competent, terminally ill adults now include adults and children with mental deficiencies, severely disabled individuals, and those with treatable psychiatric conditions such as anorexia and depression. Between 2012 and 2017, the Netherlands alone saw a 600% increase in euthanasia which was sought to address psychiatric conditions; conditions that the experts say cannot be determined to be irremediable.

So, this government has made a choice. This minister has claimed that this is only a pause. It cannot claim as a government that it stands as a champion for mental health treatment while simultaneously cheapening the value of that treatment and, indeed, human life itself.

The minister claims that MAID expansion can be done safely, but experts have been clear that expanding eligibility of medical assistance in dying to Canadians living with mental illness cannot be done safely. It is impossible to determine irremediability in individual cases of mental illness. This expansion will only blur the lines further between suicide assistance and suicide prevention.

Canadians cannot trust this Liberal and NDP government to protect the lives of our most vulnerable, including those who are simply asking for a hand in the seasons of need. Every action they have used for MAID since 2015 has achieved the opposite.

So, let us not further stigmatize those with mental illness by placing euthanasia ahead of other solutions. We need to reject a culture of death on demand and instead let us make Canada a champion for suicide prevention at all stages of life.

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

Mr. Speaker, I share my colleague's concerns. That is why I voted against the Senate amendment to Bill C-7 in the previous Parliament. I have been a member of the special joint committee on medical assistance in dying. It is very clear that Bill C-39 is necessary. We do need to have that delay in place.

The concepts we were struggling with at committee were individual autonomy versus protection of the vulnerable. I would like to get my colleague's thoughts on those concepts. What is his understanding of the capacity of a person who may have a mental disorder to make an informed consent decision and their own internal understanding of what they are going through?

This is a genuine question. I am genuinely curious as to what the member thinks about it because this is a really important debate that our country is having.

[Tracy Gray, Conservative, Kelowna—Lake Country, BC]

Mr. Speaker, it is an honour to rise this evening and speak to Bill C-39. This legislation aims to extend medical assistance in dying to those with the single underlying cause of mental illness for one year. If we do not approve of this legislation, it comes into effect on March 17.

I must begin by expressing my disappointment with the timing of the legislation before us today, with mere days before the House of Commons runs out of time to debate and vote on this, in order for it to go to the Senate to also be debated and voted on prior to March 17. This is the date that medical assistance in dying comes into effect for those with the single underlying cause of mental illness.

As it stands, this eleventh-hour legislation will only create a new arbitrary deadline of March 2024, replacing the present deadline of March 2023. There is no basis in science or evidence for this 12-month delay, only the shuffling of government timetables, although I am grateful that it will not take effect next month if all parliamentarians vote for this bill and it goes through the Senate.

This timetable was originally set, at the government's decision, when it accepted an amendment from the Senate to the original medical assistance in dying legislation, Bill C-7.

Despite the Minister of Justice initially expressing his concern at committee that medical assistance in dying could be done safely for those suffering from mental illness, he accepted that expansion upon amendment from the Senate and then shuttered debate on this issue when Bill C-7 returned to the chamber. He now returns to Parliament, trying to undo a problem that he started.

I will be voting in favour of this legislation, not because I think that the government has gotten this right but because if I do not support it, and if most members in the House do not support this legislation, medical assistance in dying would automatically become available to those suffering solely from mental health issues on March 17.

Abandoning people with mental illness to turn to medical assistance in dying instead is heartbreaking. When the Ontario Medical Association surveyed Ontario psychiatrists in 2021, 91% opposed the expansion of MAID for mental illness. Only 2% supported it.

The Special Joint Committee on Medical Assistance in Dying heard from a range of experts on the topic, clinicians, psychiatrists, and mental health advocates. They all expressed the same concern. Clinically determining that a patient will never be able to recover from a mental health challenge is impossible. It cannot meet end-of-life MAID criteria by any objective standard. Dr. John Maher, a clinical psychologist and medical ethicist, told the committee, “Psychiatrists don't know and can't know who will get better and live decades of good life. Brain diseases are not liver diseases.”

Canadians are rightfully horrified by news reports detailing the increasing prevalence of Canadians seeking MAID for circumstances for which it was never intended. Multiple Canadian military veterans who fought for our country, seeking help from Veterans Affairs, claimed to have been pressured by Veterans Affairs staff to consider medically assisted dying. It was reported that the matter was turned over to the RCMP for investigation and that the Veterans Affairs department was doing an internal review. A food bank manager from Mississauga reported clients asking about assisted suicide not for physical illness reasons.

Despite these stories, the government was undeterred in proceeding with its original March 2023 deadline. Thankfully, Canadians stepped in, phoned, emailed and wrote to every MP in the House. They called for us to think again on this matter and there was pressure put on the government. People were concerned about protecting the most vulnerable, and rightfully so. The legislation before us today is a sign of their efforts.

I was very touched by some of the correspondence from my own residents in Kelowna—Lake Country. I often try to be the voice of my residents in Ottawa.

Judith, in Kelowna, wrote to me with her concerns after hearing about the delay in the planned expansion of MAID for those with mental illness as the single underlying cause. She acknowledged that many people have brought forth many concerns to the government, and she was surprised that the Liberals were now just delaying the expansion.

Not every community has the same mental health services, especially rural areas. I was speaking in person to a young man last week who was movably shaken by the thought of medical assistance in dying being considered to be made available to individuals whose sole underlying condition is mental illness. His deceased mother had struggled with mental illness, and he was extremely angry to hear that the Liberal government had not cancelled outright the option for people to seek MAID under these parameters. Instead, this legislation delays it.

The public outcry and concern about this is really what forced the government to take this first step of MAID delay for people with the single underlying cause of mental illness. There are mental health stories from people I know or have met that I could share in the House, but I am not going to because I would not be able to get through them.

I do not want to give up on people, and the government is giving up on those experiencing mental illness. We must focus on giving people help and hope. We must focus on treatment for mental illness rather than assisted death. Conservatives do not want to give up on people.

As I said earlier, this legislation only creates a new arbitrary deadline. Parliament would be better served in our responsibility to Canadians, particularly vulnerable Canadians who feel lost in their lives, to abandon this reckless expansion of MAID to those with mental illness as the sole underlying condition. We cannot, and should not, give up on persons experiencing mental illness, and we must make it clear and ensure support is there for help and treatment.

Medical assistance in dying cannot be the most accessible solution for individuals with mental illness. Instead of bringing forth changes to expand MAID to persons with mental illness, the Liberals should instead be focusing on proposals to bolster mental health support for Canadians, many of whom are facing challenges in a postpandemic world and the impacts of the last eight years of the Liberal government, which has divided families and neighbours, and of its inflationary policies, which are squeezing peoples livelihoods.

The Liberals have failed to keep their pledge from the snap election in the summer of 2021 for a permanent multi-billion dollar mental health transfer to the provinces and territories, which was to ensure that they have the funding and support needed to expand mental health care. We are in a mental health crisis, yet the Liberal promise appears to have gone to the back of the line.

We have to remember that it was the Conservative member for Cariboo—Prince George who spearheaded a three-digit suicide prevention hotline in Canada, 988. All parliamentarians unanimously supported this motion in the House of Commons. This was over 900 days ago, and it still does not exist.

Now, that is not surprising considering the Liberals gave the task to their catch-all department, the Canadian Radio-television and Telecommunications Commission, the CRTC, to implement. What did the Liberals do instead?

They did not bring in legislation to cancel the implementation of MAID for those with the sole underlying condition of mental illness, they just delayed it. Building the mental health support systems Canadians need to live healthy, fulfilling lives will be a top priority for Conservatives in this Parliament and a future Conservative government.

People deserve mental health resources to help them. People deserve hope. Families deserve hope. This is what we will be focused on.

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

Mr. Speaker, right before Parliament resumed following the Christmas break, countless Canadians participated in Bell Let's Talk Day. They took the opportunity to talk about mental health, raise awareness, share stories and remind each other that it is good to offer or ask for help whenever it is needed. There are many members of Parliament from all parties who have joined this effort, and it is only fair to assume that they have done so because they sincerely wish to help people.

Every year, after the day comes and goes, it helps us realize that promoting mental health is actually a huge task and it is easier said than done. Over time, there has been some progress with how we approach mental health, but it can sometimes be discouraging to see that we still have to deal with some of the lingering problems or to know how much work there is left for us to do. It puts everything into perspective and shows that the results and decisions we make about an issue are more important than just talking about it.

In that light, Bill C-39, along with the larger issue surrounding it, is a real test for us. It forces us to consider what exactly we mean when we say that we want to promote mental health. Unfortunately, we are looking at a government bill that signals that we are going to take a wrong turn and fail vulnerable people who are suffering with their mental health. In a way, it is good to see Bill C-39 come forward, but it should also be clear that it is not good enough. At the very least, there will be a year before this new change takes effect, but that is nothing but a brief delay of the inevitable instead of reversing a terrible decision.

What is going to happen a year from now? Is the government going to bring another bill like this one forward to delay it another year? Will all the major problems raised by the provinces, professionals, advocacy groups and concerned citizens miraculously get resolved before the year is over? How is that even realistic? Does the government really expect Canadians to believe that?

The timeline is obviously ridiculous. It does not make sense practically and, more importantly, it will not take care of the issue at stake in the first place. There might be different views on assisted suicide for mental illness as the sole condition, but no one on either side of the debate can seriously say that it has been carefully considered in this country, if such a thing were possible. Instead, the whole process has been rushed and incomplete.

If the Liberals truly cared about making the right decision, the new legislation would be quite different. Even on their own terms, they will not be any more ready for the coming change next year than they would be if it was next month. It was only public pressure that made them slow down, but it is not going to stop them entirely. Clearly, they are planning to go ahead with the plan and hoping to get away with it again next spring.

It is highly irresponsible if we take a step back to consider the larger issue. First, I will look at this bill as it has been presented to us. We normally do not have to think too much about the official title of a bill as it comes through Parliament, but in the case of Bill C-39 it does matter, and it might even be fair to say that its name is somewhat misleading. It says that we are amending the Criminal Code related to the medical assistance in dying system, but that is only a technicality. In reality, this bill is not touching the substance of Bill C-7 as it was passed in the last Parliament. All it would do is delay the implementation of Bill C-7 or the aspect of the expansion for one year. That is definitely not a helpful or encouraging response to what Canadians and experts have been telling us since Bill C-7 became law, both inside and outside Parliament.

When Bill C-7 passed in 2021, 91% of Ontario psychiatrists opposed the expansion of euthanasia, but they were ignored. The government has not bothered to listen to critical advice and feedback. Make no mistake, there are ordinary citizens across the country who are horrified when they learn of what is happening here with expanding accessing to MAID for mental illness. I have heard from a lot of people in my own riding who are concerned. They came up to me at hockey rinks. They came up to me at my various town halls that I hosted over the winter break and told me how unimaginable it was for this is to happen in Canada.

There has been the same reaction around the world when people in other countries found out what has happened here in Canada. We stand out compared to other places that offer assisted suicide, and not in a good way. International media coverage shows how Canada's reputation has suffered as a result. It is long past time for the government to get outside of its bubble and hear what Canadians are thinking and feeling. Despite the Minister of Justice trying to claim that our system has strict safeguards, we need to look around and realize that something is not going right.

Canada reported 7,300 deaths in 2020 and 10,000 deaths in 2021. It is interesting that if we compare with another jurisdiction, it gets even more troubling. The state of California started to allow assisted suicide the same year that we did in 2016. The size of its total population is similar to that of Canada, yet it only reported 495 deaths in 2020 and 486 deaths in 2021. The difference in proportion is striking.

People see these numbers and they cannot believe that this government is considering expanding access even further to people with mental illness as a sole condition. They cannot help but wonder if these people are already slipping through the cracks and are caught up in the numbers we have here in Canada.

If we want to understand the background of how we found ourselves in the situation today with Bill C-39, we need to recall what happened with the previous bill. Back then, this Liberal government brought forward a piece of legislation that was a significant expansion from the way MAID was originally set up a few years before. It allowed assisted suicide for conditions where natural death was not reasonably foreseeable.

At the time, we heard overwhelmingly from many advocates, organizations and members from the disability community who were deeply concerned about the government's new direction. They pointed out the flaws and the risks involved for people with disabilities who could find themselves in a vulnerable position, and experience abuse rather than receiving the support and the resources they needed. They also worried about the stigma and the message it could send to the disabled as well as to wider society. It was clear that it would not be unacceptable for anyone, whether they live with a disability or not, to get the impression that these human lives are inferior or not worth living.

Here we are seemingly caught in a similar position once again. It was shocking when the Liberals accepted the last-minute amendment to include mental health as a condition for assisted suicide. Since then, they have had time and opportunity to reconsider, but they refuse to listen and protect the lives of vulnerable Canadians. If government members do not put a stop to the expansion of MAID for mental health, it will be impossible to take them seriously when they try to talk about a mental health crisis.

I want to take a moment to talk about Michael Landsberg, who spoke very passionately about mental health a number of years ago, and I consider this man to be a pioneer and a trailblazer.

Michael Landsberg was the host of Off the Record on TSN. Mr. Landsberg has a foundation called “#SickNotWeak”. A big part of what he talked about 20 years ago, and what he talks about today once again, is the stigma that people with mental illness quite often face and that people with depression face. When we look at the disability community and what we talked about earlier with the stigma around them, we are seeing that happen again for people with mental illness. I think it is important that we look at the stories of people like Michael Landsberg who has spoken so clearly and passionately around making sure that we do not provide harmful stigma for mental illness. When we look at the statistics that I quoted earlier, there is a real and present danger here if we do not address this properly while we have the opportunity.

Across the country there is a lack of mental health support, especially in rural ridings like mine. It is absolutely shameful to offer death as a solution. While Bill C-39 brings a pause in this expansion, it is inappropriate to use it as a selling tactic with the hope that public opinion will shift to their direction in the meantime.

However, a delay is not enough. We need to exclude mental health as an eligible condition for assisted suicide. This government must stop and review what it has done with the system. If not, it only shows that it is untrustworthy. There has been no sign of meaningful reflection about its previous legislation. Because of this, it has failed to reassure Canadians about further changes. We talked about the safeguards earlier; people are wondering if they even exist.

How can we ignore the veterans who are offered MAID instead of mental health support? How can we proceed when we have seen people in poverty and distress offered it against their will? These types of reports are coming far too often, and we cannot say that we had no warning. The predictions of experts and from many of us here on the official opposition have been proven to be correct so far. If this expansion happens in March 2024, how can anyone possibly pretend that these problems cannot get much worse?

Because the Liberals will not do what is necessary, one of my Conservative colleagues has taken the initiative to introduce a bill that will remove eligibility for mental illness. It would give us another chance to prevent this catastrophe, and I hope my colleagues support it.

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

Mr. Speaker, I want to begin by thanking my colleague, the hon. member for Kitchener Centre, for such a thoughtful speech, one that anticipates much of what I want to say.

We have not done enough in the year since Bill C-7 passed to know with any degree of certainty that we have lived up to our obligations when passing that act to fully study what it would mean to extend medical assistance in dying to those who are dealing with deep suffering that comes from a mental health issue, not from a medical diagnosis of traditional medicines, such as ALS, cancer or the other cases that moved us forward on this trajectory.

I want to briefly canvass what brought us here and the way in which the Parliament of Canada and the Supreme Court of Canada have dealt with medical assistance in dying, and I want to suggest, in closing, that when one looks to the Supreme Court of Canada for guidance, I do not believe we can say that the Supreme Court of Canada's guidance takes us to the availability of MAID in cases of deep mental health distress.

Going way back, as the member of Parliament for Saanich—Gulf Islands, I want to reflect on one of the champions, heroes or, as one might even say, martyrs on the issue of access to medical assistance in dying. I speak of Sue Rodriguez. She lived in North Saanich, in the electoral district that I am honoured to represent. She had ALS. She famously said, “[W]hose body is this? Who owns my life?” She went all the way to the Supreme Court of Canada back in 1993 in an effort to get access to the alleviation of suffering from a disease that would kill her. This was not in doubt. However, the Supreme Court of Canada, in 1993, denied her request.

As others have mentioned in this place over the last couple of days of discussion, a colleague and friend of many of ours and a dear friend of mine, Svend Robinson, stayed with Sue Rodriguez when a doctor assisted her illegally, and she took her own life, with the doctor's assistance, in probably the first public case of medical assistance in dying in Canada.

The courts took a long time to change, and that decision in 1993 was not changed until 2015 in the Carter case. In the Carter case, the Supreme Court of Canada found, taking a different view, that the charter rights in section 7 to life, liberty and security of the person were violated by not allowing a person to make such a decision and to have access to medical assistance in dying. The Carter case changed things by putting squarely to the Parliament of Canada that it had to deal with this.

I will quote from the Carter case. The Supreme Court of Canada said, “competent adults who seek such assistance as a result of a grievous and irremediable medical condition that causes enduring and intolerable suffering”. That was the basis for creating legal access to medical assistance in dying.

When Bill C-14 went through, I tried so hard to put forward amendments saying we have to allow advance directives. It was not right not to allow them for someone who knows they are terminally ill and are facing incredible suffering. It is their choice and they should be able to access medical assistance in dying with an advance directive. However, back when Bill C-14 went through, this was rejected. My amendments were rejected in the House as well. Similar amendments were then passed in the Senate, and we all recall it came back here without those amendments having been accepted.

Bill C-7 repaired that but opened the door to something entirely different. I do think it is entirely different to say that when people are suffering incredibly and intolerably due to a deep, chronic and unsolvable mental health condition, they should also have access to medical assistance in dying.

I will go back and say what the political promises were when we started down this road. I first want to address the medical conditions.

When Bill C-14 was first debated, a lot of members in this place were asking about palliative care: Would people choose medical assistance in dying if they had the option for palliative care? We heard many promises from the government benches that we would see increased funding for palliative care. That has not happened. That is one thing that concerns me greatly.

We have also heard, since we passed Bill C-7, that there would be more supports for mental health. That has not happened either.

What would we do if we were serious about making sure that every Canadian could exercise, fully, their rights, under section 7 of the charter, to life, liberty and security of the person?

At least, one would know that the health care system should be working well. I am pleased to see that the premiers accepted the federal offer today. I hope that the federal government will defend our public health care system with every ounce of its energy and make sure that the deals with the provinces are specific and tied to outcomes and results.

However, our health care system is in trouble. I was just talking to an incredible indigenous woman. I will not say her name; it was a private conversation. She is Cree. She lost a dear friend recently because that Cree dear friend could not get access to medical care in time to diagnose and treat her cancer. She leaves two small children behind.

The health care system in the country is not equal, any more than the litany of deeply racist and distressing conditions in which the system works against justice for indigenous peoples. We all know it. In the context of the health care system, how can we not know it?

In terms of mental health care supports, we know even more deeply that the suicide rates among youth in this country are a huge source of concern. We know that mental health issues have been worsened among our youth, through the pandemic, through isolation, through all kinds of things, through being preyed on by social media.

We know that our schools, universities and post-graduate programs are failing young people because they cannot get the mental health supports that they need when they need them. They need help to avoid addictions and to kick addictions. Our young people need so much help and we are failing them.

Opening up MAID is not a solution to solvable mental health care issues where we are just falling down on the job because we are not providing the mental health supports that we have promised over the years.

What would we do if we wanted to be serious about section 7 rights? We would bring in a guaranteed livable income, to ensure that no Canadian is living in poverty, poverty being the number one social determinant of ill health, in terms of physical health and mental health. We would address poverty and end it through guaranteed livable income.

We would do more, as I mentioned, for the end-of-life issues and access to palliative care. There is such a thing as having a good death. We do not like talking about death in our society. We are all supposed to be young and preferably sexy forever. Let us face it: people get old and it is a lovely experience. It is a good thing to be healthy in old age and enjoy it right up to the moment when whatever one thinks is going to happen to oneself happens: meet one's makers or feed the worms, whatever. A good death is a good thing.

Medical assistance in dying does give people that option of a good death, surrounded by family, feeling loved. I am very supportive of the work that we have done in Bill C-14 and half of what we did in Bill C-7, but where are the mental health supports?

Again, to the point that the hon. member for Timmins—James Bay made, I totally agree. I say yes to housing, to supports and to ending poverty.

However, I do think that we have to explore and open up. In the next year, let us get serious at looking at non-traditional therapies for people dealing with what appears to be irremediable depression. Do psychedelics make a difference? I am not going to prescribe. As the hon. member for Timmins—James Bay said, do not take health advice from politicians.

However, the evidence is coming in on using such products as psilocybin to actually trigger something that results not just in a bit less suffering and mental health conditions. There are certainly papers out there that are peer-reviewed and very interesting, that one can cure depression. I certainly would not want to turn my back on a potential cure and then embrace medical assistance in dying for people who could be cured.

Neither do I want to turn my back on people who are suffering and who are saying that we are making them wait another year and asking why we are doing that. These are not easy issues but these issues, life and death issues, are at the heart of the sacred and they are at the heart of our work in Parliament.

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

Mr. Speaker, I agree with my friend from Kitchener Centre that there is obviously a need to invest more heavily in mental health supports.

Looking at how medical assistance in dying has evolved in the last seven years, as well at the way that Bill C-7 brought forward the issue of mental health as a sole underlying condition and where we are at today, can my colleague reflect on whether we are moving at the right pace or moving too fast? I think what I heard from him is a suggestion that we are moving really fast, but we are moving based on the science that is available. In fact, the expert panel report suggested that we are in fact ready to move forward. Could he comment on the available science on this issue?

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

Mr. Speaker, I want to thank the hon member for Timmins—James Bay for such a heartfelt and sincere exploration of how it has made all of us feel in this place. I remember feeling entirely conflicted on the vote on Bill C-7, because I could not see how we could deny advance directives for people who had a terminal diagnosis and were told they had to wait for the day of their MAID procedure, and be of sound mind and confirm.

We knew that people were actually choosing MAID procedures earlier than they needed to because of the failure to have advance directives in Bill, C-14. I know, as I did vote for Bill C-7, that I was approving something to come into place automatically by default that I thought was wrong, so I thank the hon. member.

Has the member ever explored the ideas of things like psilocybin? There are mental health illnesses where the psychiatry profession says there is no hope for a person, they are chronically depressed and nothing will ever lift them out of it. Does the hon member for Timmins—James Bay have any thoughts about what other medical procedures could assist in lifting people out of the deepest of despairs?

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, I appreciate the opportunity to speak here today to an important bill.

We have to ask ourselves: why are we here this evening debating Bill C-39? What brought us to this place?

What brought us to this place was a government, once again, that had acted completely irresponsibly and with great overreach, ignoring the experts, ignoring Parliament and ignoring the most vulnerable.

We will back up a little bit. Bill C-7, which expanded medical assistance in dying in this country, went through the House of Commons and went through our committee, the justice committee.

Accompanying any piece of government legislation is a charter statement from the Minister of Justice and Attorney General of Canada. A charter statement is the government's certification that the legislation complies with our Canadian Charter of Rights.

I want to read, just briefly, from that charter statement. The minister's charter statement stated, for Bill C-7, that it excluded individuals with mental illness from eligibility to access MAID, because of:

the inherent risks and complexity that the availability of MAID would present for individuals who suffer solely from mental illness. 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.

At the time, the minister said that there was not the public support nor was the infrastructure in place to allow medical assistance in dying for individuals whose sole underlying condition is mental illness.

The bill, Bill C-7, then goes to the Senate, the unelected Senate. The Senate amends the bill to include mental illness with no safeguards, no accounting for the fact that it was an extreme broadening of Canada's MAID legislation and would, in fact, lead Canada to become an outlier.

That bill came back to the House and was passed by the government, with the opposition from our Conservative caucus members. Conservative parliamentarians were strongly opposed, because we knew that MAID should not be expanded to those who are suffering with mental illness.

When we are reaching out to those who are struggling, for example through Bell Let's Talk, and I see members of Parliament posting that on their social media, the terrible message that it sends is that we as a Parliament think that, for those suffering with mental illness, offering them death should be an option.

One may say, well, that is not what this is about. Unfortunately, that is exactly what it is about. It is already happening. Many of us were horrified to hear of bureaucrats from the Canadian government in a department to which we entrust vulnerable veterans, veterans suffering with post-traumatic stress disorder. Can one imagine the family of a veteran who goes to Veterans Affairs for help and, without even mentioning the issue, is offered the opportunity to explore medical assistance in dying, when they are suffering from PTSD?

Imagine how that would make one feel, for someone who is struggling and who is trying to stay motivated to stay alive. The Minister of Veterans Affairs said that this was a one-off, that this was just one problematic situation.

Unfortunately, we found out that it was not a one-off and that it had happened many times, an untold number of times. We do not know how many times it happened. This is before medical assistance in dying is officially expanded to those suffering with mental illness.

Why are we here today? We are here because the Minister of Justice supported this and pushed this forward in spite of, we know, the Liberal caucus members who are very uncomfortable with this, because they know it is wrong.

Just today, we read an article saying that only three in 10 Canadians support the idea of allowing patients to seek MAID based purely on mental illness. Seven in 10 Canadians, the constituents that these Liberal caucus members represent, do not support this going forward.

The Minister of Justice said, in the same article, “To be honest, we could have gone forward with the original date, but we want to be sure. We want to be safe. We want everybody to be on the same page.”

The government is saying that it needs everyone to think like it does and that everyone needs to warm up to the idea. We do not accept that. We are going to continue to fight for the most vulnerable. This is happening right now in Canada. It is very upsetting for many of us.

Then we read, in the same article, of a report that noted that an Ontario man recently made news after he requested MAID, not because he wanted to die, but because he thought it was a preferable alternative to being homeless. A disabled Ontario woman also applied for MAID after seven years of applying for affordable housing in Toronto with no luck.

The abuse of this system is happening in real time. It is happening now. Because of the passage of the amended Bill C-7, we were set for next month to have, without any safeguards, those suffering from mental illness be eligible for MAID. Bill C-39 is the government's attempt to kick this down the road another year.

Where have we seen these U-turns? We saw them with Bill C-75 on bail changes. The government overstepped, and now it is reversing course. On the gun legislation, the government realized there was a big overreach, and now it is time to climb down from that.

Canadians suffering with mental illness deserve better. They deserve a thoughtful approach. I stood in the House not long ago, back in October 2020, and Parliament was observing mental health week. Unfortunately, at that time, parliamentarians did not know that the Liberal government would soon include mental illness in its planned expansion.

The point in that speech was that one of the key foundations of Canadian society, in our collective identity, is that we are a caring and compassionate country. Canadians, many in this chamber, do not see anything caring or compassionate about making people who are living with mental illness eligible for medically assisted death.

What message does it send to Canadians who live with mental illness? They are not people who are at the end of their lives. These are not people who would otherwise die. Why is the Liberal government pushing to include them in its medical assistance in dying regime?

The president of the Canadian Medical Association said, “We have a responsibility, we believe, as physicians and as society, to make sure that all vulnerable Canadians have access to proper care and the support they need.” I listed two scenarios, and we all have these scenarios in our ridings of individuals in need who are not getting the help they need.

If we have not succeeded to make sure that every Canadian living with mental illness has access to timely mental health care or adequate support, how is it that the government and the minister were comfortable in proceeding with broadening medical assistance in dying in such a radical way to take effect next month? All this despite the fact that this radical expansion of MAID was passed in early 2021. Conservatives have not given up the fight to do what is right and to protect vulnerable Canadians. We will not give up that fight.

The government failed to conduct a mandatory review of its own MAID legislation. That was supposed to happen, and it did not happen. The minister was to complete a charter statement. He did that on Bill C-7. The Bill C-7 charter statement very clearly rationalized why individuals suffering with mental illness were not included in Bill C-7. That is how they arrived at the constitutionality of the bill.

With this massive change, we do not see the updated charter statement. We do not hear the minister talking about the charter rights of those who are suffering. This is remarkable because the statement was written over two years ago.

A few days ago, more than 25 legal experts signed a letter addressed to the Prime Minister and members of the cabinet, challenging them to do better on this.

This expansion is wrong. Conservatives will support extending the coming into force by this year, but in that time, we will not give up the fight to protect the most vulnerable.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Madam Speaker, as always, it is a true honour and privilege to stand here in the House of Commons to represent my beautiful community of Peterborough—Kawartha.

Today we are debating Bill C-39, an act to amend the Criminal Code in terms of medical assistance in dying, which I will refer to as MAID for the remainder of this speech, and extend the exclusion of persons living with mental illness from being eligible to receive MAID beyond March 17, 2023.

We are going to need to rewind a bit to paint a picture of how disturbing this legislation, conversation and ideology are. In December of 2021, without any consultation, study or discussion, the Senate added an amendment to Bill C-7 to make people with mental illness eligible for MAID. This is gravely concerning and indicative of the Liberal government's recklessness to add such a serious amendment, which targets the most vulnerable, without due diligence of study and consultation with experts.

Instead of recognizing the undemocratic and dangerous way the amendment was added and scrapping the entire thing, which should have been what happened, the Liberals' proposal is simply to extend the deadline with an arbitrary date.

The MAID special joint committee was created after the amendment was added. How backward is that? The committee heard testimony from many experts, including Dr. John Maher, clinical psychiatrist and medical ethicist, who said, “Psychiatrists don't know and can't know who will get better and live decades of good life. Brain diseases are not liver diseases.”

Of course, today I will support this bill, but let us call it what it is, which is window dressing for a much bigger ideological problem. We do not need to extend the timeline of this bill; we need to get rid of making those with mental illness eligible for MAID. We need to call out the Liberals for not providing a dime of their promised $4.5 billion to the Canada mental health transfer. We need to ensure people at home watching know we are working diligently to give them timely access to treatment and recovery when they are willing to get it. That is what we need to be doing.

I urge every member in this House to listen to their constituents and recognize how dangerous the message is that we are sending to those struggling. I encourage every member in this House to support Bill C-314, which was introduced last Friday by my colleague from Abbotsford and would solve this problem instead of prolonging and dragging out an amendment that should never have been put there in the first place.

It is difficult, if not impossible, in the case of mental illness to determine whether someone can recover, get better or get healthy. Therefore, one can appreciate how dangerous a bill like this is.

I am going to read into the record a letter that was recently sent to me.

It reads:

“Dear Michelle Ferreri,

“My name is Kayla. I am going to be sending this letter to several MPs, but as you are the MP presiding over the constituency where I reside, I thought I should send this to you first. I am very troubled by something that is going to be happening very soon in this country, and I hope you will listen to what I have to say.

“Overall, I am a very healthy individual. I have a mental health condition, but it is my sole medical condition. However, I was mortified to discover last month, that medical assistance in dying (MAID for short) will be available to people whose sole health condition is a mental health condition as of March 17, 2023.

“Persons who suffer from mental health conditions suffer horribly. I know that. I have suffered with mine for nearly 12 years. Perhaps the most appalling things of all are that ‘The law no longer requires a person's natural death to be reasonably foreseeable as an eligibility criterion for MAID,’ (Government of Canada, 2021) and ‘There is no obligation for a person or their health care practitioners to inform family members if that person has requested or received MAiD.’ (CAMH, 2022).

“I think you are an intelligent person, Michelle. I think you see this for what it is. As of March 17, 2023, I will be eligible to end my own life on the basis that I have an incurable mental illness. Let me give you a bit more background: I have two university degrees, in biology and environmental science. I have a job that I love and have held since a little while after I graduated. I have never failed to pay taxes, nor have I ever taken extended leave or gone on EI due to my mental illness, no matter how hard it gets. I have family and friends that I love dearly, and they love me too. And yet now my own government has deemed my life not worth living. This just isn't unfair. This is monstrous.

“But it gets worse. What about those people who are in the same boat that I am medically, but are much, much worse off. They cannot pay their taxes because they cannot work. They have a substance addiction. They are veterans with PTSD. They are homeless because they cannot seem to fight off their demons. These are some of the most vulnerable people in our society. To say nothing of the nature of the 'mature minors' (whatever on Earth that means) that will be able to access MAiD in the future if this doesn't stop.

“Make no mistake. This thing that we dress up with a nice name 'MAiD' is euthanasia of our most vulnerable people because they cannot 'contribute to society' like others can. The fact that the government would offer to get them out of the way (read: convince them that they should die) in this way, just because the systems that the government put in place are failing them is an unspeakable evil.

“I hope, Michelle, that you will do everything in your power as an MP, as I will do everything in my power as a citizen, to abolish this law. I understand the federal government is seeking to push back the timing of this law, likely because it has received so much criticism. I understand that it likely wasn't you that made any of the decisions for this law to go ahead. But I also understand that you are in more of a position to do something about it than many other people are. I hope you will respond after reading this letter.

“Sincerely,

“Kayla.”

I did talk to Kayla, and it was a heartbreaking conversation. She is living very well, and I would like to give Kayla a round of applause for being so brave as to share that. This letter says everything Canadians need to hear. We need to be sending a message of hope and recovery, not a message that their life does not matter.

I leave members with one final story. Elyse is a young university student and she chatted with me during the Christmas break. She said she needed to tell me something. She said she was so worried about this legislation to extend MAID to those with mental illness. She said that she had struggled with mental illness and knew with certainty that if someone had offered that to her during her times of illness, she would not be here today. She told me that she would not be getting her university degree; would not be in a happy, healthy relationship; and would not know that her life is worth living.

We have a duty in the House to bring hope and create legislation that provides a better life for Canadians. A better life means access to help when they need it. I urge every MP in the House to listen to the experts and Canadians, and not just extend an arbitrary deadline, but drop this dangerous and reckless legislation. To everyone at home watching, including families who are supporting those with mental illness and those who are living with mental illness, we see them. They are worth fighting for, and their lives are worth it.

[Ed Fast, Conservative, Abbotsford, BC]

Madam Speaker, I am pleased to be able to join this debate.

The underlying legislation of Bill C-39 is very simple. The government is simply asking that it be given more time to introduce safeguards, guidelines and professional practices that would allow assisted deaths to be administered in such a way that mistakes are not made. However, we already know that mistakes are being made under the current regime, so that should not give Canadians any confidence. In fact, Bill C-7, which is the bill that has given rise to this request for an extension, is just another case of the Liberal government getting it so wrong by failing to consult in advance and then, after the fact, trying to fix all the mistakes and fill in all the gaps.

This is another story of failure, and what I would like to do is explain a bit of the context. Members may recall that back in 2015 the Supreme Court of Canada, for the first time, opened up the door to legalized assisted suicide, and the Liberal government then responded with Bill C-14, which restricted MAID, or medical assistance in dying, to those who were at the end of their lives and living in intolerable, grievous pain. We were assured this was not a slippery slope that was intended to include other vulnerable Canadians in Canada's assisted death regime. That is what we were told. Many of us did not take the government at its word. We did push back, but the government passed the legislation anyway.

Sure enough, here we are, some eight years down the road, and our fears were confirmed when the Quebec court, in the Truchon case, ruled that limiting MAID to those whose natural death was reasonably foreseeable was unconstitutional. The government did not appeal that case, a seminal case because it is opening up a life-and-death piece of legislation and expanding it without a reference to the Supreme Court of Canada. I believe that was an abdication of responsibility in itself. Instead, the government chose to accept the ruling and move forward with Bill C-7, which ended up extending MAID to include, among others, the mentally ill.

I want to be clear here. I do note that the original Bill C-7, which was introduced by the justice minister, did not include the mentally ill in Canada's assisted suicide regime. However, when that piece of legislation, Bill C-7, went to the Senate, the other place, the senators inserted a provision expanding and extending assisted suicide to the mentally ill in Canada. When it came back to this House, the government, instead of pushing back, the way one would expect a government to do, simply rolled over and said it would accept it the way it was, and that is now becoming the law of the land.

Bill C-7 also provided that the mentally ill provisions of Bill C-7 would come into force in two years. That is the sunset clause some people talk about. During that period of time, proper safeguards and practice standards were to be put in place to ensure that mistakes were not made. Not surprisingly, as it is a Liberal government, it got to the end of the two years, and virtually nothing has been done. The government actually struck an expert panel to review this, but it did not give that panel the right to review the merits of the underlying assisted suicide regime in Canada.

There is also a joint parliamentary committee between the Senate and the House that is still reviewing these provisions, and I am looking forward to that report. However, again, the mandate of the committee did not include any real, substantive review and investigation into the substance of medically assisted suicide. All it was allowed to do was tinker around the edges to implement a policy that has life-and-death implications for many Canadians.

Here we are. We have no safeguards and there are no guidelines for our practitioners, but we support the bill because we are trying to push this down the road as far we can. I will mention why in a moment.

The woefully inadequate rollout of the government's MAID regime is a manifestation of a Liberal government that appears to be in disarray and whose ideology is moving Canada from a culture of life to a culture of death rather than providing the necessary resources to our most vulnerable. Many in the House have raised that issue and have asked this: Why is it even necessary to apply assisted suicide to the marginalized in Canada, the vulnerable? They ask because right now we are not providing them with the resources and supports they need to live a satisfying and joy-filled life.

What is really of concern is that numerous stakeholders have said they oppose Bill C-7. By the way, there is no broad consensus in Canada that we move forward with assisted suicide for the mentally ill. There is some consensus for MAID to be in place for other cases where there is extreme pain involved, but Canadians do not support extending it to the mentally ill.

What is also of concern is that the government has now signalled that it will go beyond the mentally ill and would like to include mature minor children in this regime. The government is charging ahead with a life-and-death policy that has increased Canada's momentum down the slippery slope that we had warned of.

Is death now seen as a more cost-effective way of managing the most vulnerable in our society? Many have posited that this is the case now. Canadians have a right to question whether their government can be trusted on issues of life and death. If this is being extended to the mentally ill and to mature minors, what about the indigent? What about the homeless? What about the drug addicted? What about veterans? We know that veterans have already been counselled by the government to consider MAID as an option to serve their needs and provide them with support. We know that people who are arriving at the food banks are asking where they can access MAID, because they do not want to live in poverty anymore. That is a reflection on us as parliamentarians. It is a reflection on our country, and we can do better.

There is, however, some good news, and I will end with it.

I recently tabled a private member's bill in the House, Bill C-314, the mental health protection act. It would reverse the Liberal government's reckless acceptance of the unelected Senate's assisted death amendments. It would arrest the dangerous momentum that the expansion of medically assisted death has triggered on the slippery slope. Under my bill, Canadians whose sole underlying medical condition is a mental disorder would not qualify for MAID. At the same time, the preamble to my bill calls upon the government to finally deliver the mental health supports that have repeatedly been promised in federal budget after federal budget but have never been delivered. This is the least we owe to those who struggle with mental illnesses such as depression.

In closing, to ensure that we do not implement the mental health provisions of Bill C-7 before the House has an opportunity to revisit my piece of legislation, we on this side are very supportive of moving forward and passing the bill expeditiously. It will buy another year and push the whole issue of the mentally ill down the road, and we will make sure that we implement private member's legislation that actually protects the most vulnerable.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Madam Speaker, it is important to outline what we are talking about here today: Bill C-39. Currently, due to Bill C-7, the Criminal Code explicitly states that, when it comes to MAID, mental illness is not to be considered an illness, disease or disability. However, when Liberals passed Bill C-7 two years ago, it had a sunset clause, and this is an important clarification. That means an important guardrail protecting those with mental illness from being eligible to seek MAID during times of depression or other crisis would expire two years after that bill passed, which means it is set to expire next month.

Now the Liberals, having heard the outcry from across the country, from the medical community and those serving the folks with mental illness, have introduced Bill C-39. This is a last-minute attempt to save face by extending the prohibition on MAID for mental illness for one more year. That is not good enough.

Conservatives have been united in our opposition to expanding the Liberal government’s medical assistance in dying regime to Canadians with the sole underlying condition of mental illness. We do not believe that medical assistance in dying is an acceptable solution to mental illness and psychological suffering. Our health care system should help people find hope when they need to live and not assist in their deaths.

Allowing MAID for people with mental illnesses such as depression blurs the line between suicide assistance and suicide prevention. Experts have been clear that expanding eligibility for medical assistance in dying to Canadians living with mental illness cannot be done safely. It is impossible to determine the irremediability of an individual case of mental illness.

For example, Dr. Sonu Gaind, who is the physician chair of the MAID team at the Humber River Hospital in Toronto, where he is chief of psychiatry, states, “I know that some assessors think they can make those predictions of irremediability in mental illness, and some assessors think they can separate what we consider traditional suicidality from what’s fuelling psychiatric MAID requests. And on both counts they’re wrong. The evidence shows that.”

Andrew Lawton, Canadian columnist and journalist, wrote a harrowing personal article two years ago, stating:

If Bill C-7 were the law of the land a decade ago, I’d probably be dead....

In 2010, I nearly succeeded in committing suicide. My battle with depression was worsening, and I was losing. Miraculously, I pulled through: I count my lack of success in that attempt as my happiest failure, for which I’m grateful to God’s intervention and a team of dedicated healthcare practitioners.

It’s saddening to think that under different circumstances, these practitioners could have been the ones killing me rather than saving me....

Bill C-7 undermines years of attention and billions of dollars of funding to bolster mental illness treatments and supports, including, ironically, suicide prevention and awareness campaigns and programs.

This bill kills hope and reinforces the flawed belief afflicting those with mental illness, that life is not worth living and that one’s circumstances cannot improve.

Every time I have risen to speak on these bills, that has been my emphasis as well: Life is worth living. Every life has dignity and value. We need to be far better as a nation at communicating that to those who need to hear it the most.

Two years ago my friend Lia shared her story with Canadians. She said, “I was 15 when I first tried to kill myself and I attempted suicide seven times in the years that followed...I’m speaking about my mental health struggles because I’m scared that doctors could soon be able to end the lives of people suffering with mental illness - people like me. To be honest, if medically assisted suicide had been available when I was in university, I would have used it to end my suffering as soon as I could.”

This is Lia's call to parliamentarians: “I don’t need someone to tell me how to die, I need someone to tell me to stay.”

The House should be writing laws that instill the value of life and that there is no question this is what we value. Laws need to encourage people to stay rather than seek to end their lives.

Dr. John Maher is an Ontario psychiatrist and editor-in-chief of the Journal of Ethics in Mental Health. Dr. Maher has highlighted that the wait times for mental health treatment in Ontario programs are up to five years long, and that one of his patients recently told him that he would like assisted suicide because he believed that nobody loved him.

Dr. Maher also rejects assisted suicide as a solution for mental illness by stating the following:

You're assisting someone in the completion of their suicide. The doctor is the sanitized gun...I'm not at all disagreeing that there are people who have an irremediable illness. What I defy you or any other person in the universe to prove to me is that it's this person in front of you.

The suicide prevention community has also pointed out the harsh reality for costs. Shawn Krausert, the executive director of the Canadian Association for Suicide Prevention, testified at committee and said the following:

Ending the life of someone with complex mental health problems is simpler and likely much less expensive than offering outstanding ongoing care. This creates a perverse incentive for the health system to encourage the use of MAID at the expense of providing adequate resources to patients, and that outcome is unacceptable.

Most Canadians do not support expanding MAID to those with mental illness as the only underlying condition. Today, a survey was published in which a mere 30% of Canadians support MAID for those who have a mental illness.

I can assure members that, among my constituents, that number is far lower. The vast majority of my constituents want the federal government to focus on helping people live well and to invest in palliative care and suicide prevention instead of assisted suicide.

Some of the petitions I have tabled here over the years were sent to me by constituents who have recognized that suicide is the leading cause of death for Canadians between the ages of 10 and 19. They are specifically calling on the government to protect Canadians struggling with mental illness by facilitating treatment and recovery, not death.

I agree with my constituents, and the majority of Canadians, that the government should withdraw this bill entirely and table a bill that permanently removes the extension and expansion of assisted suicide for mental illness when it is an underlying condition.

I want to end with some words from my friend Lia. She says:

I want to say right now, to whoever might need to hear this: death doesn’t have to be the answer. It takes work. It takes time. It takes others. And it's complicated. But there is hope...I’m sharing my story because I’m not the only one who has more to live for. There are people in your life who do too. As someone who struggles with mental illness, I don’t need someone to tell me how to die. I need someone to tell me to stay.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I commend my colleague who is a member of the Special Joint Committee on Medical Assistance in Dying.

I would just like to provide her with a bit of context. Bill C‑7, which is the fruit of a compromise with the Senate, was meant to respond to a requirement in a court ruling to allow Ms. Gladu and Mr. Truchon to have access to medical assistance in dying.

No one in Quebec considered the passage of Bill C‑7, which allowed Ms. Gladu and Mr. Truchon to have access to medical assistance in dying, to be reckless. There was a consensus on it. It needed to be passed. We passed it while creating a special panel of experts that was meant to table a report within two years to inform a joint committee, which was tasked with reviewing the report and making recommendations that would come later.

We have to be careful when we talk about rushing things. Let us take our foot off the gas. By March 2024, we will have been thinking about this for three years.

What is more, when my colleague says that the public is not on board, I would like her to show me some polls to support that claim. In any event, the current problem is that her party wanted the committee to table a report in June because the Conservatives were against giving the joint committee any extensions on its deadlines so that it could do a good job. Each time, we fought for an acceptable deadline to do decent work. I think they are being a bit hypocritical.

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

Mr. Speaker, it is an honour to stand to give my thoughts on Bill C-39. For those who are watching the debate today, this is the bill to amend the Criminal Code to delay, until March 17 of next year, the repeal of the exclusion from eligibility for receiving medical assistance in dying in circumstances where the sole underlying medical condition is a mental illness.

It has to be stated very clearly, because of the timeline with which we are dealing, that if this bill is not passed, the original sunset clause that was put in place by the old Bill C-7 will come into effect on March 17, which is just over a month away. It is for that reason that I will support the bill and will work with all parties to get the bill passed quickly.

Today's conversation has to happen within the context of the mental health crisis in Canada. We know and have heard, and this is not just from members of Parliament, from many advocates and stakeholders that there is an extreme lack of funding and resources. Clearly, there absolutely must be parity between physical and mental health in funding.

The Minister of Mental Health and Addictions has stated in the House that Canadians should have access to timely evidence-based, culturally appropriate and trauma-informed mental health and substance use services to support their well-being. With that I agree wholeheartedly, but words are not enough. We need to see the requisite resources and funding to follow through those words.

We know that beyond the Canada mental health transfer many advocates have long been calling for legislation to enshrine in law parity between mental and physical health. I am very glad today that I am giving my speech beside the hon. member for Courtenay—Alberni, who is our mental health and addictions critic and who has himself tabled Motion No. 67, which calls on the government to develop that legislation and to urgently fulfill its promise to establish that Canada mental health transfer.

In my own riding of Cowichan—Malahat—Langford, many of my fellow citizens are going through extreme struggles with the opioid crisis. They are dealing with trauma. They are dealing with underlying mental health challenges that are simply not being addressed. That is an extreme gap and the cause of an extreme amount of shame for a country as wealthy as Canada to be still having these conversations about the resources that need to be brought to bear in communities like mine.

I have been a member in the House since 2015, so this is now my third Parliament. I have been here for the entirety of the legislative journey of medical assistance in dying. I can remember Bill C-14 and the sometimes difficult debates we had in the House. That legislation was in response to the Carter decision in the Supreme Court, which basically said that to deny people this right was contrary to our charter. It therefore gave the government a timeline to address it with the appropriate legislation.

What is not often talked about with Bill C-14 is that there was a legislative requirement in that act when it received royal assent. There was a five-year statutory review of medical assistance in dying. Unfortunately, that never occurred before the government went ahead in the previous Parliament and introduced Bill C-7, which established a second track for people whose death was not reasonably foreseeable.

The context of today's speech and C-39 is the fact that we have a story here of the government in several instances putting the cart before the horse. It not only introduced Bill C-7 before a statutory review occurred, which was a requirement of Bill C-14, but it then went ahead and accepted a Senate amendment to the bill that ran contrary to its own charter statement. It did that pretty massive expansion to the law without establishing a special joint committee that was a requirement of Bill C-7.

I am intimately familiar with what this process has been because I have not only been a member of the House since 2015, I have not only participated in debate on Bill C-14 and on Bill C-7, but I have also been a member of the special joint committee, both in the previous Parliament and in this Parliament.

The message all along has been that this kind of a review should have occurred before we were dealing with a timeline crunch. It became quite obvious during the special joint committee that too many Canadians, too many professionals in our country had apprehension about mental disorders as the sole underlying medical condition for being able to access medical assistance in dying as early as next month. Hence, we have Bill C-39.

I want to go back to the original charter statement that the government released as a part of Bill C-7. That includes a number of important statements as to why the government felt, originally, that mental disorders should be excluded from accessing MAID. It did say in that charter statement that the exclusion was not based on the assumption that individuals who suffered from mental illness lacked decision-making capacity. It also said that the exclusion was also not based on a failure to appreciate the severity of the suffering that mental illness could produce. Rather, it was based on the inherent risks and complexity that the availability of MAID would present to those individuals.

First, that charter statement identified that the evidence suggested that screening for decision-making capacity was particularly difficult. It could be subject to a high degree of error. Second, the statement identified that mental illness was generally less predictable than physical illness with respect to the course that the illness may take over time. Finally, it highlighted the experience that a few of the countries that permitted MAID, namely Belgium, the Netherlands and Luxembourg, for the sole underlying medical condition of mental illness had and some of the concerns relating to the increasing number of these cases and the wide range of mental illnesses in respect to which MAID could be provided.

Again, it really highlighted the fact that precaution was the necessary mode that was required before we embarked on this path. However, the government in its wisdom decided to accept a late stage Senate amendment to the bill after the House, full of its duly elected members, had given a final vote on Bill C-7. As a member at that time, I could not bring myself to accept that Senate amendment. Therefore, I ended up voting against the final version of Bill C-7 because of that.

It also needs to be said, when we are going over the history, that the special joint committee that was a requirement of Bill C-7 got a very late start. It was first brought into being just before the summer recess in 2021. We only had a few meetings before the summer of 2021 and we had the unnecessary election, launched solely at the request of the Prime Minister, in August of that year. This completely wiped out anything that was happening during the 43rd Parliament. That Parliament ceased to exist, and all of the committees that were a part of it did as well.

The new Parliament, the 44th, reconvened later that year, but it was not until around April or May of 2022 that serious discussions started coming together and we could actually get the special joint committee reformed. Again, we have to put that in the context of the impending deadline of March 17, 2023.

An incredible amount of time was wasted, not only from an unnecessary election but also from the delays of getting that committee up and running. We had to twice request an extension of our mandate from both houses of Parliament because the timelines we had been given were completely unrealistic, not only in hearing from as wide a range as possible of witnesses but also in producing a report that would reflect the gravity of the subject matter with which we were entrusted. That has to be highlighted in the debate today on Bill C-39.

I also think it is important because there have been a few narratives around this legislation. It is important to go back to understand what the Criminal Code actually says, and also to put that in the context of the definition of irremediability.

It is important that, in order to be eligible for medical assistance in dying, a person has to meet all of the following criteria: they have to make sure that they are in fact eligible for health services in the province they reside in, they have to be at least 18 years of age and capable of making decisions with respect to their own health, they have to have a grievous and irremediable medical condition, and they have to have made a voluntary request. All these conditions must be satisfied. A person must also give informed consent to receive medical assistance in dying, after having been informed of the means available to relieve their suffering, including palliative care.

Now we get to the definition of a grievous and irremediable medical condition as outlined in the Criminal Code. A person has to meet the following criteria for that definition: it has to be a serious and incurable illness, disease or disability; they have to be in an advanced state of irreversible decline in capability; and that illness, disease or disability, or that state of decline, has to be causing them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions that they consider acceptable.

Those are the definitions in the Criminal Code, so despite the narratives we hear out there, those conditions must be met or the person administering MAID will have committed a crime. They will be in violation of the Criminal Code of Canada and will get the appropriate punishment as a result.

One of the difficulties is the fact that the term “irremediable” is not a medical or scientific term. It is a term that finds its definition within the Criminal Code. If we go to scientific or medical literature, it is a difficult term to define, and that, I think, is why we are seeing a lot of the apprehension around accessing MAID for mental disorders where the sole underlying medical condition is a mental disorder.

Some witnesses who appeared before our committee expressed the opinion that this should not be permitted, because there cannot be any certainty with respect to the incurability of a mental disorder. However, other witnesses told us that certainty is not required and that there are ways to consider irremediability, for example by looking at the years of treatment that people have had and whether any responses of the patient have actually been positive.

We also have to understand that the respect for personal autonomy in all of this is paramount, and it is has to be a treatment that is acceptable to the individual receiving it. They not only have to express informed consent, but it has to be something acceptable to them as a person.

I now want to talk a little about the special joint committee, which I have had the honour of being a member of, as I previously mentioned.

I think it is important to underline that our committee has struggled with the question of how to balance individual autonomy with protections for the vulnerable. We were tasked with looking at five themes through the passage of Bill C-7 and the motion that guided our work from both the House of Commons and the Senate: how we institute protections for persons with disabilities; the state of palliative care in Canada; advance requests; mature minors; and, of course, the subject of today, mental disorders as a sole underlying medical condition and their eligibility with respect to applying for medical assistance in dying.

Our final report is due to be tabled in the House this Friday, February 17. We wrapped up our committee meetings last week and finally approved a draft report. That draft report, as I speak, is going to translation services so that it can be ready for tabling here in the House, and so we will be able to meet the deadline that was given to us.

Before we did that work, we had others who did some important work ahead of us. We had the expert panel that was established. They also wrestled with major concerns, such as incurability, irreversibility, capacity and suicidality, and of course the intersection between structural vulnerability, mental disorder and medical assistance in dying.

That panel report, an important precursor to our work as a special joint committee, did state that assessors in medical assistance in dying should be able to establish incurability and irreversibility with reference to treatment attempts made; the impacts of those treatments; and the severity of the illness, disease or disability. The incurability of a mental disorder cannot be established in the absence of extensive attempts at interventions with therapeutic aims.

This means that someone who has not had access to adequate care would not be eligible for MAID. Therefore, MAID could never be used as a substitute for good psychiatric care. I think that is an important thing we have to realize. There will be safeguards in place, not only with the Criminal Code, but also, we hope, with the standards of practice.

For patients who are considering this, we want to make sure that there has been a long track record of attempts to deal with their illnesses. At the same time, we have heard very clearly that there are many Canadians and many professionals who feel that additional time is needed to make sure we get this right.

One of the witnesses before our special joint committee was the chair of the Government of Quebec's Select Committee on the Evolution of the Act respecting end-of-life care. She explained that Quebec had decided that MAID for mental disorders as a sole underlying medical condition should not be permitted at this time because of the challenges of determining irremediability, as well as the lack of social consensus. Another level of government, this time the Province of Quebec, is also underlining the concerns that many members of Parliament are expressing here today.

I mentioned the final report that will be tabled in the House, but our committee did release an interim report. That interim report was specifically on this subject matter. I will read from our conclusion. It states:

We must have standards of practice, clear guidelines, adequate training for practitioners, comprehensive patient assessments and meaningful oversight in place for the case of [medical assistance in dying for mental disorders as the sole underlying medical condition]. This task will require the efforts and collaboration of regulators, professional associations, institutional committees and all levels of governments and these actors need to be engaged and supported in this important work.

Although some work is already underway to implement the recommendations of the Expert panel, there is concern that more remains to be done to ensure that all necessary steps have been taken to be ready by the March 2023 deadline...

Again, in our interim report, our special joint committee was already, at that time, expressing concern with the upcoming deadline, and I think it is a smart move that we are moving ahead with Bill C-39. If we back that up with the testimony we heard at committee, we had a number of different witnesses who clearly expressed that they had troubles with this deadline and that those standards of practice were not yet ready.

It needs to be underlined again that, if Bill C-39 is not passed, the original sunset clause of March 17 will come into effect. My vote for this bill is occurring because of that very fact. This is aside from the broader conversation we need to have about medical assistance in dying in general. It is support for a bill that is going to extend the deadline by one year so we can make sure that we get these standards of practice right, so we have the necessary time to engage with the broader community.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, I will have to say it: The government was not a good student. It dragged its feet for too long. It established the Special Joint Committee on Medical Assistance in Dying far too late.

When Bill C-7 was passed, the government committed to reviewing the act. We did more than review the act, because we looked at other facets. What the special joint committee did was review the existing act.

However, there was an unnecessary election in the meantime, and that caused delays. Our work was constantly disrupted by ultimatums from the court or by our own inability to meet the deadlines we ourselves had set. That is unfortunate.

I sincerely believe that, once the expert panel tabled its report, after doing the job properly, we needed to take the time to set up all the infrastructure necessary to get past the level of a house of horrors in terms of mental disorders and MAID.

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

Mr. Speaker, let me just say from the outset what a pleasure it was to serve on the special joint committee with the member for Montcalm, both in the last Parliament and in this one. I always appreciated his very thoughtful interventions and I could tell that he always came to committee quite well prepared.

The member and I have been here since 2015. He will remember that in the original bill, Bill C-14, there was a statutory requirement for a five-year review. We know that Bill C-7 was introduced before that review happened and that the government decided to accept a Senate amendment before it had a chance to establish a special joint committee. That process, that timeline, underlines why Bill C-39 is necessary now.

I wonder if my hon. colleague would just reflect on what has led us to this point and why Bill C-39 is necessary, and for this House to pass it quickly, because of the impending deadline and the fact that we do need to have some space to make sure we are getting these standards right. It is extremely important.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, I would like to begin by providing some background on Bill C-39, which is not rocket science, when it comes down to it. Then I would like to talk about the philosophical foundation for dying with dignity, as well as the context and whether or not medical assistance in dying should be extended to patients whose sole underlying medical condition is a mental disorder. I would also like to talk about mental illness generally in our societies and the experts' report before finally concluding my speech.

The context is rather simple. This is not about rehashing the entire debate. We are studying Bill C-39, which simply defers the provision in Bill C-7 that would have ended the two-year exclusion for mental disorders on March 17, 2023.

Following consultations, the government has decided to extend this exclusion clause for one year, which means that on March 17, 2024, mental disorders, or rather individuals whose sole underlying medical condition is a mental disorder, would be eligible for MAID, subject to the conditions, limits, guidelines, standards of practice, safeguards and precautionary principles outlined in the expert report.

Before voting, I invite all parliamentarians in the House to read the report of the expert panel. It contains precautionary principles that do not lend credence to last week's comments by, for example, the leader of the official opposition. It really puts into perspective the ideology underlying the comments by my colleague from St. Albert—Edmonton. Let me dive right into this matter.

Why is there such a delay? The reason is that we believe things should be done properly by the medical world. When a mental disorder is the sole basis for a request for MAID, how prepared are those working in this field across the country to ensure that MAID is adequately and safely delivered in light of the safeguards?

More providers and seasoned assessors will be needed. I should note that the experts did say that assessing whether a person with a mental disorder has the capacity to choose MAID is something they are already doing. Often a person may have cancer and also suffer from a mental disorder. It is not the sole underlying medical condition, and they still need to establish the person's capacity to decide for themselves. Again, in response to the oversimplification by my colleague from St. Albert—Edmonton, first a person needs to want MAID, and then they need to meet the criteria.

As far as mental disorders are concerned, to meet the criteria, this is not going to happen overnight or anytime soon. It is going to take decades before anyone can have access. It is going to take time for the whole range of necessary treatments and possible therapies to be tested without the condition that the person demonstrate that they cannot bear any more and that their pain cannot be relieved. That is a long way from people living in poverty, who are depressed and who might have access to medical assistance in dying. We are far from it.

That being said, what are we talking about? When we talk about medical assistance in dying, I know that everyone in the House wants to do the right thing. Everyone has the best of intentions and wants to look after the best interests of patients and people who are suffering. However, being compassionate does not square with undermining human dignity. Human dignity is grounded in the capacity for self-determination.

Those are the philosophical premises. The law grants any individual with a biomedical condition the right to self-determination. Nothing can be done without the patient's free and informed consent. To that end, the role of the state is not to decide what that patient, who is the one suffering, needs. Rather, the state must ensure the conditions needed for them to exercise free will, so that patients can make a free and informed decision.

Historically, it was difficult to fight medical paternalism. At one time, people who had reached the terminal phase of an incurable disease did not have the right to die. The right to die was acquired, and it was called palliative care. Life was artificially prolonged, and people died from clinical trials or new therapies rather than dying a peaceful death in palliative care. However, palliative care is not a substitute for medical assistance in dying.

I find it strange that my colleague thinks it is unacceptable to grant access to medical assistance in dying to someone whose soul is suffering, and that he even opposes any form of medical assistance in dying, even when people are at the end of their life. He is opposed. At some point, if people are opposed, they need to explain why.

Why does the law recognize people's right to bodily autonomy throughout their lifetime but take it away from them at the most intimate moment of their lives? The government or our neighbour is not the one dying, so on what basis is the government giving itself the authority to decide for us at the most intimate moment of our lives?

These are the ethical and philosophical grounds and principles behind our position. Just because someone has a mental disorder does not mean that they should also be subject to social discrimination and stigma. Even though mental illness is now considered to be an actual illness, mental health is still not on the same footing as physical health. Mental illness results in discrimination and stigma.

Should we be telling people who have to deal with such discrimination and stigma that they will also never be given the right to MAID, even if they have been suffering from a mental illness and have had schizophrenia, for example, for 25 or 30 years? On what grounds are we refusing them that right? That is the basis of the expert panel's report. Do we give that right to someone with a mental disorder who is suffering, who has tried everything, whose problems are far from over and who says that they cannot go on?

There are people out there who have an ache in their soul, and unfortunately, we lose them when they attempt suicide. It is really no better. We absolutely must fight against suicide because it is one decision that cannot be undone.

In the report, the experts set out several precautionary measures. They talk about structural vulnerabilities like poverty. On page 11 of the report, the experts state the following: “In the course of assessing a request for MAiD—regardless of the requester's diagnoses—a clinician must carefully consider whether the person's circumstances are a function of systemic inequality”, and, if so, this should be addressed.

With respect to suicidal ideation, experts offer us another precautionary measure. It is not enough for a person to request MAID to have access to it.

The report states: “In any situation where suicidality is a concern, the clinician must adopt three complementary perspectives: consider a person's capacity to give informed consent or refusal of care, determine whether suicide prevention interventions—including involuntary ones—should be activated, and offer other types of interventions which may be helpful to the person”.

What is this claim about people who are depressed being able to request MAID? Members need to stop talking nonsense. That is not what the expert panel's report says. It says that incurability can be established over the course of several years. The patient must have exhausted all available therapies and treatments. However, that does not include overly aggressive therapy.

What does the member for St. Albert—Edmonton think should happen? When a person with a psychiatric disorder says that they reached their breaking point years ago, should psychiatric science insist that there is a treatment out there and that it is going to find it? That is what I mean by overly aggressive therapy.

Overly aggressive treatment may exist for all types of illness. Who gets to decide when it is too much? The Supreme Court and the Superior Court of Quebec have told us that it is up to the patient to decide. That is important, because the member for St. Albert—Edmonton keeps saying that we are cutting lives short, ending lives prematurely.

In reality, the opposite is true. Everyone wants to live as long as possible. People who are on what we call the second track, whose natural death is not reasonably foreseeable, want to live as long as possible. What they do not want is to be denied help when they reach their breaking point. If we do not give them access to MAID, they will find their own way to avoid ending up in that situation, because it is currently illegal for them, and they will end their lives prematurely. They will commit suicide.

The ruling that some contend should have been appealed to the Supreme Court states that there is an infringement on the right to life. The Conservatives' position infringes on the right to life because it forces people to end their lives prematurely rather than waiting for the moment of death, which sometimes is in one or two years. As proof, there is the case of Ms. Gladu. She did not go ahead with MAID, but she was relieved to know that she had that option. She did not commit suicide; she died naturally.

However, if her suffering became intolerable, she knew that she could access MAID because our compassionate and empathetic society would take care of her and ensure that she had a peaceful and dignified death. This meant that she could have the death that she did. Many people say that they choose to end their lives because they are not certain that they will be taken care of.

Is there anything more devastating than a suicide? That is a societal failure. We cannot be complacent about suicide attempts, about people feeling suicidal. In the health care system, mental illness, which is an illness like any other, absolutely must have all the necessary resources.

I just want to say a few words about the governments' ability to pay for the health care needs of the patients I am talking about, given the feds' post-pandemic offer. Governments have to deliver care to these people with irreversible illnesses, but they will not be getting money to do so. Over the next 10 years, they will barely be able to cover indexing on chronically insufficient funding. The federal government's share will go up from 22% to 24%. I hope government members are not too proud of that, especially considering that, during the third wave, people told us the system was in critical condition. The pandemic had destabilized it to the point that it would take 10 years to recover from the pandemic's side effects on patients without COVID. Right in the middle of the third wave, the Prime Minister said it would all be dealt with after the pandemic. We were told an agreement was imminent. I figured that they would come close to the $28 billion everyone expected, that they would give the governments of Quebec and the provinces the predictable funding they needed to rebuild their systems, take care of people over the next 10 years and finally recover from the pandemic.

I have heard the Conservatives say they will honour that small percentage. Of all the G7 countries, Canada still has the best borrowing capacity. If debt is unavoidable, what better justification for it than taking care of our people and restoring and rebuilding our health care systems?

I hear people say that individuals who have had an incurable mental disorder for years should not be given access to MAID on account of structural vulnerabilities. According to the expert report, however, two independent psychiatrists would have to be consulted. Not only would two independent psychiatrists be required, but we also have to consider recommendation 16. So far, I have been talking about recommendation 10, but my colleagues should hold on to their hats, because recommendation 16 states that, unlike for other kinds of MAID, when mental disorders are involved, there would be something called “prospective” oversight. This is different from retrospective oversight, as required by Quebec's commission on end-of-life care, which requires a justification every time MAID takes place. No, this does not happen after, but rather before, in real time.

This prospective oversight needs to be established in each jurisdiction, which is precisely what the delay will be used for. This additional safeguard needs to be established in controversial cases. According to the expert report, when an individual's capacity cannot be properly assessed, MAID is not provided, period. It is not complicated. There will be no slippery slope.

If there is a slippery slope, there is the Criminal Code, the courts, the police. Evil people do not belong in the health care system. They would be fired. If they do harm, they can be taken to court. To my knowledge, the provisions allow action to be taken.

My esteemed colleague seems to assume that everyone in health care is necessarily evil, which is absurd. The slippery slope is based solely on health care workers having evil intentions. However, to work in that field, people have to demonstrate skills proving the opposite. Consequently, all the precautionary measures and principles in this report are sufficient, in my opinion.

What needs to be done now is to ensure that people get training. Not all Quebec psychiatrists have read the report. If they listen to interviews given by the member for St. Albert—Edmonton, they will wonder what is happening with their profession.

We must be able to see things realistically and proportionately, provide training, and ensure that we implement a law that will be both accessible and equitable throughout the country. We must avoid situations where an institution that does not want to provide MAID prevents someone from accessing it, if it is their choice and they meet all the criteria.

This is still a dangerous situation. It is happening in Quebec, and the college of physicians warned last week that, in a simple case of MAID for a terminal patient, some doctors did not want to refer the patient to another doctor who was willing to provide it.

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

Mr. Speaker, I rise to speak on Bill C-39, a legislation that imposes a new arbitrary deadline of March 2024 in place of the Liberal government's arbitrary deadline of March 2023 whereby persons with a sole underlying mental health disorder would be eligible for MAID.

I support Bill C-39 only because it is better than the alternative, namely that in one short month from now, on March 17, MAID would be available to persons with a sole underlying mental health disorder. This would be an absolute disaster and certainly result in vulnerable persons prematurely ending their lives, when otherwise, they could have gone on to recover and lead healthy and happy lives.

Rather than imposing a new arbitrary deadline that is not grounded on science and evidence, what the Liberal government should be doing is abandoning this radical, reckless and dangerous expansion of MAID altogether. This is why I wholeheartedly support Bill C-314, which was introduced last Friday by my friend and colleague, the member for Abbotsford, and would do exactly that.

One would expect that before deciding to expand MAID in cases of mental illness, a responsible government would take the time to study the issue thoroughly and consult widely with experts. After all, we are talking about life and death. We are talking about a significant expansion that would impact a vulnerable group of Canadians.

However, the Liberal government is not responsible, and that is not what happened. This is why the government finds itself in the mess it is in today with this rushed, 11th-hour legislation to delay the expansion.

Instead, the Minister of Justice accepted a radical Senate amendment to Bill C-7, which established an arbitrary sunset clause. That set in motion this expansion of MAID in cases of mental illness, effective in March of 2023. To provide some context, Bill C-7 was a response to the Truchon decision; its purpose was to remove a critical safeguard, namely that death be reasonably foreseeable before someone is eligible for MAID. It was a terrible piece of legislation that the government should have appealed but did not.

As bad as the bill was, when it was studied at the justice committee, of which I was a member at the time, nowhere in the bill was there any mention of expanding MAID in cases of mental illness. The justice committee did not hear evidence on that point. Indeed, when the minister came to committee, he said that there were inherent risks and complexities with expanding MAID in cases of mental illness, and therefore, it would be inappropriate to do so.

The bill went over to the Senate, and all of a sudden, the minister unilaterally accepted the amendment. Then what did the Liberals do? After little more than a day of debate, they shut down debate on a bill that had drastically changed in scope and rammed through the legislation for this expansion of MAID in cases of mental illness.

There was no meaningful study and absolutely no consultation with experts, including psychiatrists; persons struggling with mental illness; or these person's advocates. There was nothing. In short, the justice minister made the decision to go ahead with this significant expansion and then said the issue would be studied later. Hence, there was the establishment of an expert panel that was appointed after the government had already made the decision to go ahead. One would think that if an expert panel were going to be appointed, it would be appointed before deciding. However, that is not what happened with the justice minister and Liberal government.

We saw a special joint committee established after the fact. Talk about getting it backward, putting blind ideology and hubris ahead of science and evidence, and showing a total disregard for the concerns and lives of Canadians struggling with mental illness. Had the Minister of Justice and the Liberal government done their homework at the outset, they would have learned very quickly that this expansion of MAID cannot be implemented safely.

I serve as a co-vice-chair on the Special Joint Committee on Medical Assistance in Dying. As early as the spring, the committee heard from multiple witnesses, including representatives of the mental health community, and most importantly with respect to some of the clinical issues, leading psychiatrists. The body of evidence showing that this cannot proceed safely was overwhelming. One of the key reasons cited for this was that in the case of mental illness, it is difficult, if not impossible, to predict irremediability. In other words, in the case of mental illness, it is difficult or impossible to determine whether someone can recover and become healthy. This is a serious problem.

Let us look at some of the evidence that was available to the minister in the spring. Dr. John Maher, a clinical psychiatrist and medical ethicist who appeared before the committee, said, “Psychiatrists don't know and can't know who will get better and live decades of good life. Brain diseases are not liver diseases.”

Dr. Brian Mishara, a clinical psychiatrist and professor at the Université du Québec à Montréal, told the committee, “I'm a scientist. The latest Cochrane Review of research on the ability to find some indicator of the future course of a mental illness, either treated or untreated, concluded that we have no specific scientific ways of doing this.”

Even the government's expert panel conceded the difficulty in predicting irremediability. At page 9 of the expert panel report, the panel observed, “The evolution of many mental disorders, like some other chronic conditions, is difficult to predict for a given individual. There is limited knowledge about the long-term prognosis for many conditions, and it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient.” The government's own expert panel said that it is difficult, if not impossible, to predict irremediability.

If one cannot predict irremediability, persons who could go on to lead healthy and happy lives may have their lives prematurely ended. This is a problem that the government cannot avoid and that has not been resolved. Let me remind this House that, under the law, one must have an irremediable condition in order to be eligible for MAID. However, here we have leading experts and psychiatrists, including the government's expert panel, saying that it is difficult, if not impossible, to predict irremediability.

According to the psychiatrists who appeared before the special joint committee, what that means is that medical assessments in cases of mental illness for MAID are going to be decided on the basis of “hunches and guesswork that could be wildly inaccurate.” Those are the words of Dr. Mark Sinyor, a professor of psychiatry at the University of Toronto, who appeared before the special joint committee. These words were echoed by other psychiatrists who appeared before our committee.

The expert panel did not use such language, but it essentially conceded the point in its report because it was unable to come up with any objective standard by which to measure whether a patient's condition in the case of mental illness is irremediable. Instead, the expert panel ridiculously and recklessly said that it was going to wash its hands clean of this and that it was going to give a big green light and say it can all be done on a case-by-case basis. There would be no objective standard whatsoever; all would be guesswork and subjective assessment.

At the special joint committee on the issue of predicting irremediability in the context of mental illness, Dr. Mark Sinyor said that physicians undertaking a patient assessment “could be making an error 2% of the time or 95% of the time.” A 95% error rate is the risk on a matter of life and death, on a procedure that is irreversible and results in the termination of someone's life. For persons who are struggling with mental illness, this is the government's solution. The minister just stood in this place and said, “Damn the evidence. Damn the facts. We are going full steam ahead”.

I cannot think of a more reckless approach than the one the Liberal government has taken on an issue of profound importance to so many Canadians. It is not just the issue of irremediability, although given that this cannot be resolved, it should be the end of the matter. In addition, psychiatrists and other experts at the special joint committee emphasized that in the case of mental illness, it is very difficult to distinguish between a request motivated by suicidality versus one made rationally. In fact, suicidality is a symptom of mental illness, and indeed, 90% of persons who end their lives by suicide have a diagnosable mental disorder.

To illustrate how radical the government is, I note that when the Ontario Medical Association surveyed Ontario psychiatrists in 2021, 91% said they opposed the expansion of MAID for mental illness under Bill C-7. About 2% expressed support. Some 91% were against, 2% were in support and the reset were undecided. This speaks to how reckless, how radical, how extreme and how out of touch the government is on the question of expanding MAID in the case of mental illness.

In the face of the overwhelming evidence that we heard at committee, we issued an interim dissenting report calling on the Liberals to put a halt to this radical and reckless expansion. The minister ignored our interim dissenting report. He ignored the experts. He ignored the evidence. It appears he is so blinded by ideology that it is impossible for him to see what is in plain sight: This cannot be done safely.

In December, when it was evident that the minister was not listening, the Association of Chairs of Psychiatry in Canada, which includes the heads of psychiatry at all 17 medical schools, said to put a halt to this expansion. However, the minister still was not prepared to act. Indeed, it was not until the day after Parliament rose for Christmas that he had a late afternoon press conference where he made some vague commitment to introducing legislation in which there would be some type of extension. Then, with only 17 sitting days left before the expiration of the sunset clause, the minister finally saw fit to introduce this bill. I think this very clearly illustrates the shambolic approach with which the government has handled this issue.

We now have legislation, but what does this legislation do? As I noted at the outset of my speech, it provides for a new arbitrary deadline, even though issues of irremediability, suicidality and capacity to consent have remained unresolved for the past two years. There is absolutely no evidence that those issues are going to be resolved a year from now.

What we have is nothing more than an arbitrary deadline, and a year from now, we are going to find ourselves in exactly the same place. Let us be clear. When we speak about suicidality, irremediability and capacity to consent, these are not issues to be brushed under the rug. These are serious legal and clinical issues that are fundamental to determining whether this can go forward.

In closing, whether this expansion takes place a month from now or a year from now, it will be an absolute disaster and will result in persons struggling with mental illness having their lives wrongfully terminated. It is time for the government to get its head out of the sand, stop being blinded by extreme ideology, follow the science, follow the evidence and scrap this ill-conceived expansion.

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

Mr. Speaker, like the minister, I have been here since 2015, so I have seen the entire legislative journey of medical assistance in dying, and I have also been the NDP's member on the special joint committee, both in the last Parliament and this one.

Back when Bill C-14 was passed, there was a requirement in that act for a statutory review of the legislation. We did have Bill C-7, and the government did accept the Senate amendment, even though it was contrary to its own charter statement on the matter. It was only after that that we established the special joint committee, which was then delayed by the 2021 election and did not get up and going until May of last year.

In the context of that, I think the Liberals have, in some instances, put the cart before the horse before we have had the appropriate review, but I would also like to hear his comments because there is a crisis in funding for mental health in this country. We have had the Canadian Mental Health Association talk about this. I would like to hear from the justice minister that his government can make a commitment to bring mental health care funding up on par with that of physical care. There is a real crisis, not only in my community, but also in communities from coast to coast to coast. I think that is going to be an important component of this conversation.

[David Lametti, Liberal, Minister of Justice and Attorney General of Canada]

moved that Bill C-39, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

Mr. Speaker, I rise today to speak to Bill C-39, an act to amend an act to amend the Criminal Code regarding medical assistance in dying. This bill would extend the exclusion of eligibility for receiving medical assistance in dying, or MAID, in circumstances where the sole underlying medical condition for MAID is a mental illness. The main objective of this bill is to ensure the safe assessment and provision of MAID in all circumstances where a mental illness forms the basis for a request for MAID.

An extension of the exclusion of MAID eligibility in these circumstances would help ensure health care system readiness by, among other things, allowing more time for the dissemination and uptake of key resources by the medical and nursing communities, including MAID assessors and providers. It would also give the federal government more time to meaningfully consider the report of the Special Joint Committee on Medical Assistance in Dying, or AMAD, which is expected this week.

My remarks today will focus on the legislative history of MAID in this country. I want to be clear that medical assistance in dying is a right, as affirmed by the Supreme Court.

In its 2015 Carter v. Canada decision, the Supreme Court of Canada ruled that the sections of the Criminal Code prohibiting physicians from assisting in the consensual death of another person were unconstitutional. In response, in 2016, our government tabled former Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts regarding medical assistance in dying.

The basic purpose of the bill was to give Canadians nearing the end of life who are experiencing intolerable and unbearable suffering the option to obtain medical assistance in dying. The bill was passed two months later, when medical assistance in dying, or MAID, became legal in Canada for people whose natural death was reasonably foreseeable. It included procedural safeguards in order to ensure that the person’s request for medical assistance in dying was free and informed, and to protect the most vulnerable.

In 2019, in Truchon v. the Attorney General of Canada, the Quebec Superior Court ruled that it was unconstitutional to restrict the availability of MAID to individuals whose natural death was reasonably foreseeable. One year later, in response, we introduced a second bill on medical assistance in dying, the former Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying.

Former Bill C-7 expanded eligibility to receive MAID to persons whose natural death was not reasonably foreseeable. It did so by creating a separate, more stringent set of procedural safeguards that must be satisfied before MAID can be provided. The government proposed, and Parliament supported, these stringent procedural safeguards in recognition of the increased complexities of making MAID available to people who are not otherwise in an end-of-life scenario.

Some of these additional safeguards include a minimum 90-day period for assessing eligibility, during which careful consideration is given to the nature of the person's suffering and whether there is treatment or alternative means available to relieve that suffering. This safeguard effectively prohibits a practitioner from determining that a person is eligible to receive MAID in fewer than 90 days.

Another additional safeguard is the requirement that one of the practitioners assessing eligibility for MAID has expertise in the underlying condition causing the person's suffering or that they must consult with a practitioner who does. The assessing practitioners must also ensure that the person be informed of the alternative means available to address their suffering, such as counselling services, mental health and disability support services, community services and palliative care. It is not enough just to discuss treatment alternatives. They must ensure the person has been offered consultations with relevant professionals who provide those services or care. In addition, both practitioners must agree that the person gave serious consideration to treatment options and alternatives.

The former Bill C-7 extended eligibility to medical assistance in dying to people whose death is not reasonably foreseeable. However, it temporarily excluded mental illness on its own as a ground for eligibility to MAID. In other words, the bill excluded from eligibility for medical assistance in dying cases where a person's sole underlying medical condition is a mental illness. That temporary exclusion from eligibility stems from the recognition that, in those cases, requests for medical assistance in dying were complex and required further review.

In the meantime, the Expert Panel on MAID and Mental Illness conducted an independent review of the protocols, guidance and safeguards recommended in cases where a mental illness is the ground for a request for medical assistance in dying. The expert panel’s final report was tabled in Parliament on May 13, 2022.

The Special Joint Committee on Medical Assistance in Dying also completed its parliamentary review of the provisions of the Criminal Code relating to medical assistance in dying and their application, as well as other related issues, including mental health. We eagerly look forward to the special joint committee’s final report, expected on Friday, February 17.

I would also like to highlight the excellent work of the expert panel, ably led by Dr. Mona Gupta.

This temporary period of ineligibility was set in law to last two years. It will expire on March 17 unless this legal requirement is amended by law. This bill would do just that, and proposes to extend this period of ineligibility for one year, until March 17, 2024.

As I stated at the outset of my remarks, this extension is needed to ensure the safe assessment and provision of MAID in circumstances where a mental illness forms the sole basis of a request for MAID. It is clear that the assessment and provision of MAID in circumstances where a mental illness is the sole ground for requesting MAID raises particular complexities, including difficulties with assessing whether the mental illness is in fact irremediable and the potential impact of suicidal ideation on such requests.

That is why, when some Canadians, experts and members of the medical community called on the federal government to extend the temporary period of ineligibility to make sure the system was ready, we listened. We listened, we examined the situation carefully and we determined that more time was needed to get this right.

As for the state of readiness of the health care system, I would like to take a moment to highlight the great progress that has been made toward the safe delivery of MAID in those circumstances. For example, standards of practice are being developed for the assessment of complex requests for medical assistance in dying, including requests where mental illness is the sole underlying medical condition. Those standards of practice will be adapted or adopted by clinical regulatory bodies and by clinicians in the provinces and territories. These standards are being developed and will be completed in March 2023.

In addition, since October 2021, the Canadian Association of MAiD Assessors and Providers, or CAMAP, has been developing an accredited study program for health professionals. Once completed, that program will include seven training modules on various topics related to the assessment and delivery of medical assistance in dying, including on how to assess requests for medical assistance in dying, assess capacity and vulnerability, and manage complex and chronic situations. That program should be finalized and ready to be implemented next fall.

This progress was achieved through our government's leadership and collaboration with the health system's partners, such as the provincial and territorial governments, professional health organizations, our government's regulatory agencies, clinicians and organizations such as CAMAP.

The Regulations for the Monitoring of Medical Assistance in Dying, which set out the requirements for the presentation of reports on MAID, came into force in November 2018.

These regulations were recently revised to significantly improve the collection of data and reporting on MAID. More specifically, the regulations now provide for the collection of data on race, indigenous identity and any disability of the person. The revised regulations came into force in January 2023, and the information about activities related to medical assistance in dying in 2023 will be published in 2024 in Health Canada's annual MAID report.

I think we can all agree that substantial progress has been made. However, in my opinion, a little more time is needed to ensure the safe assessment and provision of MAID in all cases where a mental illness is the sole basis for a request for MAID.

I want to be clear that mental illness can cause the same level of suffering that physical illness can cause. We are aware that there are persons who are suffering intolerably as a result of their mental illnesses who were waiting to become eligible to receive MAID in March 2023. We recognize that these persons will be disappointed by an extension of ineligibility, and we sympathize with them. I want to emphasize that I believe this extension is necessary to ensure the safe provision of MAID in all cases where a mental illness forms the basis of the request for MAID. We need this extension to ensure that any changes we make are done in a prudent and measured way.

I want to turn now to the more technical part of Bill C-39 and briefly explain how the bill proposes to extend the mental illness exclusion. As I stated earlier in my remarks, former Bill C-7 expanded MAID eligibility to persons whose natural death was not reasonably foreseeable. It also included a provision that temporarily excluded eligibility in circumstances where a mental illness formed the basis of the request for MAID. Bill C-39 would delay the repeal of the mental illness exclusion. This would mean that the period of ineligibility for receiving MAID, in circumstances where the only medical condition identified in support of the request for MAID is a mental illness, would remain in place for an extra year, until March 17, 2024.

I want to reiterate that we need more time before eligibility is expanded in this matter. We need more time to ensure the readiness of the health care system, and more time to consider meaningfully and to potentially act on AMAD's recommendations. This is why I urge members to swiftly support the passage of this bill. It is imperative that it be enacted before March 17. If it is not, MAID will become lawful automatically in these circumstances. It is essential that this bill receive royal assent so that this does not happen before we are confident that MAID can be provided safely in these circumstances. I trust that all colleagues in this place will want to make that happen.

The safety of Canadians must come first. That is why we are taking the additional time necessary to get this right. Protecting the safety and security of vulnerable people and supporting individual autonomy and freedom of choice are central to Canada's MAID regime. We all know that MAID is a very complex personal issue, so it is not surprising that there is a lot of debate. It should go without saying that seeking MAID is a decision that one does not make lightly. I know from speaking with members of the medical community that they take both their critical role in the process and their professional duties toward patients extremely seriously. I trust that medical professionals have their patients' interests at heart, and this sometimes involves supporting their patients' wishes for a planned, dignified ending that is free of suffering.

Once again, I strongly believe that an extension of the exclusion of MAID eligibility in this circumstance is necessary to ensure the health care system's readiness and to give the government more time to meaningfully consider and to potentially implement the AMAD recommendations. I remind the House that those recommendations are expected just one month before the current mental illness exclusion is set to expire. Therefore, I implore all members to support this bill.

Persons with Disabilities

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, it is a pleasure to rise today. I have a number of petitions to present to the House.

The first petition comes from Canadians living with disabilities who have a number of asks regarding policies within the ambit of the federal government and Parliament that relate to Canadians with disabilities.

The petitioners note that inflation has increased the cost of living and is having the greatest impact on Canadians with fixed incomes, including Canadians living with disabilities. They note disturbing reports of people accessing euthanasia in Canada due to a lack of access to care and support. They also note that Canada's leading disability advocacy organizations had warned that Bill C-7 would threaten the lives and security of Canadians living with disabilities and that a choice to access euthanasia can never be truly free if those who suffer do not have access to the support they require.

The petitioners urge the House of Commons to pass Bill C-22, ensuring that the new Canada disability benefit is accessible to all Canadians who live with disabilities and does not take away existing benefits. They also ask for us to repeal Bill C-7 so that Canadians who live with disabilities are not coerced into accepting euthanasia because they do not have access to adequate support.

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.

Medical Assistance in Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, the next petition raises concerns with respect to Bill C-7 from the last Parliament and the fact that the bill would allow euthanasia for those with a mental illness as their sole medical condition.

This petition quotes the Canadian Mental Health Association in saying that CMHA does not believe that mental illnesses are irremediable and it supports recovery. Petitioners also note that suicide is the second leading cause of death for Canadians between the ages of 10 and 19. Petitioners call on the government to reject proposals to allow euthanasia in cases where mental health is the sole condition at play and further to protect Canadians struggling with mental health challenges and facilitate treatment and recovery for them as opposed to death.

I think I will leave it there for the present.

Canada Disability Benefit Act

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, I appreciate the opportunity to speak to Bill C-22 and, more broadly, to the situation confronting Canadians living with disabilities.

Bill C-22 proposes a new federal financial benefit for Canadians living with disabilities, however, it does not actually define many aspects of the structure of this benefit. I will be voting in favour of the legislation, because I agree with the principle of providing the support, but I am concerned about some of the lacking substance with respect to how this benefit would actually work.

Increasingly, we see from the government a desire to limit the actual work of Parliament in defining the nature and scope of programs. Instead, the government wants a blank cheque from Parliament, legislation that authorizes ministers to shape and define a program independently, according to their discretion.

In general, this is not a good way for governments to operate in a democracy and, in particular, I do not think the Liberal government has shown itself trustworthy when it comes to working out the details of critical programs.

When it comes to the structure of this benefit, the government's message is “just trust us.” From a government that cannot figure out how to deliver passports in a timely manner, cannot address the affordability crisis in Canada and cannot secure our borders, the message of “just trust us” seems rather hollow.

I have two specific concerns about the prospective structure of this program that I do want to highlight.

First, I share the concern of many about how this program would interact with other existing programs, including those provided at the provincial level. If a new federal benefit leads to a loss of eligibility for other existing benefits, then it would leave people worse off overall. It is not inevitable that this would be the case, but this is a matter that will require careful and respectful dialogue with other levels of government and hard work at every stage, hard work that the government has not always been prepared to do.

At this point, the government is passing broad framework legislation without ensuring that it will actually leave Canadians with disabilities better off in every case. The government does not have to wait for this legislation to pass to begin those discussions and I would encourage it to actually engage those discussions now about protecting existing benefits, because aspects of those dialogues may inform suggested amendments.

The second concern I have is that it is critically important that the structure of this benefit program protects access for Canadians with disabilities who are working or are trying to get into work. Even with existing benefit programs at other levels, certain Canadians with disabilities may find themselves in a position where entering the workforce actually leaves them worse off. It is critically important that work always leaves people better off financially.

Supporting Canadians, including Canadians living with disabilities, in being able to access meaningful work has long been a key priority for Conservatives.

Why is this important? Overwhelmingly, Canadians of all backgrounds and circumstances want to be able to work and are happier and more fulfilled if they are able to work. In this context, by work, I do not just mean commodified work, but work of any sort, where individuals exert themselves in order to contribute positively to the world around them.

The science of happiness and fulfillment measurement shows us that work generally makes people happier by providing them with meaning and with a workplace-based community, and with a greater level of power and agency. Quite apart from the notably important income-earning properties of work, work also provides meaning and happiness, totally independent of whether it generates income.

Think tank Cardus has done excellent work on this question of work and disability. It has found that most Canadians living with disabilities want to work or want to work more, but it has also found that the vast majority of public policy, focus and money has been toward income support as opposed to supports that help people get into work.

The critical point about work support and income support is that they are not mutually exclusive. In fact, often, they are necessarily complementary. Some people require income support in order to afford the resources and transportation required to find and get a job in the first place. If income supports are withdrawn immediately once people work or start work, they may not be able to afford vital necessities, as well as the things they need to sustain them in their new job.

Having both fulfilling work and steady income are vital for human happiness and fulfillment. Having income without work or work without income are both, in a sense, problematic.

Of course, having income is not just about fulfillment and happiness; it is about basic survival. Canadians with disabilities need income to take care of their own needs and the needs of those they love.

For most of us, work comes with earning income. However, when benefit programs are poorly structured, people may actually be forced to choose between work and income, because benefits are cut off or income is lost as a result of working. In such cases, given how essential income is for survival, people will understandably choose income over work if they are forced to choose between these things. It is cruel and pointless to force people to make this choice, to choose between the happiness associated with work and receiving the financial support that they need.

Income supports for Canadians with disabilities can and should go hand in hand with workplace support, only peeling those income supports back gradually when it is clear that income support is not required because of the level that an individual is able to work.

We saw an example of this terrible choice between work and income during the pandemic with the poorly constructed CERB program. Unemployed Canadians who were accessing CERB, and who were then offered part-time work, were in many cases actually worse off financially if they took that work because part-time work would push them over the threshold for CERB eligibility, even if they were not earning close to what they would have been entitled to receive under CERB. Thus people were forced to remain out of work in order to access the resources they needed to support their families.

Not only does it make zero financial or economic sense to create a financial disincentive to work, but it also puts people in the painful position of needing to choose between the happiness and dignity that come from work on the one hand and from financial security on the other hand. That is why we feel it is very important that this new federal program be structured in such a way that Canadians with disabilities, many of whom can and do work, or want to work, are not rendered worse off by entering the work force.

There is nothing in the text of the bill that would suggest it could not be structured in a way to ensure that work always pays, but the past record of the government gives us significant cause for concern. In the 42nd Parliament, the member for Carleton, now the leader of the Conservative Party, proposed Bill C-395, a bill specifically designed to address this problem of work sometimes bringing about a loss in benefits for Canadians living with disabilities.

Bill C-395 would have amended the Federal-Provincial Fiscal Arrangements Act to ensure that, in negotiations around transfers and the construction of benefits for Canadians living with disabilities, people with disabilities would not lose more through taxation and the reduction of benefits than they gain as a result of working. It would have protected Canadians with disabilities from these kinds of perverse situations where they would have to choose between the happiness that comes from work or the financial security that comes from government benefits.

If Bill C-395 were the law of the land, we could then pass this bill, even as written, with the confidence that the benefits constructed would leave people better off, but when it came to a vote on Bill C-395, Liberals actually opposed it. Liberals opposed the common-sense proposal from our leader to ensure that Canadians who work are better off as a result of the money they earn.

Sadly, Liberals do not seem to appreciate the value, dignity and happiness that comes from hard work. I am not sure if it can be found in the scope of this legislation as written, but I would welcome amendments that would capture the spirit of our leader's past work to protect Canadians with disabilities from being punished for working.

Parenthetically, I want to say something directly to employers about hiring Canadians with disabilities. Research done by Cardus shows that many employers have an exaggerated perception of the cost associated with accommodation. Cardus' work shows that including and accommodating employees with disabilities is often much cheaper than employers initially expect and that funding may be available from different levels of government for businesses, including small businesses, seeking to accommodate customers and employees living with disabilities.

Further, as our leader has previously shared in the context of speaking to Bill C-395, there are many cases of Canadians with disabilities who make incredible, committed and loyal employees who bring unique competencies for the workplace. Governments have a responsibility to ensure that poorly structured benefit programs do not undermine the ability of Canadians to access work, but employers also need to lead in pushing aside stereotypes and recognizing the contributions that Canadians with disabilities can make to their workplace. Many employers are already doing this, and I congratulate those who are doing this already.

Those were the main points I wanted to make on Bill C-22, but it is also very important to speak to the context of the legislation, which is the significant negative impacts on the lives of Canadians living with disabilities that flow from the government's radical ableist approach to euthanasia, the so-called MAID regime. We simply cannot have a conversation about financial benefits separate from a recognition that the biggest threat to the lives of Canadians living with disabilities is that those without disabilities are much more likely to be offered suicide prevention and recovery support, while our brothers and sisters, cousins and friends who are living with disabilities are being denied those supports and actively pushed towards death, even if they are saying they do not want it.

Among those who support legal euthanasia around the world, Canada is still increasingly seen as a cautionary tale, a warning of what not to do. In this vein, I want to start with a bit of history. Euthanasia in Canada started with Bill C-14, which was passed in the 42nd Parliament. This legislation affixed the name “medical assistance in dying” to what had previously been called euthanasia, the process of doctors killing a consenting patient. That legislation sought to define a regime whereby people could choose hastened death if their death was deemed reasonably foreseeable.

I criticized the legislation at the time for, among other things, not being sufficiently clear about what was actually meant by “reasonably foreseeable”. Indeed, there were significant abuses, even in the immediate aftermath of the passage of the legislation, whereby doctors determined someone's death to be reasonably foreseeable based on a string of hypotheticals when a person had nothing approaching a terminal condition.

For example, back in 2016, I highlighted a case in Vancouver where a physician declared a depressed person eligible for euthanasia without examining the individual because that patient “could easily get bed sores and then die of infection”. A person's death was, prior to examination, declared reasonably foreseeable because the person could theoretically die from an as yet uncontracted bed sore infection if they were bed bound as a result of the depression. These were the kinds of perverse outcomes that were possible even in 2016 as a result of a lack of safeguards and the ambiguity around what was meant by “reasonably foreseeable”.

The current rules allow someone also to consult many different physicians before finding two who will approve. Therefore, if 20 or 200 doctors say no, the criteria are not met, but then two say yes, the criteria are met, then the killing of the patient can proceed. The ambiguity and the opportunity to consult multiple doctors before getting the desired result means that, indeed, the holes were, and still are, large enough to drive a truck through. These were the pre-existing problems that were already, in particular, raising concerns of the disability community. The lack of clarity around what were and were not circumstances where death was reasonably foreseeable opened the door for people who were living with disabilities to be encouraged to pursue MAID, even if they did not want to, and even if they were actually not eligible.

Members do not have to take my word for it because the minister responsible for this legislation, the Minister of Employment, Workforce Development and Disability Inclusion of Canada, during a subsequent discussion of Bill C-7, said, “I regularly hear from families who are appalled by the fact that they take their child, potentially their older child and are offered unprovoked MAID. I think that has to stop.” That is from a minister in the government. This was already the context following the passage of Bill C-14 and prior to the passage of Bill C-7.

The road to Bill C-7 was much more contrived than the road to bill C-14. The already nebulous reasonable foreseeability clause was challenged and a lower court in one province proposed to overturn this restriction. The federal government could have appealed that lower court decision and, indeed, had a strong basis for doing so. An appeal would, at the very least, have given parliamentarians more time to consider a broad range of legislative options. Instead, the government made a political choice to embrace the lower court ruling and the artificial timeline it created, pushing medical assistance in dying for Canadians with disabilities. This was not about following a court ruling. This was about something the government could have appealed, but wanted to use the court ruling to advocate for a long-standing objective.

Following this contrived process, the government put forward Bill C-7, which was rightly opposed by all of the leading organizations representing Canadians living with disabilities, as well as by domestic and international human rights authorities.

Krista Carr from Inclusion Canada said, “Inclusion Canada has advocated for safeguards in MAID since we intervened in the Carter case. Our biggest fear has always been that having a disability would become an acceptable reason for state-provided suicide. Bill C-7 is our worst nightmare.” She continued, “By having a disability itself under Bill C-7 as the justification for the termination of life, the very essence of the Charter of Rights and Freedoms would be shattered. Discrimination on the basis of disability would once again be entrenched in Canadian law.”

She said further that the “singling out of one particular...group” of people based on their personal characteristics, which happen to be protected under the Charter of Rights and Freedoms, and to use those as grounds to justify the termination of the lives of the people who have those characteristics is just wrong, and that we would never consider doing this for any other group of people, including those who are indigenous, racialized or LGBTQ.

Dr. Heidi Janz from the Council of Canadians with Disabilities said:

People with disabilities are at a higher risk of suicide due to systemic and internalized ableism, yet they face substantial barriers when trying to access suicide prevention services. Medical professionals overlook typical sources of stress. Problems arising from relationship breakdowns, depression and isolation are wrongly attributed to disability. The removal of “reasonably foreseeable” natural death as a limiting eligibility criterion for the provision of MAID will result in people with disabilities seeking MAID as an ultimate capitulation to a lifetime of ableist oppression.

Finally, Bonnie Brayton from the DisAbled Women's Network of Canada pointed out, “Bill C-7, is sadly lacking in any meaningful public consultation with any people with disabilities despite how much more profoundly it could affect anyone who lives with a disability.” The disability community overwhelmingly opposed Bill C-7 and has repeatedly raised concerns about negative pressure and coercion impacting Canadians living with disabilities.

What about autonomy? The government would argue that Bill C-7 provides people with disabilities the option of medically facilitated death, but they do not have to chose that option. It is just another option that people have. To this, I would note that autonomy is always expressed in a social, legal and economic context. The context is that many Canadians living with disabilities struggle to access the key supports and services they need.

We do not have sufficient workplace supports in place and there are gaps in terms of community and income supports. In that context, the law and the medical system say to a person living with a disability that they have a simple way out and they can choose to die. If someone is at a point of existential agony and they have a disability, then the system will offer them death as a supposed solution.

In effect, if a person like me, without a disability, is experiencing existential distress and suicidal ideation, and if I were to discuss that distress with a doctor, I would be offered suicide prevention. However, if a person with a disability, the same as me in every other respect, is experiencing the same existential distress and suicidal ideations, and they discuss their distress with a doctor, they will be offered suicide facilitation by that same medical system.

That difference in the way the law and the health system treat those living with and without disabilities obviously sends a message to everyone involved in those interactions about whose life the law and the health system deem to be more or less worth living. The Liberal government has built a staircase to suicide prevention and a ramp to suicide facilitation.

As much as members opposite would like to say that this is about autonomy, the social and legal context that the government has created is not neutral and it is, in fact, discriminatory. Disability rights groups overwhelmingly see this reality, which is why they have been diametrically opposed to the approach of the government, and so much for “nothing about us without us”.

Canadians with disabilities feel devalued by a system that offers them easy death and does not offer them critical supports to live. Sadly, the mentality of the medical system is changing as well in response to these legal changes. The House has heard from many witnesses at different times and in different communities where patients were repeatedly pushed toward death and even called selfish for rejecting that option.

I will quote the minister again who said herself, “I regularly hear from families who are appalled by the fact that they take their child, potentially their older child and are offered unprovoked MAID. I think that has to stop.”

In response to the testimony we heard, Conservatives sought to amend Bill C-7 to guarantee that a physician or other health care worker would not raise euthanasia or MAID with a patient, unless the patient raises it first. This amendment would have ensured that, for instance, a person with a disability who goes to the doctor for something unrelated would not be offered facilitated death out of the blue. This would have solved the problem the minister identified, but the government opposed this—

Protection of Freedom of Conscience Act

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

Thank you, Madam Speaker. Now I feel I can deliver a speech.

I want to make one thing clear to the House of Commons. I think this is the appropriate time to point it out, and I think everyone here will agree with me. No one is condoning bullying, be it of health care workers or here in the House. We all know people who have bullied others. Bullies are mean-spirited people whose actions betray their insecurity and fear. We all agree on that.

That being said, we are well aware that this bill has nothing to do with bullying or protecting health care workers from bullying. What this bill would actually do is interfere with people's ability to obtain medical assistance in dying. As I said this morning, the Conservative Party is once again exploiting a serious problem to put forward a misleading solution. The party claims this bill will protect health care workers from bullying, but it is hiding the real objective, which is to interfere with medical assistance in dying. As I said this morning, this is populism.

This morning, a member corrected me, saying that being populist was not necessarily a bad thing. Fine. I should have used the term “demagoguery”. It is demagoguery.

We know full well that this bill does not seek to eliminate the bullying of health care professionals. Its objective is simply once again to obstruct existing legislation in Quebec. What is more, it seeks to allow a medical practitioner or a health care professional to not refer a case to a colleague. That goes against what we have in Quebec.

Obviously, the Bloc opposes this bill, just as we opposed Bill C‑268 in the last Parliament, and just as we opposed the proposed amendment to Bill C-7 when it was studied in committee. We have always been opposed to this. I do not know why it has come up a third time. Apparently, they have run out of topics, when there are so many to work on. If the Conservatives are looking for topics, we can help them with that.

Again, the Conservative Party is presenting us with a bill that has a certain objective, but which is worded differently in order to hide its real objective.

We oppose this bill for two reasons.

First of all, it contravenes the Quebec charter of values, rights and freedoms. There are already laws in place to protect health care workers in such situations involving intimidation. Let me give some examples of legislation that allows health care workers to refuse to provide medical assistance in dying.

Quebec's Act respecting end-of-life care states the following:

A physician practising in a centre operated by an institution who refuses a request for medical aid in dying for a reason not based on section 29 must, as soon as possible, notify the executive director of the institution or any other person designated by the executive director and forward the request form given to the physician, if that is the case, to the executive director or designated person. The executive director of the institution or designated person must then take the necessary steps to find, as soon as possible, another physician willing to deal with the request in accordance with section 29.

Subsection 241.2(9) of the Criminal Code states:

For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.

Health care workers are already protected by the Criminal Code.

Finally, section 24 of the Code of ethics of physicians of Quebec recognizes conscientious objection for medical practitioners, which is the right not to resort to a medical act that goes against their values. It is also recognized in Quebec's Act respecting end-of-life care. The physician is nevertheless required to find another physician.

A physician must, where his personal convictions prevent him from prescribing or providing professional services that may be appropriate, acquaint his patient with such convictions; he must also advise him of the possible consequences of not receiving such professional services. The physician must then offer to help the patient find another physician.

Ontario has a similar provision. Therefore, physicians and health care workers in that province do not need this bill.

Second, we are opposed to this bill because it allows physicians not to refer a case. Let us recall certain statistics. It is all too clear: There is a growing demand for medical assistance in dying, in Quebec as well as in Canada, since these laws were passed.

End-of-life care meets a need and helps ease the suffering of patients who are dying. Since the act came into force, the number of cases of MAID in Quebec has increased year over year. In 2016-17 there were 599 cases and in 2020-21 there were 2,426, which represents a 405% increase.

According to the annual report of the commission on end-of-life care, three-quarters of patients who requested MAID had cancer.

We can all agree that individuals who request MAID do not do so lightly. These people have a right to dignity and that is what is most important in all of this.

A certain balance must be struck and a decision made. That is the issue: striking a balance between an individual's dignity and freedom of conscience and religion. This has already been studied. Quebec has been discussing these issues for 10 years. That was the objective of the bill sponsored by Ms. Hivon, who I would like to congratulate today, and which was adopted on June 5, 2014. A lot of work went into this. Years were spent studying and evaluating these issues. Why not trust the work that has already been done by Quebec in this area?

This seems to be a recurring theme in the House. The federal government starts from scratch without building on what has already been done. It does not have to look far; Quebec is just across the Ottawa River.

The Quebec National Assembly is working on the issue; among other things, the Select Committee on Dying with Dignity was created on December 4, 2009. There is a consensus in Quebec that access to medical assistance in dying should not be restricted. The Quebec National Assembly spent 10 years examining both sides of the issue I just spoke about.

I will conclude here. I repeat: Medical assistance in dying is not designed to go against the values, religions or religious practices of certain Conservative Party members. Medical assistance in dying is an essential measure that allows people to die with honour and dignity. That is in line with Quebec's charter of values and its charter of rights and freedoms.

Extension of Sitting Hours and Conduct of Extended Proceedings

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, as I was saying, I rise in the House feeling extremely disappointed. I am disappointed with the government's vision of parliamentary democracy. What a waste of time and energy.

Since securing the support of the NDP, the government has been acting with the arrogance of a majority government. Some will ask whether I am truly surprised. I will answer that I entered politics because, first and foremost, I refuse to be cynical.

Last Thursday, I heard the Parliamentary Secretary to the Leader of the Government brazenly state that this type of motion was nothing out of the ordinary. A brief review showed me that, indeed, this happens too often in the House.

The Liberals said that it was not uncommon and that it was not a big deal, because the Conservatives did it before. Just because the Conservatives did something once, that does not mean that another party is justified in doing the same thing once in power. There is no reason to normalize parliamentary mediocrity and an inability to manage the parliamentary agenda.

The government has been lax, not to say lackadaisical, in administering its legislative agenda, especially when it comes to medical assistance in dying. There was an election, there were three sessions before the election, and a committee was created, but the committee was not recalled until late March, and its first meeting was held on April 8. That is totally unacceptable.

In my view, this motion is unworthy of a democratic Parliament. It is despicable. Either this motion is malicious, deceptive and twisted, or it is astoundingly insensitive toward people who are suffering. Today, with this motion, not only is the government limiting the powers of the opposition parties, but it is doing so for partisan reasons. This is end-of-session quibbling over matters of life and death. The government is exploiting the issue of end-of-life care and capitalizing on the suffering of people who are dying, who are experiencing intolerable suffering, who would like to have access to support in dying with dignity and who would like the proper respect to be shown for their right to make a free, informed choice.

These people trusted us last year when we passed Bill C-7. They assumed we would spend the next year conducting a rigorous, thorough cross-party analysis and produce a credible report on the revision of the act.

In our opinion, the Liberals’ strategy is the epitome of cynicism. They are preparing to trample on the powers of the opposition parties with the NDP’s complicity, while in 2017, 2018 and 2019 the NDP voted against this type of motion. The Liberals are muzzling the opposition parties, something we have always voted against. They are imposing closure, but they are careful to add in the same motion what the Bloc Québécois wants, namely to extend the mandate of the joint committee until October 17. On the one hand, they are giving us less time. On the other hand, they are extending the deadline.

Fortunately, knowing that we could not divide the motion, the Speaker allowed us to divide the vote.

By tabling the motion last Thursday, however, the government placed the Bloc Québécois in a position where it had to vote against its desire to implement a rigorous and credible process to review the act respecting medical assistance in dying in order to allow the joint committee to submit a report worthy of expectations or alternatively compromise its principles of parliamentary democracy. This is the Liberals’ twisted way of governing.

Since the last election, the government has dragged its feet when it came to reconstituting the special joint committee. It did so not in a separate motion, but—nice going—in a motion adopted under a gag order, which muzzled the opposition.

Since the beginning of the 44th Parliament, the Bloc, represented by myself and my excellent House leader, has told the government that we were short on time and that we should proceed by consensus to extend the deadline for the joint committee’s report. A first compromise was made, and the deadline was extended until June 23. Unfortunately, to succeed, we would have had to sit continuously, and intensively, more than once a week, starting with the first meeting.

The way we conduct this process is important for ensuring the credibility of the findings. This part of Motion No. 11 should at least have been moved separately. Discussions could have continued with the Conservative party; so far, the Conservatives are claiming that the June 23 deadline is reasonable and sufficient.

Obviously, the schedule can be reorganized at the end of the session. Obviously, with this hybrid parliament, resources cannot be optimized to accommodate more work, even until midnight. Obviously, this limits the organization of business. Claiming that we can call witnesses and ensure—

Protection of Freedom of Conscience Act

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

Madam Speaker, I rise in strong support of Bill C-230, the protection of freedom of conscience act, introduced by my friend, the member for Carlton Trail—Eagle Creek.

The bill before us is much-needed legislation to protect the charter rights of medical professionals who conscientiously object to providing or otherwise participating in medical assistance in dying. I want to commend the member for her steadfast leadership in championing conscience rights and for bringing this bill back to the House, as she introduced a similar bill that died on the Order Paper in the last Parliament.

Medical assistance in dying raises profound legal, moral and ethical questions. The trial judge in the Carter decision, which struck down the Criminal Code prohibition against physician-assisted death, stated, “The evidence shows that thoughtful and well-motivated people can and have come to different conclusions about whether physician-assisted death can be ethically justifiable.” This is true of patients, and it is true of medical professionals.

Medical professionals have a duty to do what is in the best interest of their patients and to provide the best possible advice based upon their judgment and experience, all of which are grounded on moral and professional convictions. In the case of medical assistance in dying, there are professional, moral and ethical considerations of the highest weight.

In the Carter decision, the Supreme Court predicated its decision on two things: a willing patient and, as importantly, a willing physician. At paragraph 132 of the Carter decision, the court said that nothing in its pronouncement would compel medical professionals to participate in MAID. The court went further in stating that, “However, we note...in addressing the topic of physician participation...that a physician’s decision to participate in assisted dying is a matter of conscience and, in some cases, of religious belief.” In other words, again, it requires a willing patient and a willing physician.

Now, there are those who would say that this legislation is redundant, that it is not needed, and that in terms of medical assistance in dying, conscience rights of medical professionals are already protected. They would point to the pronouncement in Carter. They might also cite Bill C-14, which includes a preamble that expressly recognizes conscience rights as well as a “for greater certainty” clause in the Criminal Code, which simply provides that “for greater certainty, nothing in this section compels an individual” to provide MAID.

While the intention of Parliament was to protect the conscience rights of medical professionals when Bill C-14 was debated and passed—and I was there for, and actively participated in, that debate and the study of that bill at committee—in practice, conscience protections and the rights of medical professionals are not being respected across Canada. There is a gap, and that is why, when Bill C-7 was studied at the justice committee, we heard from medical professionals who expressed serious concerns about pressure and coercion in providing MAID.

Indeed, the Ontario Medical Association wrote to our committee and specifically called on the committee to amend Bill C-7 to provide greater conscience protections for medical professionals, given that the “for greater certainty” clause, although better than nothing, simply does not have teeth. It is not enforceable. In that context, while the Criminal Code does not compel a medical professional to provide MAID, there is nothing in the Criminal Code that specifically protects medical professionals when they are pressured or coerced to provide MAID. This bill addresses that gap and would close it by establishing two targeted offences; namely, it would make it an offence to intimidate or coerce a medical professional with regard to providing or participating in MAID, and secondly, it would make it an offence to dismiss or refuse to hire a medical professional solely on the grounds that they object to participating in MAID.

While this legislation would protect the rights of medical professionals, it must also be emphasized that this bill would just as much protect the rights of patients. The bill would protect the rights of patients by protecting the physician-patient relationship. It would do so by safeguarding the ability of medical professionals to provide their best advice and judgment, free of pressure and free of coercion, to a patient who is considering medical assistance in dying. It would protect patients by protecting their right to a second opinion. There can be no second opinion, or at least a guarantee of a second opinion, in the face of coercion or pressure to provide medical assistance in dying. There can be no second opinion when the only choice offered to a patient is medical assistance in dying as a result of pressure and coercion.

The need to safeguard the patient-physician relationship, which this bill works toward achieving, is all the more needed in the face of the radical expansion of medical assistance in dying in Canada with the passage of Bill C-7, which removes critical safeguards, including the criterion that death be reasonably foreseeable and opens the door to medical assistance in dying for persons who are suffering solely from a mental illness, even though it is never possible to predict when someone who is suffering from mental illness can get better. It is never possible to predict irremediability in the case of a solely mental illness. As a result of the removal of those critical safeguards, vulnerable patients are put at greater risk.

When the conscience rights of medical professionals to exercise their best judgment are protected free of intimidation and coercion, the rights of patients are equally protected. This is a timely, targeted and necessary piece of legislation that would protect the rights of medical professionals and their charter rights and the rights of patients. I urge its passage.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Madam Speaker, I am pleased though a bit surprised to be speaking on Bill C-230. Less than a year ago, on May 27, 2021, we were in the House debating Bill C-268, the very same bill from the very same member for Carlton Trail—Eagle Creek. While I am a bit in awe of the member's ability to place so highly in the random draw for Private Members' Business in two successive Parliaments, I am also at a bit of a loss to explain why the member would squander her luck on this bill.

There are two reasons I say this. As MPs we get limited opportunities to place bills directly before the House. I had that opportunity in 2013, and I used it to put forward Bill C-279, which sought to add gender identity and gender expression to the list of prohibited grounds for discrimination in the Canadian human rights code and in the hate crime section of the Criminal Code. Though many thought it unlikely, the bill did pass the House with support from MPs from all parties. It took a lot of work to put together that coalition of MPs. While my bill followed a somewhat torturous path, there was always a path forward and it became law.

I wonder why it is that having heard so clearly, in speeches less than a year ago, that there was limited, if any, support for this bill outside her own party, the member for Carlton Trail—Eagle Creek has brought it back again. Since there is nothing to indicate any change of circumstances or any change of heart, this bill will go nowhere this time as well. Failing to bring forth a bill that might have some prospect for passing or reintroducing this bill instead of bringing forward a new bill presenting ideas not already debated here in the House leads me to call reintroducing this bill, at best, a missed opportunity.

The second reason I have for declaring the reintroduction of this bill a lost opportunity has to do with the bill itself. This bill picks up a tiny portion of the extensive and important debates on medical assistance in dying that took place on Bill C-14 in Parliament in 2016 and again on C-7 in the last Parliament. It seeks to take one small and very debatable point and turn it into a wedge issue in the House.

We are waiting for the Special Joint Committee on Medical Assistance in Dying to get down to work on outstanding important and critical issues around medical assistance in dying, but as that committee has yet to get under way, I want to take this opportunity today to restate the principle that has guided New Democrats through these debates.

We believe that medical assistance in dying is an important tool for helping to end unnecessary suffering for patients facing end-of-life issues and for avoiding the unnecessary suffering of their families, who have to accompany them on this journey. This is the reason New Democrats will always defend the right of access to information about MAID and access to the service for all those who qualify for assistance in dying and choose to proceed.

In the debate on Bill C-7, many issues arose concerning the challenges Canadians face at the end of life, some of which Bill C-7 addressed directly and some which have not yet been addressed. Two important concerns were front and centre, and these, for me, were the most important. The first was to help alleviate unnecessary suffering by eliminating the waiting period, which was a cause of great concern for patients who feared loss of capacity before they could complete the waiting period and thus make them ineligible for medical assistance in dying and forced to consider suffering.

The second was a change allowing a waiver of final consent. This is a provision I know quite well, personally, as a friend of mine chose to go earlier than she would have liked because of a brain tumour and her fear that she would lose capacity to consent at the last moment and, in doing so, have to continue making her family suffer.

A second challenge was also debated in Bill C-7. How do we preserve as much autonomy as possible for Canadians who are dying? Most of the issues related to this still have to be dealt with at the special joint committee. This includes questions of advance directives, the question of access to MAID for those with mental illness and for mature minors, and whether protections for people with disabilities from being pressured to seek MAID are adequate. I remain frustrated with the delays in dealing with these very important issues. The bill before us is not one of those.

A third challenge that came up in the debate on Bill C-7 was access to services at the end of life. We learned there are a great many gaps in services in our Canadian health care system for those who are facing death. There are gaps in diagnostic and treatment services depending on where one lives, whether it is a major city with excellent facilities or a rural and remote area. We learned of important gaps in palliative care.

However, instead of addressing these challenges, the challenges of autonomy and the challenges of access to services, Bill C-230 is about something else altogether. What this bill would do is override a patient's right to access information about and to have access to legally provided medical services, based on the personal beliefs of a service provider.

Let me put that in plain language. Let us suppose there are a variety of treatments available to a patient. It does not really matter in this case what they are. If a medical professional believes that one of them should not be available, this bill says there is no obligation on that professional to make sure patients find out all the options available to them. Professional organizations, like colleges of physicians and surgeons, and colleges of nurses, have found this to be unethical behaviour, so they require doctors, to varying degrees, to refer patients to someone who is supportive of those services and who is available to provide those services.

This requirement to refer exists in its strictest form in Ontario as the right of patients to an effective referral, meaning a referral to a health care professional who is available, capable and willing to provide that service. This has been upheld by the courts as a reasonable compromise between the rights of patients' access to medical issues and the conscience rights of service providers. That is the main reason I cannot support this bill. If passed, it would result, on a very real and practical basis, in the denial of access to necessary health services for many Canadians.

Many communities have a very limited number of doctors and if one of those doctors, or even more than one of those doctors, is unwilling to let their patients find out about medical assistance in dying, then we are condemning those Canadians to suffer at the end of life in ways that other Canadians would not have to suffer. No health care professionals are in fact required by law to participate, and that is why I find titling this bill “intimidation of health care professionals” disingenuous at best. Is requiring a referral actually participation in medical assistance in dying? Clearly it is not, and trying to torque a requirement to provide information into participation helps no one understand the real issues of conscience involved in medical assistance in dying.

An equally important reason for opposing this bill is the dangerous precedent that this bill would set. Its role as a potentially precedent-setting bill has already been noted by anti-choice advocates who have been vocal in their support for this bill. They recognize that it would provide a precedent for denying referrals for access to contraception and abortion services, and I want to point out that denials of service and denials of information are very real in our existing Canadian medical care system.

This bill would also be a very bad precedent for current attempts to deny transgender minors the counselling and medical services they need to affirm who they are. Without access to services that others may think are inappropriate, this will leave families with trans minors struggling to find the information and support that their kids really need. If this kind of precedent is allowed, medical professionals would not have to provide a referral to someone who would be providing a medically necessary service.

As I approach the end of my comments today, I cannot end without mentioning yet another unfortunate precedent set in this bill, and that is its use of inflammatory language. I have no doubt, as I said in my question to the sponsor of this bill, of her personal convictions and their strength. However, as sincere as they may be, the language used in this bill conjures up a spectre of the use of violence to intimidate medical professionals, something of which there is absolutely no evidence of happening in Canada. Invoking the spectre of violent intimidation is certainly not conducive to an informed debate on the real issues that are in question here.

I will close my comments today by restating that, on principle, New Democrats are opposed to any legislation that would limit access to Canadians seeking information about or the service of medical assistance in dying. No matter how strong the beliefs others may hold, this right exists to access medically necessary services. There is no doubt that the end of life is a difficult moment for all families, and medical assistance in dying, I still believe, is an important way of ending unnecessary suffering both for patients and families at the end of life. I would not like to see anyone denied access to information they need to make a choice that protects their own autonomy of how their lives end. At this point, let me salute the health care professionals who assist patients and their families through this very difficult process.

Once again, I lament the tendency of not just this member but, indeed, many Conservative members of the House to use private member's bills for scoring political points and sharpening divisions in the House—

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, the bill we are debating today has to do with protecting the freedom of conscience of health care professionals and practitioners when it comes to medical assistance in dying.

I think we should base our debate on the approach that Quebec took on this matter back in 2010. Quebec studied this issue from 2010 to 2014. The debates were non-partisan. The process allowed for all points of view to be heard and compiled. The focus of the debate was human dignity.

When talking about end-of-life care, we must not forget that the way to protect human dignity lies in freedom of choice. No one can claim to be acting in a patient's best interests if that patient is not allowed to make their own decisions. What is interesting about the Conservatives' bill is that they want the state to be less involved in the economy but more involved in our lives, especially when it comes to death, which is one of the intimate decisions a human being will make.

It is not the state or Conservative members who are going to die in place of the individual, the person who is dying, the patient, so why are they trying to interfere in this decision?

This bill is pointless, and I say this because subsection 241.2(9) already stipulates that no one can be compelled or forced to provide medical assistance in dying against their will.

As I just mentioned, the Quebec legislation should guide us in our debate here today. Section 31 of the Quebec legislation stipulates that medical practitioners cannot be forced to participate directly or indirectly in MAID, and I quote:

A physician practising in a centre operated by an institution who refuses a request for medical aid in dying for a reason not based on section 29 [which sets out all the conditions that a doctor must meet before deciding whether to provide medical assistance in dying] must, as soon as possible, notify the executive director of the institution or any other person designated by the executive director and forward the request form given to the physician, if that is the case, to the executive director or designated person. The executive director of the institution or designated person must then take the necessary steps to find, as soon as possible, another physician willing to deal with the request in accordance with section 29.

This means that a patient who is dying and highly vulnerable should not be burdened with having to take the steps I just mentioned. The bill the Conservatives are introducing today would do just that. It would force these individuals to take those steps at the most vulnerable time of their lives, when they are dying or about to die. However, medical practitioners can refuse to participate directly or indirectly in MAID.

As we heard during the Standing Committee on Justice and Human Rights' study of Bill C-7, some practitioners, citing freedom of conscience, are currently refusing to abide by the Collège des médecins du Québec's code of ethics and forward the request. In other words, they are ignoring the request, which they are not allowed to do.

In Quebec, conscientious objection is defined as follows: “Health professionals must not ignore a request for medical aid in dying. However, a doctor may refuse to administer medical aid in dying because of his or her personal values. The doctor must notify, as soon as possible, the executive director of the institution”.

That is the issue. The Conservatives have introduced a bill to add a provision to the Criminal Code that would make what they call intimidation in health care facilities an offence.

This would be a situation where a health care professional dealing with a family supporting a dying patient—a father, a mother, a brother, a sister—offers end-of-life options without ever mentioning medical assistance in dying. That is the kind of scenario we are talking about.

Quebec was a leader in this area and contributed to advancing the legislation, but there is still a lot of resistance on the ground when a patient requests medical assistance in dying. That can manifest in various ways. The surprising thing is that this resistance stands in stark contrast to what I consider the essence of Quebec's legislation, which was to integrate end-of-life care into the palliative care continuum.

In the current debate, there is one side advocating for palliative care and another advocating for medical assistance in dying. Quebec's legislation did not fall into the trap of such unnecessary division. Palliative care should be accessible, and the continuum of palliative care can give rise to a request for medical assistance in dying. A request for MAID emerges when a patient is given the opportunity to make a free and informed choice.

A person's dignity must not be defined by how they die, and it cannot be compromised because death is considered to be distasteful. To respect a human being is to respect their dignity, and that means respecting their independence and capacity for self-determination until their last breath.

The law enshrines the principle of self-determination throughout our lives, especially when it comes to medical decisions. No one can interfere with my person without my free and informed consent. Why then, at the most intimate moment in my life, would the state interfere in my life and take away my right to self-determination? I can only make a free choice if the practitioner is able to offer me all the choices, including access to palliative care, palliative sedation, and medical assistance in dying. This is a decision that only a dying person can make.

These types of bills and debates take us away from far nobler objectives. There is nothing new here to crow about; it was already set out in the legislation.

I would like members to understand why the Bloc Québécois will oppose this bill. We oppose this bill because at present, in Quebec, some people requesting MAID in a hospital are not being admitted to a palliative care unit. It is shameful that people at the end of their lives must live their last moments in a place that is far from peaceful and far from what is recommended as appropriate for dying with dignity. Why oppose that?

We must focus our efforts on having a continuum of care, working to ensure that palliative care is as available and accessible as possible in all forms, whether at home, in hospices, or elsewhere. A request for assisted death must be viewed not as a failure, but as a success in accompanying an individual towards death.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

moved that Bill C-230, An Act to amend the Criminal Code (intimidation of health care professionals), be read the second time and referred to a committee.

Mr. Speaker, it is a privilege to rise today to begin the debate on my private member's bill, Bill C-230, the protection of freedom of conscience act. This bill revives my private member's bill, which died on the Order Paper, from the last Parliament, with some slight modifications.

I would be remiss if I did not once again acknowledge that this bill is built on the hard work and determination of former members of Parliament. The first bill proposed to address this issue was introduced by the late Mark Warawa in 2016. His bill did not proceed because of the government's introduction of Bill C-14. After Bill C-14 was passed into law, my former colleague David Anderson introduced his private member's bill, Bill C-418, during the 42nd Parliament. However, that bill also died on the Order Paper when the general election was called in 2019.

I would like to thank all those who have been championing this issue for many years and their willingness to work with me. Experts throughout Canada have provided information and advice, while thousands of grassroots Canadians voiced their support for protecting our fundamental freedoms. I would also like to thank the Library of Parliament for its timely, diligent and expert research, which helped inform this proposed legislation.

For the purposes of this debate, I think it is important to understand conscience. There are numerous definitions of conscience, but they are consistent in defining it as an individual’s inner sense of knowing the difference between what is right and wrong and allowing that knowledge to guide their behaviour. The Canadian Charter of Rights and Freedoms, under the heading of “Fundamental Freedoms”, in subsection 2(a) states that everyone has the fundamental freedom of conscience. In this way, Bill C-230 is straightforward. It seeks to add two new offences to the Criminal Code of Canada. I will read the summary so members will know what they are:

This enactment amends the Criminal Code to make it an offence to intimidate a medical practitioner, nurse practitioner, pharmacist or other health care professional for the purpose of compelling them to take part, directly or indirectly, in the provision of medical assistance in dying.

It also makes it an offence to dismiss from employment or to refuse to employ a medical practitioner, nurse practitioner, pharmacist or other health care professional for the reason only that they refuse to take part, directly or indirectly, in the provision of medical assistance in dying.

This bill is a response to calls from disability rights groups, first nations, the Ontario Medical Association, legal experts and many medical and mental health professionals to protect conscience rights. It ensures that medical professionals who choose not to take part in or refer a patient for assisted suicide or medical assistance in dying will never be forced or coerced to violate their freedoms as stated in the charter.

Previous Parliaments have passed laws that created the unintended consequence of doctors and medical professionals being forced to participate in providing a patient's death, regardless of whether they believe it is in their best interest. Bill C-14 and Bill C-7 created a federal standard for medical assistance in dying and assisted suicide but not for conscience protections.

By way of background, sections 241.1 to 241.4 of the Criminal Code of Canada deal with the provision of medical assistance in dying. These sections are in part VIII of the code. It deals with offences against the person and reputation, which include offences such as homicide, kidnapping, assault and many more. Subsection 241(1) of the Criminal Code still makes it a criminal offence to counsel or aid in a suicide. It reads:

Everyone is guilty of an indictable offence and liable to imprisonment for a term of not more than 14 years who, whether suicide ensues or not,

(a) counsels a person to die by suicide or abets a person in dying by suicide; or

(b) aids a person to die by suicide.

When creating the exemption allowing for MAID, the government had to create an exemption to this prohibition on counselling or aiding in suicide. This then leads to the untenable claim that the Criminal Code already protects the conscience rights of medical professionals.

Some claim that the clarification clause, section 241.2 (9) of the Criminal Code, somehow protects conscience rights. It states:

For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.

While I understand why some would want to think it protects conscience rights, I believe they are sadly mistaken. While I appreciate and support this inclusion in the Criminal Code, it only addresses one side of the coin. This clause only confirms that the Criminal Code is not the source of compulsion to participate in medical assistance in dying.

For the Criminal Code to have any teeth on this issue, it should articulate that it is an offence to compel someone to provide, or assist in providing, medical assistance in dying against their will. Compelling someone to participate in MAID can and does happen, which is why I have brought forward this legislation and why it needs to pass.

Regarding jurisdictional questions about this bill, as I mentioned earlier, this bill proposes that two new offences be added to the Criminal Code of Canada to address intimidation, dismissal from employment or refusal to employ a medical professional. This is similar to section 425 of the Criminal Code, which addresses the same actions taken by an employer to compel employees with respect to belonging to or organizing a union. I would suggest that if it is appropriate to have section 425 in the Criminal Code, it is reasonable to include the amendments I am proposing.

I would also submit that it is inaccurate to argue that conscience rights legislation somehow interferes with the role of the provinces while, at the same time, believing that the legalization of medical assistance in dying does not. Ensuring that conscience rights are protected is the responsibility of Parliament and of the Government of Canada, which is why I introduced this bill and why it should be passed.

Additionally, provinces can introduce their own conscience rights legislation for medical professionals. For example, Manitoba has passed simple and clear legislation in this regard, and I would encourage all provincial legislatures and parliaments to follow Manitoba’s example.

While the text of this bill focuses on the conscience rights of medical professionals, this legislation also serves to protect the right of patients to receive a second opinion. What do I mean by this? If all doctors are forced to propose MAID as a treatment option to their patients, this one-size-fits-all approach would give Canadian patients less choice, not more.

Additionally, individuals who object to MAID would be deterred from entering the medical profession altogether. Patients would no longer be able to seek a second opinion for their end-of-life care. In this way, conscience rights for medical professionals not only protect medical professionals and their patients, but they also protect our health care system.

Without conscience rights, doctors are constrained to provide, or refer their patients to receive, medical assistance in dying, regardless of whether it is their professional opinion that it is in the best interest of the patient. This concern for the patient’s best interest does not mean that a medical professional objects to medical assistance in dying in all cases, just that in his or her opinion it is not an option that should have to be offered in every case. This became especially pertinent to the medical community with the passage of Bill C-7.

To highlight the impact of the removal of the safeguard that death be reasonably foreseeable, I would like to quote from a recent column published online in Policy Options magazine which states the following:

Many injuries and physical illnesses are indeed accompanied by temporary depression and suicidal thinking. For example, research demonstrates increased risk of suicide for two years after a spinal cord injury. This suicidality overwhelmingly ends with adaptation and recovery support. Offering death to anyone during a period of transient increased suicidality is, in our view, unethical and violates the standard of medical care by which physicians must abide.

The fact that the newly expanded law may facilitate death in those circumstances of increased suicidal thinking is, in and of itself, problematic.

Some have tried to frame conscience rights as the rights of the patient versus the rights of the doctor. Nothing could be further from the truth.

Health care is fundamentally about the doctor-patient relationship. For example, take the psychiatrist who supports MAID in certain circumstances, but in a certain case has spent 15 years counselling a patient who suffers from bouts of depression and suicidality. For 15 years, they have built understanding and trust. What would happen if that patient, suffering from a bout of suicidality, should demand assisted suicide? Under current law, that psychiatrist would be forced to refer that patient to someone else so he or she could die. They must do this, despite knowing that the suicidal thoughts are temporary and that otherwise the patient is joyful and loves his or her life. Ending that patient's life would be wrong, but the psychiatrist’s hands are tied. This should not be what passes for medical care in Canada.

Some might claim that there are safeguards in place to prevent such tragedies, but I would ask them if they are absolutely sure. With the passage of Bill C-7, many safeguards for medical professionals were removed. We are talking about ending a human life. There is no room for uncertainty when a life hangs in the balance.

Additionally, should the first line of safeguards not be the expertise of the medical professionals who know their patients best? If those medical professionals do not believe death is the answer, should we not at least consider if they are right? However, this then leads to the concern some raise that protecting the conscience rights of medical professionals will block access to those who truly want it. I would suggest this is both misleading and nothing but baseless fearmongering. Medical assistance in dying and assisted suicide are readily available throughout all of Canada. There are information phone lines, hospitals staffed with willing medical professionals, even email addresses to help set up appointments. In a word, MAID has become the status quo. It is available.

The Canadian Medical Association also stated clearly that conscience protections would not affect access because there were more than enough physicians willing to offer MAID. Therefore, common sense should tell us that the charter rights of medical professionals are breached when they are forced to either offer or refer assisted suicide or medical assistance in dying. Surely, we have the capacity to both ensure access to MAID while still protecting the fundamental charter right to freedom of conscience.

Finally, some have suggested that medical professionals should leave their morality at the door. I do not believe we want this to happen. For example, we would all want and expect doctors to be bound by their morals if they were offered a bribe to move someone up on a waiting list. If we hold our medical professionals to a higher standard, we cannot then tell them to ignore their personal moral standards. Further, while discussing the issue of conscience rights with a doctor, she told me that, in the absence of conscience protection, the group with the most to lose are the patients, and they are the ones we are trying to help. This bill protects the doctor-patient relationship by ensuring that doctors and other medical professionals are always able to recommend and provide the care they believe is best for their patients. Patients need this bill to pass. Canada’s medical professionals need this bill to pass.

Over the past two years, we have seen just how important our health care system is and how critical the medical professionals who work in that system are to Canadians and our way of life. We need to create a work environment for medical professionals that protects them, supports them, and encourages them to continue in the critical work they do.

In closing, I encourage all members to support passage of the protection of freedom of conscience act.

Alleged Premature Disclosure of Bill C-10

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

Mr. Speaker, I am very pleased to participate in today's debate.

However, I want to raise a very serious concern about what we call a question of privilege.

I am rising on a question of privilege regarding the premature disclosure of the content of Bill C-10, an act respecting certain measures related to COVID-19, by the Prime Minister himself while it was on notice and before it was introduced and tabled in the House of Commons. On Saturday, a special Order Paper was published that contained the notice for Bill C-10.

As members know, according to our Standing Orders, notices of bills must be very succinct. In this case, the notice was. It gave the title of the bill and the number, Bill C-10.

Yesterday at noon, the Prime Minister held a press conference in front of his house. Incidentally, we were able to see that, despite the fact that he and his two children have COVID-19, he is doing well. That is good.

However, he said a lot more about Bill C-10 than what was written in the notice.

In fact, CTV, in a publication following the press conference, noted that the Prime Minister provided a bit more detail about the bill's contents beyond its title. Those details provided by the Prime Minister were as follows: “We'll be introducing legislation to ensure we continue providing as many rapid tests as possible to the provinces and territories.”

Yesterday, after question period and the Prime Minister's press conference, Bill C‑10 was introduced during Routine Proceedings. At that very moment, it became clear to us and to all Canadians that what the Prime Minister had said was exactly what was in the bill.

The bill authorizes the Minister of Health to make payments of up to $2.5 billion out of the consolidated revenue fund in relation to the coronavirus disease 2019, well known as COVID-19, tests. It also authorizes the Minister of Health to transfer COVID-19 tests and instruments used in relation to those tests to the provinces and territories and to the bodies and persons in Canada.

The Prime Minister talked about Bill C‑10 in detail at the press conference before the bill was introduced. In our view, that is a breach of trust under the rules that govern us.

The Prime Minister's disrespect for Parliament goes beyond just the premature disclosure of a bill. The Prime Minister, having wasted so much time with a prorogation, followed by an expensive and unnecessary election, is trying to play catch-up by leaning on the opposition to co-operate and fast-track his bill.

In an attempt to show some goodwill, his House leader provided embargoed copies to the House leaders of the opposition. For our part, and for the part of all opposition parties, we did respect the fact that we cannot make any comment publicly about the bill. That is the way to do it. Unfortunately, yesterday the Prime Minister did not respect that situation.

On March 10, 2020, you commented on the premature disclosure of Bill C‑7 on medical assistance in dying. You said the following:

...based on a reading of the Canadian Press article on Bill C‑7 on medical assistance in dying, and in the absence of any explanation to the contrary, I must conclude that the anonymous sources mentioned were well aware of our customs and practices and chose to ignore them. It seems clear to me that the content of the bill was disclosed prematurely while it was on notice and before it was introduced in the House.

...

The rule on the confidentiality of bills on notice exists to ensure that members, in their role as legislators, are the first to know their content when they are introduced. Although it is completely legitimate to carry out consultations when developing a bill or to announce one's intention to introduce a bill by referring to its public title available on the Notice Paper and Order Paper, it is forbidden to reveal specific measures contained in a bill at the time it is put on notice.

On April 19, 2016, the Speaker found there was a prima facie question of privilege regarding a similar bill, namely Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts, respecting medical assistance in dying. He said the following:

As honourable members know, one of my most important responsibilities as Speaker is to safeguard the rights and privileges of members, individually and collectively. Central to the matter before us today is the fact that, due to its pre-eminent role in the legislative process, the House cannot allow precise legislative information to be distributed to others before it has been made accessible to all members. Previous Speakers have regularly upheld not only this fundamental right, but also expectation, of the House.

Another question of privilege was raised on March 19, 2001, regarding the media being briefed on a bill before members of Parliament. In that ruling, Speaker Milliken said, at page 1840 of the House of Commons Debates:

In preparing legislation, the government may wish to hold extensive consultations and such consultations may be held entirely at the government's discretion. However, with respect to material to be placed before parliament, the House must take precedence. Once a bill has been placed on notice, whether it has been presented in a different form to a different session of parliament has no bearing and the bill is considered a new matter. The convention of the confidentiality of bills on notice is necessary, not only so that members themselves may be well informed, but also because of the pre-eminent rule which the House plays and must play in the legislative affairs of the nation.

The Speaker at that time found another case of contempt on October 15, 2001, again involving the media being briefed on the contents of a bill prior to the legislation being introduced in the House. The precedents are very clear in these matters. The Prime Minister is in contempt of the House for disclosing the content of Bill C-10 while it was on notice and prior to being introduced in the House.

In conclusion, I would like to point out that this issue of COVID tests was part of the opening round of questions during the first question period my leader attended in September 2020 after becoming the leader of the official opposition. This issue is a really serious one and we care about this situation. It may have taken the Prime Minister a while to get it and I understand he now needs help to hurry things along, but he does himself no favours by thumbing his nose at the privileges of this House and the goodwill of the opposition parties by playing by his own rules.

This practice has gotten him into trouble before. On more than one occasion, he ran into difficulty with the Ethics Commissioner. The commissioner found in 2019 that he breached ethics rules. The Prime Minister had tried in 2018 to undermine a decision by federal prosecutors allowing a construction company, the SNC-Lavalin Group, to face a corrupt trial. The Ethics Commissioner also sanctioned him in December 2017, ruling that he broke conflict of interest rules when he accepted a vacation on the Aga Khan's private island in 2016.

I could go on and on, but to quickly get to the point and pursue a resolution to this matter, I ask, Madam Speaker, that you find a prima facie case of privilege. I am prepared to move the appropriate motion.

Medical Assistance in Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, I thank you for your wise exercise of discretion on that point.

The petition I was tabling when I was interrupted by my good colleague was on Bill C-7, a bill that came forward in the last Parliament. At the time, the government chose to support an amendment that came from the Senate, an amendment that allowed individuals who are suffering from mental health challenges to receive facilitated suicide within the medical system.

Petitioners highlight the fact that mental health challenges are not irremediable. The Canadian Mental Health Association states, “As a recovery-oriented organization, CMHA does not believe that mental illnesses are irremediable".

Petitioners are very concerned this policy change completely changes the message to those who are struggling with mental health challenges, effectively offering them suicide instead of recovery as a path forward. They call on the government to reject this policy of facilitated suicide for those suffering from mental health challenges and to protect Canadians struggling with these challenges by facilitating treatment and recovery.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, the next petition highlights concerns about Bill C-7 from the last Parliament.

The petitioners note this bill raised significant concerns from the disability community about how this would really push people toward death instead of giving them options for life. They called on the House to reject this approach of allowing mental illness to be an adoption for assisted death and to protect Canadians struggling with mental health challenges by facilitating treatment and recovery, not death.

Resumption of Debate on Address in Reply

[Alain Therrien, Bloc, La Prairie, QC]

Mr. Speaker, we can look at all the bills and go over their history. I have no problem with that.

We could talk about Bill C-7 on medical assistance in dying. The Conservative Party blocked that bill, as my colleague said. The Bloc Québécois, meanwhile, decided to support the bill and move it forward.

No, the Conservatives' approach to Bill C-6 was not exemplary. However, an election should not be called simply because one or two bills get stuck, when many bills are going through without a hitch. I know; I was there.

Yes, the Conservatives could take a good hard look at themselves when it comes to this bill. They have not been effective, one could say, but the fact remains that this is a democracy. The Conservatives were against the bill and they showed it.

What I am trying to say is that when there is a strong, robust, intelligent and effective legislative agenda, things go well. That was the problem in the last Parliament. The government did not get the job done.

Bill C-10—Time Allocation Motion

[Greg McLean, Conservative, Calgary Centre, AB]

Madam Speaker, we were talking about the very notion of the freedom of speech Canadians enjoy, one of the rights Canadians have enjoyed since being introduced by Prime Minister John Diefenbaker in 1960 and embedded in Canada's Constitution in 1982. Freedom of expression in Canada is protected as a fundamental freedom by section 2 of the Canadian Charter of Rights and Freedoms. The charter also permits the government to enforce reasonable limits.

I would say from experience that a large amount of Canadian communication between parties, individuals, businesses and organizations of all types, even governments and their agencies, happens via the Internet. Where does the problem arise in this legislation? Bill C-10 creates a new category of web media called “online undertakings” and gives the CRTC the same power to regulate them that it has for TV and radio stations. What is an online undertaking? Whatever one uploads onto the web is an online undertaking, such as videos, podcasts, music and websites. It is a huge regulatory stretch. However, Canadians should not fret as the CRTC will not act in the way the legislation is written, or so it has said.

Let us look back at that notion of freedom of expression and how we as legislators are supposed to ensure the legislation we consider abides by this fundamental piece of protection embodied in our constitutional bill of rights and freedoms. The Department of Justice Act requires the justice minister to provide a charter statement for every government bill that explains whether it respects the charter. The charter statement for Bill C-10 directly cites the social media exemption in its assessment that the bill respects this part of the Canadian Charter of Rights and Freedoms. Then, poof, at committee the Liberals removed the cited exemption from the legislation. When my Conservative colleagues rightly asked for a new assessment based on the new wording of the legislation, the Liberals decided to shut down debate at the committee.

At this point, I think Canadians would ask where the Minister of Justice is on this issue and why he will not seek and provide the legislative charter statement from his department. I have watched the Minister of Justice and let me illustrate how he operates in my opinion.

Regarding Bill C-7, an act to amend the Criminal Code (medical assistance in dying), admittedly no bill is perfect, yet this bill passed through committee here in the House of Commons and members from all parties voted in a free vote to pass the legislation. The legislation passed with the input of witnesses who wanted to respect the rights of disadvantaged Canadians and it worked through this House. The minister, despite that democratic process, manipulated the legislation with an amendment at the Senate and forced an amended bill back to this House, a bill that disrespects the input he received through witnesses and parliamentarians in the process. It was pure manipulation.

Regarding Bill C-15, an act respecting the United Nations Declaration on the Rights of Indigenous Peoples, after one hour of debate on a bill that my indigenous constituents are asking for clarity with respect to the defined terms in Canadian law and how it affects them, the Minister of Justice shut down debate, saying it had been debated enough.

Perhaps it is unparliamentary to state openly here that the minister's remarks are completely disingenuous. I have watched him during question period while he brazenly denies that his judicial appointments have nothing to do with Liberal Party lists. That is disingenuous. I know why Canadians are losing faith in governments.

Now we have this, the refusal to provide an updated charter statement. Shame on the minister.

Coming back to the bill, if passed, Canadian content uploaders will be subject to CRTC oversight. Yes, the Canadian Radio-television and Telecommunications Commission will be looking at uploads all day long. That is in fact who is writing the bill and in fact the government organization trying to gain some relevance with it, but Canadians do not have to worry because it will not enforce the law as it is written.

Let me quote Timothy Denton, a former national commissioner of the CRTC, who now serves as the chairman of the Internet Society of Canada, who stated:

...their fundamental [principle here] is...that freedom of speech through video or audio should be in the hands of the CRTC — including Canadians’ freedom to use the internet to reach audiences and markets as they see fit.... The freedom to communicate across the internet is to be determined by political appointees, on the basis of no other criterion than what is conducive to broadcasting policy — and, presumably, the good of our domestic industry. As always, the interests of the beneficiaries of regulation are heard first, best, and last. Consumers and individual freedoms count for little when the regulated sector beats its drums.

Finally, let me congratulate the government on this one step. We have been through 15 months of an unprecedented time in our modern history, with lockdowns, economic dislocation and devastation, and literally a pandemic. The press does not cover what happens in the House and the myriad mistakes the government has made because governments make mistakes in unforeseen, unprecedented times. Canadians have given the government some benefit of the doubt about these mistakes and so do all people of goodwill, but it is our job in opposition to do our utmost for the country in oversight and to provide solutions to make our outcomes better.

I thank all my colleagues for the work in helping Canadians during these unprecedented times. I should thank the Liberal government for providing a coalescing issue that has Canadians from all backgrounds and political beliefs in my riding united in reaching out to make sure the bill does not pass. The bill and the government's responses to reasonable amendments to protect Canadians' rights show its ambivalence to Canadians and their rights.

Medical Assistance in Dying

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Mr. Speaker, I want to present a few petitions.

The first petition I am bringing to the attention of the House is signed by Canadians from across Canada. They are concerned with the Senate amendment to Bill C-7 that would allow Canadians with mental illness as their sole medical condition to access euthanasia.

The petitioners recognize that suicide is the leading cause of death for Canadians between the ages of 10 and 19. Therefore, they are calling on the government to reject the Senate amendments to prevent those struggling with mental illness from obtaining assisted death and to protect Canadians struggling with mental illness by facilitating treatment and recovery, not death.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, the third petition I am presenting is with respect to Bill C-7 that recently passed and the issues raised in it around euthanasia or medical assistance in dying for those with mental health challenges. The petitioners are very concerned about the decision of the government to add in euthanasia for those with mental health challenges at the last minute, when it had previously said it did not support these measures. They want to see the government do more to protect Canadians struggling with mental illness by facilitating treatment and recovery, not death.

The petitioners are also supportive of the idea of having a national, three-digit suicide prevention line.

Criminal Code

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Madam Speaker, conversion therapy has been found by all experts to be fraudulent and harmful. It is not sanctioned by any professional organization and many Canadians are surprised this practice still goes on in Canada. However, we heard powerful testimony at the justice committee, documenting the fact that conversion therapy still took place in both what I would call its traditional form, focusing on sexual orientation, and in a new form that argues that those who are transgender, non-binary or gender diverse ought to be talked out of their personal identity.

The New Democrats and almost all members of the SOGI community have long been calling for a complete ban on conversion therapy in all its forms. What we have before us, after amendments at the committee, is a bill that comes close to a complete ban, as close as possible without actually being one.

The Minister of Justice has repeatedly said that the reason for not going ahead with a complete ban is his fear that it would not survive a charter challenge on the basis that it would restrict the rights of consenting adults to freely choose to subject themselves to conversion therapy.

There is an alternative argument that says a complete ban would indeed likely survive a charter challenge because there are strong legal precedents that argue that no one can actually consent to being defrauded or injured. The clearest parallel in the Criminal Code is the case of fight clubs, which remain illegal, as one cannot consent, no matter how freely, to being physically injured. Therefore, if the evidence is undeniable that conversion therapy is inherently fraudulent and harmful, the same legal principles should apply.

What is banned in Bill C-7? The strongest provision in the bill is a complete ban for minors, including the offence of transporting a minor outside the country to undergo conversion therapy, which is a much more common practice than most Canadians would assume.

Growing up in a society that remains heteronormative and intolerant of any challenges to the binary cisgender norms is challenging enough for queer youth without ending up being pressured into therapy whose goal is to get them to deny who they actually are.

Though Bill C-6 does not institute a complete ban on conversion therapy, it will establish an effective ban on the practice as it prohibits generally what might be called the business practices around conversion therapy. This means there will be a ban on charging for, or profiting from, conversion therapy and a ban on paid or unpaid advertising of conversion therapy.

Working together at committee, we did strengthen Bill C-6, although the Conservatives are acting like no amendments actually took place at committee. One of the most important improvements was to alter the original language in Bill C-6, which proposed banning conversion therapy “against a person's will”. This was vague language with no parallel elsewhere in the Criminal Code of which I know. My amendment was adopted to change this language to a ban on conversion therapy “without consent”.

Using the language of without consent clearly situates the ban on conversion therapy within the well-understood and well-developed Canadian jurisprudence on what does and does not constitute consent. I was disappointed that a second amendment, which sought to spell out the specific limitations on consent that would apply in the case of conversion therapy, was defeated. The testimony we heard from survivors about the kinds of duress they were almost universally under to subject themselves to conversion therapy would clearly obviate any claim of consent.

The second important improvement made at the justice committee was to expand the scope of the definition of conversion therapy to include gender identity and gender expression. This makes the language in Bill C-6 consistent with our existing human rights legislation and the hate crimes section of the Criminal Code as amended by Bill C-16. This is important as the new forms of conversion therapy I mentioned are directed at transgender and gender diverse individuals and at the attempt to get them to deny their gender identity under the guise of helping individuals “adjust”.

A third change to Bill C-6 made at committee was to add to the definition of what was in effect a for greater certainty clause stating what was not covered in the ban, something the Conservatives say they wanted and something they are certainly ignoring as it is now in the bill.

Bill C-6 now makes clear that it does not ban good faith counselling. Let me cite the specific definition again, as I did in my question earlier, as it could not be more clear. This definition “does not include a practice, treatment or service that relates to the exploration and development of an integrated personal identity without favouring any particular sexual orientation, gender identity or gender expression.” That is specifically in the bill.

Opponents of Bill C-6 continue to insist that the bill will somehow prevent conversations between parents and children or pastors and their faithful on the topics of sexual orientation or gender identity. There is no truth to this claim. The only way these conversations could be captured is if, in fact, they were part of a sustained effort to change someone's sexual orientation or gender identity that constitutes a practice or service under the bill. It would be a giant stretch to characterize efforts of parents or pastors to “try to talk their kids out of it” as a practice, service or therapy.

The vehemence of the debate on Bill C-6 around gender identity certainly reflects the fact that trans and gender-diverse Canadians face the highest levels of discrimination of any group in Canada. That discrimination results in high levels of unemployment, difficulties in accessing housing and high levels of violence, including the murder of two transgender Canadians in the last year alone, just for being trans.

During hearings in committee there was a wave of hatred expressed toward me as an individual on social media, which showed me the level of hostility generally toward trans and gender-diverse people in our country. The insults thrown at me ranged from interfering with parental rights to supporting mutilation of children and, most absurdly, being in the pay of big pharma, apparently because transitioning involves hormones. That is a particularly ill-informed charge against someone who has fought all my time in public life for reducing the power of pharmaceutical companies through shorter patents, expanded use of generics, bulk-buying to bring down costs and, ultimately, the establishment of universal pharmacare.

Those insults also included direct threats of violence directed at me, but, again, I remind myself that the hatred I saw, and will inevitably see again after this speech today, provided only a small glimpse into what transgender and gender-diverse Canadians face every day of their lives.

Many of those objecting to the bill have used what I call a “false detransitioning narrative”. To be clear, I am not rejecting the validity of the stories of individuals who may have chosen to detransition, but opponents of Bill C-6 have adopted those stories to construct a false narrative about the number who choose to detransition and their reasons for doing so. Professional, peer-reviewed studies from the U.K. and Scandinavia tell us that very few transgender people actually later detransition. Both major studies cite a number of fewer than five in 1,000 who detransition, and, even more interesting, both studies report that most of them say they detransitioned not because it was not right for them, but because they did not get support from family, friends and the community they live and work in.

The implication by critics seems to be that there is something in this bill that would prevent counselling concerning detransition, when this is absolutely not the case. Using the detransition narrative to detract Bill C-6 is false, in that I am pretty sure this argument often actually has nothing to do with the ban on conversion therapy being proposed; it is an argument about the very validity of transgender Canadians.

Let me say that I find these arguments against the bill, and being at my most charitable, are at a minimum parallel, if not identical, to those that continue to cause harm to trans and gender-diverse Canadians, and they indicate why we need this ban. At some point, some might ask why have a bill at all, when CT is universally condemned as fraudulent and harmful. Again, as many members have pointed out, studies show that literally tens of thousands of Canadians have been subjected to this practice.

It is important to listen to the voices of survivors of conversion therapy; only then can we understand the need for this bill. Once again, I want to extend personal thanks to two survivors, Erika Muse and Matt Ashcroft, who spent a lot of time with me trying to give me a better understanding of the horrors they faced and their own challenging roads to recovery.

On a personal note, let me say again that I have seen progress in my lifetime for some in the sexual orientation and gender identity community, but we have a much longer road to follow when it comes to those who are transgender and gender-diverse. What a ban of conversion therapy really says is this: we know it is impossible to change someone's sexual orientation, gender identity and expression, and trying to change or repress one's identity is harmful. Let's stop literally torturing young Canadians for being who they are. Let's put an end—

Protection of Freedom of Conscience Act

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

Madam Speaker, it is an honour to rise in strong support for Bill C-268.

This is a straightforward piece of legislation, the objective of which is extremely important, namely to ensure that the charter rights of health professionals who conscientiously object to participating in medical assistance in dying, or MAID, are protected, charter rights that include freedom of religion and freedom of conscience, those rights being not any rights but fundamental freedoms guaranteed under the charter.

For that, I want to commend my colleague, the hon. member for Carlton Trail—Eagle Creek, for her steadfast leadership in bringing forward this timely and targeted bill to address an issue of charter infringements on health care professionals. I would also acknowledge my former colleagues Mark Warawa and David Anderson for their leadership in bringing forward similar pieces of legislation in previous Parliaments.

Contrary to the assertion of the Parliamentary Secretary to the Minister of Justice, the infringement of charter rights of health professionals is not a hypothetical. It is real. It is happening in Canada and has been happening since the Supreme Court of Canada struck down the blanket Criminal Code prohibition against physician-assisted death in the Carter decision.

Many health professionals have been pressured or coerced into participating in MAID, notwithstanding their conscientious objection to doing so. At the justice committee, on Bill C-7, we heard many witnesses who came forward and spoke about serious concerns about coercion and pressure, the need for clarity in the law and a set national standard. That is precisely what this legislation seeks to do by amending the Criminal Code to see that no one will lawfully be able to coerce or pressure health care professionals for the purpose of compelling them to participate in MAID, or refuse to hire or terminate one's employment on the basis of a health care professional objecting to MAID.

The Parliamentary Secretary to the Minister of Justice made reference to Bill C-14 in his speech. It is a piece of legislation that I am very familiar with, because I sat on the special joint committee leading up to Bill C-14, and I sat on the justice committee when Bill C-14 was studied. At that time, there was much discussion around protecting conscience rights.

The parliamentary secretary is correct that the preamble of the bill was amended to include an expressed recognition of conscience rights. He is further correct to note that at subsection 241.2(9) of the Criminal Code, there is a “for greater certainty” clause that simply provides that no one shall be compelled to participate in MAID.

In that broad sense, there was an expressed intention of Parliament to protect health care professionals. However, what is missing is teeth. There is no enforceability mechanism provided for in the legislation. That was something that I saw as a problem at the time, and it has borne out to be so. That is precisely what this bill seeks to do, to fill that very real void.

The Parliamentary Secretary to the Minister of Justice as well as my colleague, the member for Esquimalt—Saanich—Sooke, spoke at varying lengths about the Ontario Court of Appeal decision in Christian Medical and Dental Society of Canada v. the College of Physicians and Surgeons of Ontario and the issue of access, that somehow this bill would interfere or undermine access to medical assistance in dying.

I say two things to those who would raise the issue of access. Manitoba passed Bill 34, which provides for conscience protections, not dissimilar to what this bill proposes. There has not been one instance that has been brought forward where access has prevented a willing patient from accessing MAID in that province, a law that has been on the books for more than four years. With respect to the Ontario Court of Appeal's decision, although the court, in its analysis, looked at hypothetical issues around access, the court actually incorporated the divisional court's finding into its ruling. The divisional court said on the question of physicians who object on the basis of conscience, “...there was no direct evidence that access to health care is a problem caused by physicians' religious objections to providing care”. There we have it right from the Ontario Court of Appeal that on the issue of access, when it came to providing direct evidence, it simply was not there. At the justice committee, when we studied Bill C-7, it was not there either.

When we talk about the Carter decision, it is important to emphasize that it is predicated upon two things: number one, that there be a willing patient; and, number two, and equally important, that there be a willing physician. Too often over the last five years, we have focused singularly on the issue of a willing patient, which is very important, to the exclusion of a willing physician notwithstanding charter rights of those physicians that are very much at play.

In the Carter decision, the Supreme Court did expressly acknowledge the rights of health care professionals in terms of freedom of religion and freedom of conscience, but the court actually went further. The court warned against compelling health care professionals to provide or otherwise participate in MAID. More specifically, at paragraph 132 of the Carter decision, the court said:

However, we note...in addressing the topic of physician participation...that a physician’s decision to participate in assisted dying is a matter of conscience and, in some cases, of religious belief.

Now, the foundational principles that underlie freedom of religion and freedom of conscience, guaranteed under paragraph 2(a) of the charter, were set out in the Big M Drug Mart Ltd. decision; and, in enunciating those principles, this is what the Supreme Court had to say:

Freedom can primarily be characterized by the absence of coercion or constraint. If a person is compelled by the state or the will of another to a course of action or inaction which he would not otherwise have chosen, he is not acting of his own volition and he cannot be said to be truly free.... Coercion includes indirect forms of control which determine or limit alternative courses of conduct available to others.

Those are precisely the principles that this bill seeks to uphold and on that basis I urge its passage.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Madam Speaker, I am pleased to speak today to Bill C-268.

This bill picks up a tiny portion of the extensive and important debates on medical assistance in dying that took place on Bill C-14 in the previous Parliament in 2016 and again on Bill C-7 in this Parliament. I want to start today by restating the principle that has guided the New Democrats through these debates.

We believe that medical assistance in dying is an important tool for helping to end unnecessary suffering for patients facing end of life issues and for avoiding the unnecessary suffering of their families, who have to accompany them on this journey. This is the reason the New Democrats will always defend the right of access to information about MAID and access to the service for all those who qualify for assistance and choose to proceed.

In the debate on Bill C-7, many issues arose concerning the challenges Canadians face at the end of life, some of which Bill C-7 addressed and some of which have not yet been addressed. Two important concerns were front and centre, and these, for me, were very important. The first was to help alleviate unnecessary suffering by eliminating the waiting period, which was a cause of great concern for patients who feared loss of capacity before they could complete the waiting period, as this would make them ineligible for medical assistance in dying. The second was allowing a waiver of final consent, which deals with the same issue. It was often known as “Audrey's amendment”. This is a provision that I knew quite personally, as a friend of mine chose to go earlier than she would have liked because of a brain tumour and her fear that she would lose capacity to consent at the last moment. Bill C-7 would make some important improvements on eliminating suffering at the end of life.

A second challenge was debated: How do we preserve as much autonomy as possible for Canadians who are dying? Most of the issues related to this still have to be dealt with at the special joint committee on medical assistance in dying that will begin its work next Monday. This includes questions of advance directives and whether protections for people with disabilities from being pressured to seek MAID are adequate. I was disappointed that Conservative senators spent a lot of time holding up the establishment of this new joint committee. It was very frustrating because the five-year statutory review of Bill C-14 was supposed to have started over a year ago. However, it is good news that this committee will commence its first regular meeting next Monday and will deal with the outstanding issues that were not dealt with in Bill C-7.

A third challenge that came up in the debate on Bill C-7 was access to services at the end of life. We learned there are a great many gaps in services in our Canadian health system for those who are facing death. There are gaps in diagnostic and treatment services, depending on where one lives, whether it is in a major city with excellent facilities or in a rural and remote area. We learned of important gaps in palliative care. Again, depending on where one lives, access to palliative care is highly variable. Of course, we also learned of gaps in the ability to access information about medical assistance in dying and the ability to access the service.

There are some very important questions here about the absence of services in rural and remote areas, about the inadequacy of services and about the shortage of trained professionals. Very important to me was the testimony we often heard about the complete absence of culturally appropriate services for indigenous Canadians and for new Canadians from different cultural backgrounds.

However, instead of addressing these challenges, the challenges of autonomy and the challenges of access to services, Bill C-268 is about something else. What this bill would do is override a patient's right to access information about, and to have access to, legally provided medical services, based on the personal beliefs of a service provider.

Let us put that in plain language. Let us suppose there are a variety of treatments available to a patient. It does not really matter in this case what they are. If a medical professional believes that one of them should not be available, this bill says there is no obligation to make sure patients find out all the options available to them. Professional organizations like colleges of physicians and surgeons and colleges of nurses have found this to be unethical behaviour, so they have required doctors, to varying degrees, to refer patients to someone who is supportive of those services and is accessible to them.

This requirement to refer, as mentioned in a previous speech, has been upheld by the courts. That is the main reason I cannot support this bill. It would result, on a practical basis, in the denial of access to necessary health services for many Canadians.

Many communities have a very limited number of doctors, and if one of those doctors, or even more than one of those doctors, is unwilling to let their patients find out about medical assistance in dying, then we are condemning those Canadians to suffer at their end of life in ways that other Canadians would not have to suffer. No health care professionals are, in fact, required by the law to participate. It is the professional associations who require some form of referral. Whether a referral is actually participation, I will grant to author of this bill, is debatable. I do not really believe it is.

An equally important reason for opposing this bill is the dangerous precedents that this bill would set. Its role as a potentially precedent-setting bill has already been noted by anti-choice advocates who have been vocal in their support of this bill. They recognize it would provide a precedent for denying referrals for access to contraception and abortion services. I want to point out that denials of service and denials of information are very real in our existing Canadian medical care system.

Just this year, Providence Health Care, which runs St. Paul's Hospital in Vancouver and is building a new hospital with $1.3 billion of public money, announced that in this new facility, abortion and contraceptive services will not be provided, nor will medical assistance in dying. I find this particularly problematic. I know of several cases in Vancouver where those who wished to access medical assistance in dying were forced to leave the hospital where they were being cared for and transfer to another facility, at a time when they and their families were already in a great deal of distress.

This bill would also be a very bad precedent for the current attempts to deny trans minors the counselling and medical services they need to affirm who they are. Without access to the services that others may think are appropriate, this will leave families with trans minors struggling to find the information and support their kids need. If this kind of precedent is allowed, medical professionals would not have to provide a referral to someone who would be providing a medically necessary service.

As a gay man who lived through the AIDS epidemic, I am also concerned about any precedent that allows the denial of access to medically necessary services. The AIDS crisis was generally ignored by the public, and treatment for those suffering from HIV and AIDS was regularly denied to members of my community, who quite often suffered very painful and tragic deaths as a result of that.

As I approach the end of my comments today, I cannot end without mentioning yet another unfortunate precedent set in this bill, and that is its use of inflammatory language. I have no doubt, as I said in my question to the sponsor of this bill, of her personal convictions and their strength.

However, as sincere they may be, the language used in this bill conjures up a spectre of the use of violence to intimidate medical professionals, something of which there is no evidence of happening in Canada. Using the kind of language that involves violence is certainly not conducive to an informed debate on the real principles that are in question here.

I will close my comments today by restating that on principle, New Democrats are opposed to any legislation that would limit access for Canadians to medically necessary services based on the personal beliefs of others, no matter how strong the beliefs the others hold are. There is a right in this country to access legal medical services, and that right can only be effective when, as professional organizations have recognized, doctors who do not wish to participate make referrals to doctors who will provide those services.

There is no doubt that the end of life is a difficult moment for all families and medical assistance in dying, I still believe, is an important way of ending unnecessary suffering, both for patients and families at the end of life. I would not like to see anyone denied access to the information they need to make a choice that protects their own autonomy about how their lives end.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

Madam Speaker, Bill C-268 is part of a movement we have seen a number of times in recent years, especially in committee, to prevent individuals from accessing medical assistance in dying.

This is deplorable because the roots of the current system, which was brought in when Bill C-7 was passed in March, go back a long way. The idea was not to please certain lobby groups. The idea was to meet the needs of the general population and satisfy the courts' requirements.

Seven years ago, on June 5, 2014, under the leadership of MNA Véronique Hivon, Quebec passed Bill 52, the Act respecting end-of-life care. The bill contributed to a palliative care continuum.

Earlier, my Conservative colleague urged us to think twice because this is important, this is about terminating a human life. I would argue that this is not about ending a life. We are not talking about ending a life. We are talking about helping people who opt to end their own life do so with dignity and without pain. Those are two very different concepts. This is not about murder; this is about helping people exercise their rights as set out in our charters and laws. Quebec dealt with the issue on June 5, 2014, with Bill 52.

In February 2015, the Supreme Court of Canada added in Carter that criminalizing a person who wishes to end their days is contrary to the Canadian Charter of Rights and Freedoms.

In April 2016, Parliament passed Bill C-14, which was the first iteration of Canada's medical assistance in dying legislation. That legislation had some flaws; it was not perfect, but it was a step in the right direction. It was consistent with the decision of the Quebec National Assembly and the values of all Quebeckers and Canadians.

Subsequently, in September 2019, the Quebec Superior Court issued a ruling in Truchon. Based on that ruling, a criterion in Bill C-14, specifically the provision requiring a reasonably foreseeable natural death, was inconsistent with our laws and charters, and we were told that it had to be removed.

Just recently, on March 17, Bill C-7 received royal assent. Finally, the criterion requiring a reasonably foreseeable natural death was removed. This is a concept that I myself had been struggling with since 2016. In my view, from the moment one is born, death is reasonably foreseeable. We just do not know when it will happen. It is a bit of an odd concept.

Bill C-7 put an end to the debate, so that is good. Since March 17, we can proceed not only in accordance with the wishes of certain lobbies, but also while respecting the wishes of the vast majority of the population and in compliance with the charters and the court decisions.

Secondly, introducing Bill C-268 into our debates is simply an attempt to upset the fragile balance we achieved with Bill C-7 at the federal level and with Bill 52 in Quebec. Bill C-268 upsets the balance between freedom of conscience, freedom of religion and the right of patients to dignity and comfort in their most difficult moments. This fragile balance was difficult to strike and I think we must avoid taking any action that might upset it. We do not have the right.

Bill C-268 is worded in such a way as to relieve health care professionals of any responsibility to a patient who says that they have an incurable disease that they are certain to die from unless they die of other causes first, that life is intolerable, that they want to end their suffering by dying and that they need help. Indeed, the bill says doctors are not obligated to help patients end their suffering by dying. Therefore, this is a way to release doctors from any responsibility related to their duty, and I find that absolutely deplorable.

Beyond all the human considerations I just raised and of which my colleagues spoke before me, there is also the jurisdictional issue, which is of grave concern to us. The federal government must refrain from interfering in areas of jurisdiction belonging to Quebec and the provinces, as Bill C-268 would do.

The way the physicians' code of ethics is managed and the way physicians process MAID requests are already set out in Bill 52 in Quebec and Bill C-7. I do not think we can tell a physician who is helping a patient end their suffering and assisting in their dying in accordance with Quebec law that he is committing a crime.

Criminalizing something that is under Quebec jurisdiction and already enshrined in Quebec law has no place. It cannot be allowed. We must ensure that the House of Commons respects the jurisdictions of the provinces and Quebec, especially when it comes to end-of-life care legislation.

What does the Quebec law say? The first part of section 30 states, and I quote:

A physician practising in a centre operated by an institution who refuses a request for medical aid in dying for a reason not based on section 28 must as soon as possible notify the director of professional services or any other person designated by the executive director of the institution and forward the request form given to the physician, if such is the case, to the director of professional services or designated person. The director of professional services or designated person must then take the necessary steps to find another physician willing to deal with the request in accordance with section 28.

If a doctor refuses to administer MAID, Quebec's Bill 52 provides specific directions to ensure respect for patients' rights and compliance with existing charters and the decisions of the Superior Court and the Supreme Court. In my opinion, Bill C-268 must not be allowed to interfere with Quebec's legislation.

I urge my colleagues in the House to think carefully about the need to respect jurisdictions and, most importantly, respect a patient's right to put an end to their suffering for which there is no other viable option.

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

Madam Speaker, I rise today to speak to Bill C-268, the protection of freedom of conscience act.

This bill proposes to create two new offences to protect the freedom of conscience of health care professionals in the context of medical assistance in dying, or MAID. The first offence would prohibit using violence or threats of violence, coercion or any other form of intimidation to compel a health care professional to take part in MAID. The second offence proposed would criminalize persons who refuse to employ or dismiss from employment health care professionals because they refuse to take part in MAID.

Protecting the freedom of conscience of our health care professionals is obviously a laudable goal. We have all recently debated Bill C-7, which amended the Criminal Code's MAID regime to remove the reasonably foreseeable death criterion. Some Canadians are very much in favour of MAID for anyone with decision-making capacity, others are profoundly opposed to it in any circumstance and many have opinions that fall somewhere in between those two positions. Many of my constituents in Parkdale—High Park, for example, are largely in favour of MAID, in favour of providing autonomy to Canadians and to empowering them with the tools to reduce suffering, with important safeguards being put in place to protect those who are vulnerable.

Our government understands that medical assistance in dying is deeply complex and personal. We were proud to have passed Bill C-7 in March of this year, which responded to the Superior Court of Quebec's September 2019 Truchon ruling and to the emerging societal consensus on the specific issues relating to MAID. We remain committed as a government to protecting vulnerable individuals and the equality rights of all Canadians, while supporting the autonomy of eligible persons to seek medical assistance in dying. We are working with the provinces and territories to implement the changes in Bill C-7 and ensure adequate access to health care support services and medical assistance in dying to all Canadians who wish to seek it.

This range of views also exists among health care professionals who are the ones directly involved in MAID, whether it be providing MAID, assessing a person's eligibility, dispensing the substances, being consulted or supporting the patient. Clearly there are practitioners who do not want to be involved in MAID at all and there are others who find meaning in responding to the wishes of their patients who are suffering by providing MAID.

Let us get to the heart of what is being moved by the member opposite. The Canadian Charter of Rights and Freedoms protects freedom of conscience and religion from government interference. That is subsection 2(a) of Canada's charter. That freedom is subject to reasonable limits prescribed by law that can be justified in a free and democratic society. It is important to keep in mind that the charter, not the Criminal Code, is the source of that constitutional protection for freedom of conscience and freedom of religion.

I also think it is critical to underscore that the Criminal Code does not in any way compel anyone's participation in MAID. Let me be crystal clear on this point, because it was raised by the member opposite. Concerns about conscience protection also arose in 2016 when she and I were both members of this House, when we enacted Canada's first MAID regime. In order to be abundantly clear, while the preamble already articulated this, our government supported an amendment to Bill C-14, which added to the Criminal Code. I am going to read it for the purposes of clarity. This amendment was to subsection 9 of section 241.2, which states, “For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.” We have the charter, we have the preamble and now we have subsection 9.

This provision exists to protect the conscience rights of medical practitioners, but it will not stop there. The entire MAID regime was prompted by the Supreme Court's decision in Carter. I will read from paragraph 132 of the decision of the court, which said, “In our view, nothing in the declaration of invalidity which we propose to issue would compel physicians to provide assistance in dying.” The court itself has been crystal clear on this issue.

When I asked the member, in the context of the debate this evening, whether there is any evidence of criminal prosecutions against institutions that are compelling physicians or nurses to provide MAID, instances of a wrongful dismissal suit or a human rights complaint, the member was not able to provide a single instance of such a situation arising, which begs the question whether there is actually an acute problem that the member is trying to address or whether, apropos of the question posed by my Bloc colleague, this legislation is simply an attempt to address a broader concern about MAID generally that perhaps is held by the member opposite and members of her caucus.

While there may be requirements for practitioners to participate in MAID in some form, it is at the level of regulation of these practitioners as professionals. That was raised by the member for Esquimalt—Saanich—Sooke. For example, in Ontario, The College of Physicians and Surgeons has an effective referral policy for MAID. It requires that practitioners refer their patients in good faith to a non-objecting, available and accessible physician or agency if they do not personally want to participate in medical assistance in dying. That policy was challenged in court under subsection 2(a) of the charter, the very provision that I put to members in this chamber. In 2019, the Court of Appeal for Ontario upheld the policy and that policy was never taken to any higher level of court afterward. That is the highest example of a court ruling in this country on whether effective referral violates the charter. It does not, according to Canadian jurisprudence.

This is one example of an effective referral policy from a regulatory body created by provincial legislation that aims to reconcile patient access to MAID with physicians' freedom to refuse participating in MAID. As the Ontario Court of Appeal noted, it is a solution that is neither perfect for the patients nor perfect for the practitioners, when questions like MAID raise difficult moral issues that are hard to reconcile with absolute perfection.

I would also note that neither of the offences the bill proposes would have an impact on an effective referral policy from a regulatory body. Such policies are not using violence, threats or intimidation to compel participation in MAID and the colleges that would issue them are not the health care professionals' employers. The offences proposed in this bill are not aligned with that particular objective of the bill.

I also have some questions about the proposed offences. The offence of intimidation reflects an opinion that I think we all hold. Health care professionals should not be the victims of violence, threats of violence or intimidation, whether it is to force them to provide medical assistance in dying or for any other reason. That is such a fundamental principle that the Criminal Code already sets out offences that prohibit such behaviour, regardless of who the victim is and regardless of the objective of the violence, threats or intimidation.

What is more, we have not heard about any doctors being forced by threats, violence or intimidation to provide medical assistance in dying, or MAID. Although the offence of intimidation set out in Bill C-268 may send a message regarding the importance of not engaging in such behaviour to force a health care professional to provide MAID, it would duplicate the offences currently set out in the Criminal Code, such as assault, uttering threats, extortion and intimidation. In fact, it would not provide any additional protection and seems to target a problem that we have no proof even exists.

The employment sanctions offence raises questions about the appropriateness of using the criminal law, which is a very blunt tool that brings about significant consequences, including the deprivation of liberty to punishing employers who refuse to hire or who would fire health care professionals because they did not want to take part in MAID.

Again, I think many of us would agree that practitioners should not face employment consequences if they object to participate in medical assistance in dying, but this seems to me like an improper use of the criminal law to try and push feelings of conscience and religion in the workplace.

I reiterate that our government is committed to the protection of health care workers, now more than ever, given how much they have worked for Canadians during this pandemic. As well, we are committed to ensuring that all Canadians have access to the right of medical assistance in dying. Our government is proud of what we have achieved in Bill C-14 in the last Parliament, and Bill C-7 in this Parliament.

I look forward to working with the Special Joint Committee on Medical Assistance in Dying to review where medical assistance in dying in Canada will be going with respect to the laws on MAID in Canada and recommending any necessary changes.

I urge all members to keep these things in mind as we continue our study of Bill C-268, a private member's bill.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Madam Speaker, I introduced this bill as it addresses the very real challenges that doctors and other medical professionals are facing regarding their conscience rights as defined in the charter and as a result of the legalization of medical assistance in dying in 2015 and the recent expansion of it through Bill C-7.

Doctors have come forward to tell us that they are being forced to offer death as a treatment option regardless of a patient's medical history. In my discussions with stakeholders, I heard that, without conscience rights, some medical professionals may choose to leave their field or the profession altogether. Furthermore, we have heard that there are doctors who are not necessarily opposed to MAID in theory but who are deeply concerned as to where the law has gone.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

moved that Bill C-268, An Act to amend the Criminal Code (intimidation of health care professionals), be read the second time and referred to a committee.

Madam Speaker, I am proud to rise today to begin the debate on my private member's bill, Bill C-268, the protection of freedom of conscience act. I would be remiss if I did not acknowledge this bill is built on the hard work and determination of former members of Parliament. The first iteration that sought to address this issue was introduced by the late Mark Warawa in 2016, but it did not progress when the government introduced Bill C-14.

I do consider it a tremendous honour that my bill is the same number, C-268, as his was. After Bill C-14 was passed into law, my former colleague David Anderson introduced his private member's bill, Bill C-418, which died on the Order Paper when the election was called in 2019.

I would like to thank all those who have been championing this issue for many years and for their willingness to work with me.

Experts throughout Canada provided information and advice, while thousands of Canadians have voiced their support for protecting our fundamental freedoms. While there are numerous dictionaries that define conscience, they are consistent in defining it as an individual's inner sense of knowing the difference between what is right and wrong and that guides their behaviour.

An article by Cardus called “The Imperative of Conscience Rights” references the following:

“Conscience” traces to the Latin conscientia, and is related to the Greek synderesis. While conscientia refers to the application of our moral knowledge to particular situations, synderesis refers to the moral awareness built into each person and that urges us to do good and avoid evil.

Bill C-268 is straightforward as it seeks to enshrine in law a minimum national standard of conscience protections for medical professionals while respecting the jurisdiction of my provincial colleagues to expand on it. It is a response to calls from disability rights groups, first nations, the Ontario Medical Association and many hundreds of medical and mental health professionals to protect conscience rights.

It would ensure the medical professionals who choose to not take part in, or refer a patient for, assisted suicide or medical assistance in dying would never be forced by violence, threats, coercion or loss of employment to violate the freedoms protected in section 2(a) of the charter. This bill also serves to protect the rights of patients to receive a second opinion, and by doing so, would protect our health care system.

In my consultations, I spoke with disability rights advocate Heidi Janz. She told me about being born in the Soviet Union. Doctors told her parents that Heidi would never walk, talk or think and that she would be dependent on others for the rest of her short life. They told her parents to put her into an institution and forget they ever had her. Heidi Janz has severe cerebral palsy.

Her parents did not listen to the dominant narrative of their day. They loved their daughter and believed her life had value. Eventually, they found the support they needed. Today, Dr. Heidi Janz holds a Ph.D. and is an adjunct professor of ethics at the University of Alberta. In her spare time she is a playwright and author, and somehow, despite how busy her life is, she also serves as the chair of the ending of life ethics committee for the Council of Canadians with Disabilities.

Dr. Janz is a remarkable woman. While some might pity her, she will have none of it. She says that everyone talks about how bad it must be to have a disability, but that she chooses daily to live in opposition to that narrative. She also says that disabled people can be so much more than their diagnosis, and that she is proof of that fact.

If it had been up to the dominant view of her day, she would never have had the chance to disprove that narrative. If her parents had not had the option to find the help they wanted to get that crucial second opinion, none of my colleagues in this place would be hearing about this marvellous woman. This is not just a theoretical story.

In a similar vein, earlier this year the Minister of Crown-Indigenous Relations, who is a doctor herself, wrote to her constituents about her experience of ageism in our health care system as it related to her 93-year-old father.

While I will not repeat the whole story, I will just quote her last two sentences:

My Dad got better without needing the ICU, but I remember thinking that as an MD I had been able to firmly take a stand. I worried that other families wouldn’t have been able to question the clear ageism in the choices being put in front of them.

The minister's father and all Canadians have the right to find a doctor who will offer them hope, offer them another choice, offer them a second opinion. All Canadians deserve that same right.

Now, this is anything but a guarantee in Canada. We have passed laws that have the unintended consequence of forcing doctors and medical professionals to provide patients death, regardless of whether they believe it is in their patient's best interest. Bill C-14 and Bill C-7 create a federal standard for medical assistance in dying and assisted suicide, but not for conscience protections. Despite the claims of some, it is patently absurd to argue that a conscience rights bill would somehow interfere with the role of the provinces while the legalization of medical assistance in dying does not.

We are speaking of the very first fundamental freedom laid out in the charter. Ensuring that conscience rights are protected is the responsibility of Parliament and of the Government of Canada, which is why I introduced this bill and why it should be passed. Above all, it is the right thing to do for patients and medical professionals.

Some have tried to frame conscience rights as the rights of the patient versus the rights of the doctor. Nothing could be further from the truth. In fact, conscience rights are critical to how our health care system works. Patients have the right to a second opinion, but there can be no second opinion if every medical professional is forced to provide the exact same list of options.

Health care is fundamentally about the doctor-patient relationship. Take the case of a psychiatrist who supports MAID in certain circumstances, but who has spent 15 years counselling a patient who suffers from bouts of depression and suicidality. For 15 years, they have built up an understanding and trust. What would happen if that patient, suffering from a bout of suicidality, should demand assisted suicide? Under the current law, that psychiatrist would be forced to refer the patient to someone else so that the patient could die. The psychiatrist must do this, despite knowing that the suicidal thoughts are temporary, that otherwise the patient is joyful and loves life, and that ending that life is wrong. The psychiatrist's hands are tied. Is that what passes for medical care?

Some might claim that there are safeguards in place to prevent such tragedies, but I ask, are members completely sure? With the passage of Bill C-7, many of the safeguards have been removed. We are talking about ending a human life. There is no room for “maybe” when a life hangs in the balance. Should the first line of safeguards not be the expertise of the medical professionals who know best? If they do not believe death is the answer, should we not at least consider if they are right? This is, after all, a matter of life and death.

Medical assistance in dying and assisted suicide are readily available throughout all of Canada. There are information phone lines, hospitals staffed with willing medical professionals, even email addresses to help set up appointments. In a word, MAID is becoming the status quo. To claim that protecting the conscience rights of medical professionals will somehow block access for those who truly want it is both misleading and nothing but baseless fearmongering.

The Canadian Medical Association stated clearly that conscience protections would not affect access, because there were more than enough physicians willing to offer MAID. This is further reinforced by a McGill study that showed that 71% of recent medical school graduates would be willing to offer MAID.

Every court case on the subject, as well as common sense, has stated clearly that the charter rights of medical professionals are breached when they are forced to either offer or refer assisted suicide or medical assistance in dying. Surely, we are clever enough to ensure access to MAID while still protecting the fundamental charter right to freedom of conscience.

I believe it is no accident that former prime minister, Pierre Trudeau, placed conscience rights as the first of the enumerated rights in our charter. It is an acknowledgement that the state cannot and should not attempt to force any one of us to do what we believe is immoral.

Dozens of first nations leaders wrote to every MP and senator. They said that, “Given our history with the negative consequences of colonialism and the involuntary imposition of cultural values and ideas, we believe that people should not be compelled to provide or facilitate in the provision of MAiD.”

We claim to be a pluralistic, free society. If that is true, it demands of us a tolerance of the moral views of others. Some have argued that protections already exist in Bill C-14. While I applaud the former minister of justice, the hon. member for Vancouver Granville, for ensuring that conscience rights were acknowledged in that legislation, acknowledgement is no longer enough. There are examples of medical professionals being forced or bullied into participation in assisted suicide against their conscience.

Dr. Ellen Warner, an oncologist who has served her patients for 30 years, told me about her experiences. She said:

I think it will shock Canadians to hear of healthcare providers being coerced into participating in MAID, yet such coercion has been happening frequently. A brilliant colleague of mine was bullied into becoming the physician legally responsible for MAID on his hospital ward. It was a great loss to us when he left for a different position. Two other co-workers told me that, despite strong, moral objections, they would carry out MAID if asked to do so for fear of losing their jobs. At one of our staff meetings, a psychiatrist stood up and announced that any physician who does not actively support MAID should not be working at our hospital.

Finally, some have suggested that medical professionals should leave their morality at the door. However, no one truly believes or wants that. As an example, no one would want a doctor to forget their morality if they were offered a bribe to move someone up on a waiting list. If we hold our medical professionals to a higher standard, we cannot then tell them to ignore their personal moral standards. As Dr. Ellen Warner stated, “In the absence of conscience protection, the group with the most to lose are the patients—the people we are all trying to help,”

This bill would protect the doctor-patient relationship by ensuring that doctors and other medical professionals are always able to recommend and provide the care they believe is best for their patient. Canadians need this bill to pass. Canada's medical professionals need this bill to pass. Additionally, they will need individual provincial governments to protect their rights through provincial regulations and legislation.

I encourage all members in this place to do our part and pass the protection of freedom of conscience act.

Financial Statement of Minister of Finance

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Madam Speaker, the people of London have gotten a bad deal through years of Liberal and Conservative governments. Well before the pandemic, many neighbourhoods in London—Fanshawe were left behind by government policies. We would hear about rising GDP and economic prosperity, but many in my community did not see that directly. That is only because the ultra-wealthy, the 1% of Canada, do not live on Hamilton or Southdale Roads, Dundas Street or Jalna Boulevard. Many in my community have been directly impacted, of course, by COVID-19, and the people I have spoken with in London—Fanshawe are worried that they will again be left behind in the recovery.

During the pandemic, the Liberal government offered Canadians the least help possible. The NDP had to force it to do better. This budget is no different. The Prime Minister has chosen to continue to give his rich friends a free ride. He has chosen to continue to fail young people who are facing crushing debt. He has chosen to continue to protect the profits of big pharmaceutical companies and for-profit, long-term care providers, and he has not addressed the housing crisis.

My constituency office staff and I have tried every day to do our best to help the thousands of people who have reached out for help. The challenges and supports offered by the government are inconsistent for different people and are consistently being scaled back. This budget will leave many more still struggling, struggling with rising bills and how unaffordable everything has become, and that includes housing and drug coverage.

For two decades, Canadians struggling with the cost of medication have been promised a pharmacare program. Instead of taking bold action, the Liberals keep breaking their promises and making people wait. Millions of Canadians are without affordable prescription drug coverage. Even more people have lost their jobs and benefits because of COVID-19, including tens of thousands of people in London. At a time when the need is so great, it is inexcusable that the Liberals refuse to give Canadians the affordable, life-saving medicines they so desperately need.

The New Democrats have repeatedly asked the federal government to establish a public drug manufacturer in Canada to address the vaccine shortage, but the Liberals continue to put the interests of multinational pharmaceutical companies and foreign governments ahead of the health of Canadians.

As a third wave of the pandemic rages on, Canadians, including Londoners, are depending on public health care as never before. COVID-19 case counts approach record highs in the London-Middlesex region, with ICUs now setting record case counts. COVID-19 has revealed serious gaps and long-standing problems in our health care system that budget 2021 does not address.

Following the budget, I have heard about the unfair treatment from people living on fixed incomes, specifically seniors and people living with disabilities in my riding. They, too, have been hit by this pandemic financially. They have seen a rise in the cost of prescriptions, food, food delivery and housing.

This summer, seniors received an addition $1.50 as a result of indexing; wow. Now only those over the age of 75 will get a one-time payment of $500 and small increases thereafter. I have constituents aged 65 to 74 telling me that they do not feel the government cares about them, that they do not matter. That is tragic.

People living with disabilities also got nothing. During the debate on Bill C-7, people living with disabilities made it very clear that they were on the brink. They have been ignored for too long, pushed to extreme poverty and disparity and without the choices that others have. Instead of direct assistance, they will also get a task force. Again, my constituents have told me that they cannot pay their bills or buy food with a task force. They cannot afford skyrocketing rent with a task force.

As the NDP's critic for women and gender equality, like so many of my colleagues have, I want to acknowledge that this is the first federal budget presented by a woman. This is an excellent step, there is no doubt, and it is about time.

What is also about time is the delivery of a universal, affordable, early-learning and child care system. Of course, after having sat on the Standing Committee for the Status Women and hearing 99% of the witnesses from all different sectors talk about the need for child care; after repeatedly hearing the statistics that women had been disproportionately impacted by the pandemic, not being able to return to work in staggering numbers because they could not access safe and affordable child care; and after being a member of a political party who has fought for child care for longer than the Liberals have promised to create it, I was pleased to hear the minister's plans to create that national system. Of course, fool me once, shame on you, fool me for 28 years, that is another story. Suffice it to say that I will watch, with scrutiny, what is presented on child care from this government. However, I am more than willing to work with the government to ensure that the wait it over. We must create that universal and affordable system.

I will insist that this system be publicly funded. I also sincerely hope that child care will not share the same fate as electoral reform or pharmacare. We have too often heard promises of task forces, committees or focus groups, or whatever the Liberal term of the day is, and there is an election with more promises. Then there is a new government that will come forward with a new mandate that cannot possibly move ahead with child care.

As a New Democrat, I come to this place with a lot of hope, but as a Canadian woman I have watched for decades and seen the Liberals' shell game in action. If there is a way to make child care a reality, let us work together and get it done because it is about time.

Child care is not the only thing women need to help them recover from the pandemic, so I was happy to see the recognition and funding for gender-based violence organizations. However, again, despite the evidence showing how vital core operational-based funding is, the government has still only provided two years of funding to these organizations and only five years of funding to a secretariat for the national action plan to end gender-based violence and to crisis hotlines for gender-based violence.

I will also note that the Minister for Women and Gender Equality still has not come forward with an actual national action plan to end gender-based violence. I think that is a bit odd, but it has only been six years. It has not been 28, so I suppose women will continue to wait.

Another group I consistently hear from is young people, who have been among the hardest hit by COVID. They had to make fundamental shifts in their education, employment and financial situations. However, instead of helping young people during the first wave of the pandemic, the government rushed to give almost $1 billion to its well connected friends at WE, and the money still has not made it to students.

Despite the second and third waves, the government will not extend the Canada emergency student benefit. During their studies, students are the ones working in the restaurants and the service sector. They hold retail jobs too. However, these businesses are still closed, and because of the poor vaccine rollout, they are unable to open. Students were also unable to collect the hours, although reduced by the government, required to obtain supports like the recovery benefit. This budget could have taken a New Democratic lead, and we could have put forward a very bold plan to ensure that students thrive instead of being buried in debt.

We believe the federal government must work with the provinces and territories to create tuition-free post-secondary education. We want to ensure that the federal government stops profiting from student debt, by permanently removing interest on all federal student loans and by giving new graduates a five-year head start without having to repay any federal student loans. Let us let them get ahead in their careers by cancelling up to $20,000 per student of federal student loan debt.

These are the ways that a federal government can show leadership. They are tangible ways to invest in people, who then invest in the long-term viability of our economy.

There is so much more to say about housing, the environment and the end of the recovery benefit, but I know that I am at the end of my time, so I will conclude with this. Governing is about choices. This budget was about choices, and the government has made some choices that only help some people. However, it is not too late. The choices that bring people together and raise up all people equally are the choices we must make now and together.

Alleged Premature Disclosure of Private Member's Bill

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Mr. Speaker, I rise on a question of privilege concerning the premature disclosure of the contents of Bill C-288, an act to amend the Companies’ Creditors Arrangement Act. This bill is sponsored by the member for Sudbury.

On Sunday, April 18, 2021, the Toronto Star posted an article entitled “Liberal MP's bill aims to keep turmoil at Laurentian University from happening at other schools”. The member is quoted in the article disclosing the contents of his bill. The problem is that the bill, which was on notice at the time the article was published, was not introduced until Monday, April 19, 2021. The article attributes several statements to the member for Sudbury. The article says:

“I’m going to add post-secondary institutions to the exemptions for institutions that cannot avail themselves of CCAA protection. It’s as simple as that,” [the member stated], referring to the Companies’ Creditors Arrangement Act, which allows for court protection during financial restructuring....

The article also quotes the member as saying:

“This includes additional financial support from our CCAA lender in order to continue to operate as Laurentian implements its plans to position the university for long-term sustainability and a basis for recovery for its creditors and stakeholders.”

On March 10, 2020, the Speaker, ruled a prima facie case of privilege following the premature disclosure of the contents of Bill C-7, an act to amend the Criminal Code (medical assistance in dying). The Speaker said:

...based on a reading of the Canadian Press article on Bill C-7 on medical assistance in dying, and in the absence of any explanation to the contrary, I must conclude that the anonymous sources mentioned were well aware of our customs and practices and chose to ignore them. It seems clear to me that the content of the bill was disclosed prematurely while it was on notice and before it was introduced in the House....

The rule on the confidentiality of bills on notice exists to ensure that members, in their role as legislators, are the first to know their content when they are introduced. Although it is completely legitimate to carry out consultations when developing a bill or to announce one’s intention to introduce a bill by referring to its public title available on the Notice Paper and Order Paper, it is forbidden to reveal specific measures contained in a bill at the time it is put on notice.

On April 19, 2016, the Speaker, in finding a prima facie case of privilege regarding the premature disclosure of contents of Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts (medical assistance in dying), stated:

As honourable members know, one of my most important responsibilities as Speaker is to safeguard the rights and privileges of members, individually and collectively. Central to the matter before us today is the fact that, due to its pre-eminent role in the legislative process, the House cannot allow precise legislative information to be distributed to others before it has been made accessible to all members. Previous Speakers have regularly upheld not only this fundamental right, but also expectation, of the House.

Another question of privilege was raised on March 19, 2001, regarding a similar matter. Speaker Milliken, on page 1840 of the House of Commons debates, supported this principle and said:

In preparing legislation, the government may wish to hold extensive consultations and such consultations may be held entirely at the government's discretion. However, with respect to material to be placed before parliament, the House must take precedence. Once a bill has been placed on notice, whether it has been presented in a different form to a different session of parliament has no bearing and the bill is considered a new matter. The convention of the confidentiality of bills on notice is necessary, not only so that members themselves may be well informed, but also because of the pre-eminent rule which the House plays and must play in the legislative affairs of the nation.

In addition, there was another case of contempt on October 15, 2001, where the Department of Justice briefed the media on the contents of a bill prior to the legislation being introduced in the House.

Given the contents of the article, and that it was published before Bill C-288, an act to amend the Companies’ Creditors Arrangement Act, was introduced in the House, I ask that you find a prima facie case of privilege. I am prepared to move the appropriate motion.

Medical Assistance in Dying

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Mr. Speaker, I am presenting several petitions this morning.

The first petition is from Canadians across the country, and these petitioners are calling the attention of this place to the prime importance especially relating to human death and Bill C-7 and the current amendments that would protect those suffering from mental illness.

Petitioners are calling on the government to support measures to protect human life, as all human life should be regarded with great respect from conception to natural death. Petitioners say that we should support Canadians who are most vulnerable and defenceless and not facilitate their death.

Second reading

[Greg McLean, Conservative, Calgary Centre, AB]

Madam Speaker, I represent a riding that is in Treaty 7 territory, the traditional territories of the Blackfoot Nation, including Siksika, Piikani and Kainai, theTsuut’ina nations; and Stoney Nakoda First Nation. We acknowledge all the many first nations, Métis and Inuit, whose footsteps have marked these lands for centuries.

Let me start today's debate on Bill C-15, introduced to ensure that the laws of Canada are consistent with the UN Declaration on the Rights of Indigenous Peoples, with the questions I am often asked about its clarifications.

How is United Nations involved? How do its edicts fit in Canadian law, which of course is much more robust? How do the United Nations edicts affect jurisdictions that have an established rule of law? How does UNDRIP consider and affect unique institutional rights, like section 35 of the Canadian Constitution? How do the two go hand in hand? As this is legislation, will it remain subservient to the constitutional law of Canada that supersedes it? What happens to existing Canadian laws? How are decades of legal precedent affected by this declaration?

Who will be the decision-makers? That is, the arbiters to balance the various interests and outcomes of these very pertinent questions. Will it be the same stagnant bureaucrats and interest groups that have ensconced the Indian Act as the status quo, in spite of decades of compulsion from all affected corners of Canada to move beyond this paternalistic legislation? Will it be a star chamber of legalists who have never set foot on the ground or experienced the problems that generations of first nations have been striving to overcome?

One thing is clear: Based on outcomes that have not arrived, the status quo is broken. How do we know it is broken? Let me count the ways. The words that describe the rights of Canada's indigenous people are a meaningful gesture, but gestures themselves are empty. There is no reconciliation that does not include economic reconciliation. Any legislation that we consider must not contribute to any negative impacts on the many indigenous communities that rely on resource development for jobs, revenues and a means to better outcomes. The decision-makers, bureaucrats, legalists, self-serving interest groups, those with a stake in maintaining the miserable status quo, should not be ensconced as roadblocks to the change that Canada requires.

It is also worth noting that those with a large stake in the benefits of the status quo have no stake in the misery associated with the status quo, which is borne by those who have been actually seeking to escape that misery for decades. Wholesale change is long overdue, and bringing forth legislation to secure the interests of these regressive middlemen is the opposite of what Canada and its indigenous population require.

Let me caution the Minister of Justice about placing his faith in the same interest groups and intervenors who have been part of the problem on this matter for decades. If the minister wants to get on the ground and hear about the frustrations with those voices by indigenous Canadians throughout Canada who will be affected by this legislation and the uncertainty it brings forth, please take the time to meet with those groups and have fulsome consultation, which has not happened, including in this House where we have had one hour of debate on it prior to today.

Weeks ago, I asked questions in this House about the effects of the government's actions on the flight of capital for project development in Canada. Oddly, it was after one of the government's appointees blamed risk and uncertainty as the underlying reasons that projects were no longer being viewed as viable investments by foreign capital in Canada. Of course, rather than addressing the causes of the risk and uncertainty and changing the destructive course on which the current government has ventured for six years, the solution seems to be for the government to allocate capital to replace private investment: the magic of social finance to the rescue.

We know what this means. It means more risk and uncertainty for Canada's taxpayers. What are others are recognizing as a problem is going to be a problem for Canadian taxpayers, and the government is doubling down on the risk Canadians will bear. In regard to UNDRIP, this legislation, as written, adds another level of risk and uncertainty to development in indigenous territories.

Prior to this country's battle to get ahead of a pandemic 13 months ago, the biggest issue we were facing, as a country and as a cohesive society, were the blockades that were initiated by certain indigenous organizations in support of some parties opposed to the Coastal GasLink pipeline, traversing Wet’suwet’en territory in northern British Columbia. Do we know who these initiators were? Do we know what standing they had: traditional, authoritative, representative, legal, responsible?

Do we know if these parties had other interests in the outcome? We know the democratic process for the band matters was completely usurped and endorsed by the Minister of Crown-Indigenous Relations, thus by the current government. Therefore, a well-understood process, which had changed substantially, was quickly usurped. Do I need to define “risk” and “uncertainty” for the current government? What does the government see as having legitimacy in the eyes of project proponents? It is definitely not the process as represented. As proponents have attested, if they do not have process, they do not have a path forward.

This bill, Bill C-15, proposes to increase that risk and uncertainty for indigenous organizations and adds another barrier to the participation in economic reconciliation. Even as project proponents themselves attracted real capital for the development of their own economic opportunities, they will be thwarted again by the government. I thank them for the words, but how about some real action? Let me illustrate the costs of that uncertainty.

Kitimat LNG is a project on Canada's west coast. The project has been progressing for a decade, along with its partner development the Pacific Trails pipeline. The project proponents have spent over $3 billion to get to this point, which represents a raft of documentation for the regulators, a gravel pad, full agreement from all 16 indigenous organizations traversed by the pipeline and full partnership with the Haisla First Nation at the project site. Thousands of indigenous jobs, hundreds of millions of dollars of benefits to people in indigenous communities, advanced trade training for a generation of people in those communities and the creation of capacity for advancing economic interests do not arrive out of thin air. In addition, more than 40 million tonnes per annum of greenhouse gas reductions will not be met. Sadly, at the end of the day, this project is on hold because there is no path forward at this point in time. Putting aside the ancillary environmental benefits, another file on which the current government is all talk with little tangible results, economic reconciliation delayed is reconciliation denied. Members should tell their children after 10 years that the reason they could not get a better education and advance their own, their society's and the world's interests is because the process was obscure and caused a decade of delays. Then members will understand the frustration.

The interests advancing this confusion have no stake in the outcome. Let us acknowledge that some of those interests, such as the NGOs that are short-term participants, often funded by foreign actors, have their own interests at heart and are often funded as well by the federal government.

Words and actions: we hear much of the former from the government and receive little of the latter. How many indigenous organizations have to stand up and say to the Minister of Justice they do not think the law will work and are worried that it adds further to the difficulties they have already experienced before he pays attention, before he gathers consensus, before he shuts down debate in the House of Commons on a fundamental piece of legislation that will change our country's governance going forward, including with those groups we are constitutionally bound to consider under section 35 of the Constitution of Canada?

We have seen this minister in action with Bill C-7 on medical assistance in dying. Let me remind members that we moved this bill through this House and, on this side of the House, many of my colleagues supported the government's legislation before it went to the Senate. The minister manipulated that legislation in the other place and brought it back here in an entirely different form that ignored the at-risk groups that were left behind in the legislation. As a result, as that represented manipulation, we voted against the process. It was not democratic.

Does the minister believe that first nations organizations have not recognized his actions? Does he think they are unnecessarily wary of his non-democratic tendencies and partiality to other interested parties? I will repeat that there are many who are moving this legislation forward who have no stake in the outcome. That spells moral hazard and we must divert it.

Real outcomes, accountability and trust are in short supply with the current government. We must do better.

Sex-Selective Abortion Act

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

moved that Bill C-233, An Act to amend the Criminal Code (sex-selective abortion), be read the second time and referred to a committee.

Madam Speaker, one of my responsibilities I have greatly enjoyed and look forward to again is attending many of the trade shows throughout my riding of Yorkton—Melville. They are an incredible way to connect with hard-working Canadians. I always bring along petitions to ensure I am responding to the concerns of my constituents, everything from firearms to palliative care and also a petition on sex-selective abortion.

Every member of the House will know that Canadians are not shy in voicing their deeply-held opinions on matters of conscience. Like a majority of Canadians, many expressed to me how they firmly believed in continued access to abortion. However, as we talked, all were horrified to learn of the practice of sex-selective abortion in Canada, which is the deliberate termination of a pregnancy due solely to the sex of a child. Further, they were shocked to learn that Canada had no law against it. Needless to say, those who were at first very apprehensive were very quick to sign my petition.

Sex-selection abortion is wrong, it is a discriminatory practice on the basis of sex and it takes place in our country because we have no law against it. As members of Parliament, we have been sent here to represent the Canadians' concerns and their needs. That is why it is an honour and privilege to rise today to represent the 84% of Canadians who would like to see this Parliament enact a Criminal Code prohibition of sex-selective abortion.

I am speaking this evening on behalf of pro-choice and pro-life Canadians, religious and non-religious, those on the left, right and centre of the political spectrum; new Canadians, the young, the elderly and those in the medical profession across our country seeking support for a framework from the federal government to make sex selection in utero illegal. I am standing today in response to all seven Supreme Court justices who agreed that the state had some interest in protecting the fetus and expected a new law to be created to fill the gap left by their decision in the 1988 Morgentaler case.

The sex-selective abortion act would create protections for unborn baby girls whose lives are ended simply because they are girls. During the past quarter of a century alone, sex-selective abortion and post-natal sex selection has deprived over 100 million women and girls the opportunity to live, work and affect change through their unique abilities. These global trends are very disconcerting, however, they are not the focus of my bill.

Sex-selective abortion is a Canadian problem that requires a Canadian solution. Peer-reviewed studies from the Canadian Medical Association Journal point to a worrying trend in Canada. In fact, a ratio of 1.96 males to every female has been recorded among those who had previously given birth to two girls. Following one or two induced abortions, the ratio becomes even more alarming.

The absence of any law to protect preborn girls shouts to the world that valuing one sex over the other is permissible in Canada. We are the only democratic country that has no law against it, the only one. The only other country that also fails in any way to protect preborn children from sex selection is North Korea, not good company for Canada. Our health care profession has shown concern about sex-selective abortion and discourages the practice.

In 2007, the executive of the Society of Obstetricians and Gynaecologists of Canada stated that medical technologies for the sole purpose of gender identification in pregnancy should not be used to accommodate societal preferences and that the SOGC did not support termination of pregnancy on the basis of gender. The College of Physicians and Surgeons of Ontario as well as British Columbia and Saskatchewan also echoed these concerns. However, medical bodies do not make laws. Canadians send parliamentarians to Ottawa to work on their behalf and to reflect Canadian human rights values at home and internationally.

It is in this spirit that I brought forward this proposed sex-selective abortion act. Over a year ago, I introduced Bill C-233 to amend the Criminal Code of Canada to make it an offence for a medical practitioner to perform an abortion, knowing that abortion was sought solely on the grounds of the child's sex. It would also require the federal Minister of Health, in consultation with provincial counterparts, to establish guidelines respecting information provided by a medical practitioner in relation to a request for an abortion from the medical practitioner to the individual asking for an abortion. Fittingly, the criminal sanctions in my bill for a medical practitioner who is found guilty mirrors those that are actually found in Canada's assisted dying laws.

I introduced Bill C-233 in response to Canada's lack of the legal framework to respond to the wishes of a clear majority of Canadians and to honour our core values.

Canada prides itself on our commitment to ending discrimination against any person on the basis of sex. Equality between men and women forms a crucial part of Canada's efforts to promote and protect human rights, as reflected in its laws and international commitments.

As long as we do not have a law, we continue affirming ending the lives of baby girls simply because they are baby girls. Canadians believe it is time for our country to join the rest of the world by implementing a strong legal framework prohibiting sex-selective abortions. If a baby girl is unwanted simply because she is a girl, I am pleased to say that the majority of Canadians believe abortion access has gone too far.

A new reality is rising in Canada. A very recent national poll found that a majority of Canadians would be more likely to support a political party if that party promised to legally restrict sex-selective abortion in its platform. Among the results, 52% of Canadians overall, 58% who voted Conservative in 2019, 51% who voted Liberal and 61% who voted for the Bloc would be moderately to much more likely to vote for a party that promised to restrict sex-selective abortion. This critical mass of Canadians is calling on political parties to stop playing politically with the lives of baby girls and legally restrict sex-selective abortions in Canada. There is unity across the country for Canada to assert itself on this fundamental human rights issue.

This poll result comes less than a year after the results of a 2019 DART & Maru/Blue poll conducted for the National Post, which found that 84% of Canadians believed it should be illegal to have an abortion if a family did not want the baby to be a certain sex.

These 2019 poll results reinforce that Canadians are united and no longer accept the myth that Canadians are polarized. They are not. They want this law.

In the same DART poll, it was determined that 62% of Canadians identified as pro-choice, while 13% identified as pro-life. With 84% of Canadians opposed to sex selection, it is clear that this issue has overarching public support.

I have been so truly humbled by the response of Canadians to this bill. Tens of thousands have signed petitions and family and youth are urging their MPs to support the bill in creative and unique ways. Citizens across the country have taken notice.

In its statement of endorsement, the Vedic Hindu Cultural Society Of British Columbia declared that Bill C-233 was a reasonable limit on abortion that would work to enhance Canada's human rights image. The United Sikhs is a UN-affiliated international non-profit, non-governmental, humanitarian relief, human development and advocacy organization. The Canadian chapter sent a letter of endorsement as well. It stated, “C-233 proposes a reasonable limit that would reflect Canada’s respect for human rights at all stages of life. The practice [of] sex-selective abortion takes place in Canada and it is our duty to defend those whose lives would be ended simply because of their sex.”

The Minister of Justice has also publicly declared, in response to petitions tabled by many members of the House, “The Government of Canada condemns all practices that are motivated by discriminatory views of women and girls, including sex selective practices.” Countless Canadians are encouraged by that statement and wait with anticipation for how members of the Liberal Party will vote on this bill.

If the Prime Minister and his cabinet truly claim to be feminist and wish to condemn sex-selective practices, then their voting for Bill C-233 at second reading and sending it to committee is a reasonable expectation by their supporters. I encourage every member of the House to have the courage to exercise their rightful freedom to vote their own conscience, the way that we on this side of the floor have that freedom to do, and pass this bill.

Stopping short of a full commitment to ending sex-selective abortion in the second half of the Minister of Justice's petition response, he attempts to wash his hands of any responsibility. It reads, “In Canada, the administration and funding of health care services is a provincial responsibility that falls under the purview of the provincial governments. As is the case for other medical procedures, the delivery of abortion services is determined by the policies of the provincial governments and the standards set by the medical profession itself." On delivery, it is very true.

Canadians, however, are very aware that there are many bills that we have worked on in the House together, such as Bill C-7 and Bill C-8, where the federal government chose intentionally to legislate on primarily provincial issues when it believed a charter interest was in play. With regard to discrimination on the basis of sex, the same applies.

The federal government has already recognized the inherent discrimination tied to sex selection. In 2004, a Liberal government created a precedent in law with regard to sex selection through the Assisted Human Reproduction Act. According to the act, no one may, “For the purpose of creating a human being, perform any procedure or provide, prescribe or administer any thing that would ensure or increase the probability that an embryo will be of a particular sex, or that would identify the sex of an in vitro embryo.”

In an attempt to downplay the need for a law, I have heard the justification that choosing to abort a baby girl simply because she is a girl rarely takes place in Canada compared to countries like China and India. The number aborted is not a legitimate reason to not have a law, and currently research indicates that this number is approximately 2,000 per year in Canada.

Canadians have spoken loudly on other issues for women. When the Liberals tried to remove female genital mutilation from our citizen book, they spoke out loud and clear, and we have a law to highlight that value. Those who are fine with allowing sex-selective abortion in Canada also claim that the law would be useless because it would be impossible to enforce.

As members of Parliament, our role is not to enforce laws, but to create laws that reflect Canadians' values and respond to the concerns of Canadians. Through Bill C-14 and Bill C-7, the federal government crafted a response to a national mandate it received from vocal Canadians and the courts. Ultimately, the enforcement of assisted dying laws were delegated to the provinces and provincial medical bodies, as would be the case here.

Bill C-233's language clearly outlines a directive to the federal government to work with the provinces to determine effective communications on the framework that sex-selective abortion is illegal in Canada. Indeed, enforcement is an important consideration, but just as impaired driving laws have not removed all drunk driving from our roads, the sex selective abortion act would not put a hard stop to the practice all on its own. However, the bill enshrined in Canadian law will send a clear message about what our country stands for within our country and to the rest of the world, and also what it does not permit.

Canada must bring legislation in line with human rights obligations to prevent sex selection before birth. Bill C-233 is a necessary step in doing so.

It is an honour to rise alongside my colleague from Elgin—Middlesex—London today. We are traditionally from opposite sides of the abortion debate. However, we are both part of the 84% of Canadians who recognize that sex selection is not permissible in a society that advocates for equality of the sexes. Adopting appropriate legislation to end discrimination against any person based on sex is part of Canada's commitment to advancing human rights. My bill addresses inequality between sexes at the earliest stages of life.

This is a cause for which Canadians are united. While some oppose and some promote, we can all stand together, side by side, against sex-selective abortion, as we all have a moral obligation to stand against gender inequality. No issue important to Canadians should be vetoed from debate in this place by absolutist political narratives for political gain. It is past time to stand in the gap and do the right thing in defence of preborn girls.

Will elected members of Parliament from all political parties condemn this practice and make it clear to all that Canada values women and equality? Every female preborn child who is terminated because of her sex has paid the price with her life because our lack of laws say she does not matter. With the implementation of this bill, we will be telling the world that Canada has had a change of heart.

Economic Statement Implementation Act, 2020

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

Mr. Speaker, I am sure there are many reasons, but if I look at how the Liberals have been scheduling House business over the last couple of months, it has been a bit of a scattergun approach. There does not seem to be any rhyme, reason or logical following for which bills are being brought up for debate. As for delay, when the Liberals decided to bring in a motion accepting Senate amendments to Bill C-7, it led to a whole new round of debate on a bill that the House had already presented its opinion on. This, of course, sidelined many other important pieces of legislation.

I just wish that in the weeks ahead we would have a little bit more reasoning behind the scheduling of House business. I would agree with him that Bill C-14 has some important measures, and that Canadians would like to see some of the measures passed.

Gender-Based Violence

[Stephanie Kusie, Conservative, Calgary Midnapore, AB]

Madam Chair, I will be splitting my time with the member for Cloverdale—Langley City. As always, I look forward to her remarks. I find her to be an incredibly thoughtful individual who is constantly in touch with her constituents. I know she will add a lot to this debate.

Before I begin my comments, I will compliment the member for Port Moody—Coquitlam. This is a member who joined our caucus after the 2019 election. She has repeatedly touched my heart with her remarks, specifically about Bill C-7 and the necessity for hope. I actually think those sentiments ring true here this evening as well, as we discuss such an important matter, the issue of violence against women here in Canada. This has really come to light with the terrible tragedy of these seven lives recently being lost in Quebec.

As I reflect upon this and the situation within myself, my family, my circle of friends and my community, what I keep coming back to is the incredible toll this last year of being in the pandemic and working together for the collective good has taken. It has been so important, but it has come at such a price to our mental health.

I genuinely believe that although this problem existed, and of course it existed, as the previous speaker indicated, for generations before I was here, we have really seen it amplified in the last year with the situation of the pandemic.

I am really happy that my leader, in his five-point plan for securing the future, has indicated he will make mental health a priority. That is of absolute necessity. Our discussion here this evening reflects it.

I see it in my own community. CTV here in my city has reported that before COVID-19, 5% of Canadians reported high to extreme levels of anxiety. Now we see that that number has multiplied to 20%. Self-reported cases of depression have more than doubled from 4% to 10%. When asked what they expect if social isolation continues onwards, respondents generally anticipated anxiety levels to remain the same but for depression to worsen.

These types of mental health impacts are the things that we are seeing playing out within the pandemic. It is taking a severe toll. In fact, there is fear that when we finally come out of this pandemic or return to the new normal, we will experience an echo pandemic.

In addition, we have seen opioid overdoses spike during COVID-19, as a result of people's attempts to cope and figure out a way through this pandemic. My province recorded 301 opioid deaths from April to June of this last year, more than double the rate from January to March. We see that increasing significantly, as well.

Distress Centre Calgary has said that suicide-related calls, texts and chats were up 66% in the month of October over previous months. I could go on and on.

All to say, I think this is a problem that has existed for a long time, but the situation we have found ourselves in over the last year has amplified it beyond belief. We have to figure out a way to emerge from this as a society with the government leading the way. Unfortunately, it has led to horrific consequences, as we have come to learn.

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

Madam Chair, that question resonates a great deal with me. Being a pastor's wife, we deal a great deal with a lot of the hurts that people experience in their lives, and life is full of those. I do not know if this is a government responsibility actually. I am on the veterans affairs committee, and VAC has its role, but veterans helping veterans is where it is at.

We need to be investing in relationships at a young age. Building community is so key. Of course, with the COVID scenario we are in, isolation is absolutely a horrific scenario. One of the individuals who talked to me about Bill C-7 is a psychiatrist and he works at the University of Toronto and with the hospital. He is in favour of the bill, but even he said the number of seniors—

Medical Assistance in Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, the fourth petition I am tabling deals with Bill C-7, the government's euthanasia bill.

The petitioners are very concerned about the fact that the government is, through this bill, removing safeguards it said were vital not so long ago. They are expressing particular concern about the removal of the 10-day reflection period, the reduced requirement around witnesses, and other problems in the bill, including the government's inclusion, at a late stage, to allow euthanasia for those with mental health challenges.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Madam Speaker, the second is a petition from Canadians from across the country. They are especially concerned about the lives of the elderly with regard to Bill C-7 and the inclusion of mental illness. The petitioners call on the government to support measures to protect human life, as all human life should be regarded with great respect. They are calling on the government to support Canadians who are the most vulnerable and defenceless, instead of facilitating their deaths.

Opposition Motion—Long-Term Care

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, I wonder if my colleague could pick up on where she was at the end of her speech in talking about issues of ableism and the implications of that. Many in our caucus have been very concerned about provisions in Bill C-7, and we have joined with people in the disability community in highlighting the ways in which the mechanics of that bill could really perpetuate the kind of ableism that people with disabilities experience when interacting with our health care system.

I know the NDP members supported Bill C-7 at third reading, but then they opposed the message to the Senate. I wonder if that was in response to hearing feedback from all the disability groups that were speaking out about the bill.

What does the member think we can do in this context to fight ableism in our health care system?

Medical Assistance in Dying

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Mr. Speaker, the last petition I am presenting today is with respect to the importance of the lives of the elderly and the passing of Bill C-7. The petitioners are calling on the government to support measures to protect human life, as all life should be regarded with great respect. They believe we should support the most vulnerable and defenceless Canadians instead of facilitating their death. The petitioners are concerned about the passage of Bill C-7, especially with the inclusion of mental health.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, the third petition deals with Bill C-7. The petitioners are very concerned by the fact that this bill has removed vital safeguards associated with the euthanasia regime, safeguards which the government said were essential only a few short years ago.

The petitioners call on the government to restore the 10-day reflection period, restore the original requirement that a person must give consent to a life-ending procedure immediately before it is performed, restore the requirement for two independent witnesses, require medical professionals to do everything possible to enable the person to access life-affirming services to relieve their suffering, and accommodate persons with communication disabilities by clarifying their refusal of or resistance to administration of physician-assisted death.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, the second petition raises significant concerns about Bill C-7, which just passed the House last night. The bill would bring in the possibility of same-day death by eliminating the 10-day reflection period. It risks making disabled Canadians second-class citizens when they access the health care system and undermines suicide prevention work through the changes related to mental health.

Justice

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

Madam Speaker, yesterday, we moved a very important step closer to passing the critical changes to medical assistance in dying, through Bill C-7. We listened through this process to more than 300,000 Canadians. We heard from countless experts. We spent more than 45 hours of debate on this important legislation. However, the job is clearly not done yet.

We finally brought the unfortunate obstruction by the official opposition Conservative Party to an end in the House. Now it is up to the other place, the Senate, to complete this bill's journey so that these critical changes can become law and suffering can end for Canadians.

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, the government has indicated that it plans to finally move forward with a parliamentary review of Canada's medical assistance in dying legislation, nearly one year late. Persons with disabilities and mental health advocates are worried that their concerns will continue to be ignored. They are concerned that engaging in the process will be a waste of their time. Can the minister confirm that all options will be on the table in this review, including reversing some of the changes pushed through in Bill C-7?

Medical Assistance in Dying

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, yesterday the Liberals invoked closure on their motion that significantly altered Bill C-7 by expanding medically assisted death to those with mental illness. They did so at the absolute last moment possible in the parliamentary process.

I have received hundreds of emails, letters and calls in opposition to Bill C-7, in particular from persons with disabilities and groups that advocate for them. Many of them wanted more time to speak out in committee against Bill C-7. The government has now expanded Bill C-7 so that MAID will be accessible by those with mental illness. This was done with no consultation directly on this issue in the House of Commons.

I call upon the government to actually listen to those who are raising concerns with the changes made by Bill C-7 and be willing to address them through the upcoming parliamentary review.

Employment Insurance Act

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

Madam Speaker, the member has indicated that speaking to this legislation is worth the effort. I am pleased that he spent a portion of his time on this issue. I agree with him that COVID is a huge issue and we need to be there for Canadians.

Mental wellness is at an all-time low in Canada, so my question for him is this. If the legislation is worth the effort, why was there no effort on the side of the Liberals to stand up and speak to Bill C-7 and the huge changes made to it in the House yesterday?

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Again, Madam Speaker, the member has to speak about the current bill. He has not heard any resistance that Conservatives are going to vote one way or another. He is talking about the concurrence motion now. All he is trying to do is justify what the government did on Bill C-7. Part of the reason we wanted more debate on Bill C-7 was the fact it was supposed to undergo a five-year review, and that was not permitted.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons]

Madam Speaker, it is quite a pleasure to speak to Bill C-24 at third reading.

Earlier in the week, I spoke on Bill C-24 at second reading. Back then, I emphasized how important the legislation was to the Government of Canada. Since the very beginning of the pandemic, the Prime Minister has made a commitment to have the backs of Canadians. Once again, we have legislation before the House that is absolutely critical with respect to supporting Canadians today and continuing to do so going forward.

When I spoke on the bill earlier in the week, I was somewhat upset and I expressed my feelings about the Conservative Party and how it was filibustering important legislation on the floor of the House of Commons. In fact, I recall citing a tweet by the member for Kildonan—St. Paul about importance of the legislation for workers. However, the Conservatives were filibustering important legislation during the pandemic, and we witnessed that during the debate on Bill C-14. At the time, I indicated that the only way the House could see legislation passed was if the Conservatives were made to feel ashamed of their behaviour. I am pleased that it would appear as if the Conservatives saw the merit, through a bit of shaming, in allowing the bill to pass. It is important to recognize that.

If we review what has taken place during the week, there are some encouraging signs, at least from some of the opposition parties. However, that is not universally held. I am afraid that the Conservatives still feel obligated to play that destructive force on the floor of the House of Commons, and I will expand on that.

Bill C-24 would provide badly needed funds, essential funds, to thousands of Canadians in all regions of our country. To see how we should proceed, all we need to do is look at the desire and what we have seen this week. I will cite a few examples of that. The reason I am doing this is because I want to encourage members of the Conservative Party particularly to recognize the true value of legislation like Bill C-24, and it appears the member for Kildonan—St. Paul has recognized it, and to see the value in passing it.

The best example I can think of is something that took place yesterday. We had very important legislation, Bill C-7, which is literally on life and death, before us. Because we are in a minority situation, it does not take very much to prevent the government from passing legislation. However, in this situation, the Bloc, indicated that it supported the legislation and would assist the government to bring forward closure. Had we not received that support, we never would have been able to advance it through the House of Commons and people would have been denied the opportunity to have access to this through this legislation.

Earlier in the week, we also had some indication from my New Democratic friends about Bill C-5, important legislation that is not necessarily as direct as Bill C-24 is with respect to the pandemic. Quite possibly it could be somewhat of assistance indirectly during the pandemic.

In this situation, the New Democrats said that they would like to have unanimous consent to allow that additional debate and ultimately see Bill C-5 passed in the House. Of course, much like with the Bloc's suggestion, the Conservatives outright said that they did not want anything to do with it. Again, it is not to come across as not being grateful for the Conservatives recognizing the importance of Bill C-24, but it is more so to encourage the Conservative Party to look at what other opposition parties are doing to facilitate the passing of important legislation.

Bill C-24 was recognized the other day by the Conservatives when they stopped debate, allowing it to get out of second reading so it could go to committee. As a result, we are now at third reading stage today. We know that if the Conservative Party wanted to do more, it could.

For example, look at what the Conservatives did with the Canada-United Kingdom agreement, which is critically important legislation. It would have a direct impact, even during the coronavirus pandemic. The Conservatives requested unanimous consent for a motion with respect to the trade agreement, and we supported it.

It is important to recognize that my New Democratic friends, who have traditionally voted against anything related to expanding trade relations, also supported the motion to see the bill on the United Kingdom trade agreement pass through the House of Commons even though they opposed it. It is important to recognize that. The NDP and the Bloc have, on occasion, have recognized what I have been saying to the House for quite a while, which is that the behaviour of the Conservatives has not been favourable to the House of Commons in passing the legislation that is so badly needed to support Canadians during this difficult time. They have gone out of their way to frustrate the House of Commons and our desire to see important legislation like Bill C-24 passed.

I will continue to remind my Conservative friends that they have an important obligation to Canadians, as the government has since day one, to focus their attention not on an election, but rather supporting Canadians. One of the ways they can do that is by providing support on legislation such as this.

When I spoke on Bill C-24 earlier in the week, members of the Conservative Party were somewhat critical of me, saying that the government had just introduced the legislation so how could I expect them to pass it, implying that I was maybe not being as principled on enabling members to speak to important legislation. I want to assure members of the House that I have always been an advocate for members of Parliament to express themselves on legislation.

Many would say that I have no problem expressing myself on a wide variety of issues on the floor of the House. I am very grateful for the position that I have been put in by the Prime Minister and the support I get from my caucus colleagues. I often speak on behalf of many of my caucus colleagues in expressing frustration and in expressing support for initiatives that are being taken on the floor of the House of Commons.

The bill was introduced for the first time in February, and nothing would have prevented further discussion and additional debate if in fact—

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?

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons]

Madam Speaker, I can appreciate the gravity of the debate that has been taking place on this very important piece of legislation. It is nothing new to members, no matter what side of the aisle they are on. Those who have been around for the last four or five years have literally seen hundreds, if not thousands, of hours of debate and discussion when we factor in what has taken place in the Senate and its committees, the hours of debate in second reading and third reading, the committee hearings and the special committee hearings.

An amazing amount of consultation has taken place, in particular, with the current minister responsible for the legislation. I know the parliamentary secretary to this particular ministry has done a phenomenal job in terms of reaching out and explaining the many complicated aspects of this legislation, and comparing it with what had taken place previously.

The issue of medical assistance in dying has been on the floor of the House and in our communities for years. We are in this position now because of a specific superior court ruling from the province of Quebec. I think the deadline is now the end of the month. This is the second or third, and final, extension, as has been made very clear. I believe that we need to have legislation dealing with medical assistance in dying and that it needs to comply with our courts. I very much support the rule of law in our democratic system.

I understand there are extremes on either side of the issue. There are those who, for personal and passionate reasons, believe that we should not have the legislation and those who, for personal and passionate reasons, believe that we have to have the legislation. I have chosen the side of supporting the legislation. I made that determination for a number of reasons. I respect the debates that have taken place over the years. I have seen tears on the floor of the House of Commons as MPs plead their position on MAID, at times with a great deal of passion. It is not easy for many, if not all, members of Parliament to ultimately make that determination.

We have heard from our constituents by email, by Canada Post, by telephone and by public meeting. Many of our constituents are following this issue and want us to make a decision from their viewpoint. What I have often found when speaking to constituents is that they understand why we are in the position we are in today. Some would ultimately not want to see this legislation pass, period. They are prepared to use whatever mechanisms they can. I am referring, in particular, to members of the official opposition. They will take whatever actions they can to prevent the passage of this legislation.

When asking a question of the Minister of Justice earlier, I indicated I had listened to many hours of debate on this issue, and I had posed questions to other members.

Let it be put on the record clearly that I believe there are members within the Conservative caucus who do not want this legislation to pass, period. End of story. As a whole, the Conservative Party has taken the position that it wants to continue debate and has somehow drawn the conclusion that it is inappropriate for the government to move closure. I want to highlight two aspects of that, because I think it is very misleading for the Conservatives to try to give the impression in any way that the Government of Canada has not been listening to Canadians, or is trying to ram through legislation.

First, we are in a minority government. We could not be doing this without the support of a majority of the members sitting in the House of Commons. That means that many opposition members are supporting the need to allow this legislation to come to a vote. I suspect, when it does come to a vote, that some of the Conservatives who voted against allowing it to come to a vote will vote in favour of the legislation, so the Conservatives are using the rules to try to prevent that. It is important to recognize that it is not just the government saying the official opposition is being irresponsible with respect to this legislation.

Second, the Conservatives are saying they want more debate and that is what this is all about. They do not want the government to bring in closure. That is just not true. That is not the case. I do not believe that for a moment. Those who are following the debate need to understand and appreciate that the Conservative Party of Canada was offered not once, not twice, but on three separate occasions the opportunity to continue to debate this issue for hours on the floor of the House of Commons. The Conservatives said no to every opportunity they were provided for additional debate. That clearly demonstrates that the Conservative Party is not interested in having more debate time; rather, it wants to filibuster this legislation. In one sense, the Conservatives would be very happy if we debated this bill every day. If we accommodated their so-called desire, they would criticize us for not having more debate on other government bills.

There is a finite amount of time on the floor of the House of Commons. In my opinion, the Conservative Party continues to abuse the opportunity to allow for healthy debate. With Bill C-7, we are talking about life and death. There are examples I could give that further show what I believe has been a very destructive attitude by the Conservative Party of Canada when it comes to the proceedings in the House.

If it were not for shaming the Conservative Party of Canada, some of the legislation and other things that have taken place in the last 24 hours would not have occurred. If Canadians understood the tactics the Conservative Party is using, I believe they would be outraged.

Today is about life or death and Bill C-7. On other occasions, and I would cite Bill C-14 as an excellent example, there were hours and days of debate. I suspect there were probably more days of debate on Bill C-14 than there were on a budget bill, and more speakers than on a budget bill. Conservatives wanted to talk it out. I believe we finally got it through because they were shamed into doing so.

Bill C-7, as I indicated at the beginning, concerns a complex and deeply personal issue. It is about reducing suffering, among other things. In previous debates on this issue, I have shared with the House my own experiences of the passing of my father at Riverview and of my grandmother in palliative care at St. Boniface Hospital.

In these debates, there has been a great deal of discussion about what else we could do. For example, the importance of hospice care and the issues of long-term care, recognizing the federal government has a role to play in those areas—

The House resumed from February 23 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 That Debate Be Not Further Adjourned

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, unfortunately, we heard the minister use the word “consensus” over and over again in the last little while. The fact is that when he appeared before the justice committee on Bill C-7, he said there was no consensus to include mental illness. When he went to the Senate and spoke there, he said there was no consensus in the medical community or in Canada on the issue of mental illness.

He is now showing complete contempt for Parliament by having no debate and no study at committee and complete contempt for those in the mental illness community and those in the suicide prevention community. They include such groups as Inclusion Canada, the Canadian Institute for Inclusion and Citizenship, the DisAbled Women's Network, the Council of Canadians with Disabilities and the Canadian Feminist Alliance for International Action.

Hundreds of organizations have signed a letter asking members of Parliament to please vote against the inclusion of mental illness in Bill C-7. Why is the minister putting the cart before the horse? We need to first study this legislation before moving forward.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, some members seem to be forgetting that in addition to the sensitive issues that will be sent to an expert panel and a committee in the next 30 days for review, Bill C-7 contains a number of other improvements.

The bill enables terminally ill patients to give final consent right away without waiting 10 days. It also makes it possible to respond to the situation of people like Ms. Carter, Ms. Parker, Ms. Gladu and Mr. Truchon, who received medical assistance in dying. Patients who are terminally ill are suffering, and they are waiting for us to take action. Bill C-7 already makes that change. The court said that, if we did not give these people the opportunity to be heard, then we were violating their right to life. Bill C-7 resolves that issue.

Does the minister believe that the panel will be set up in the next 30 days? Will the panel continue to work on the issue regardless of whether an election is called? Members of the panel in question will be able to work with other stakeholders. At least that will enable us to make progress on this issue. In a year—

[David Lametti, Liberal, LaSalle—Émard—Verdun, QC]

Madam Speaker, again, these are the kinds of arguments that we have been hearing in this House with respect to Bill C-7 generally, and the member's party has fixated on them. The fact of the matter is that we consulted widely with the leadership of disability groups.

Nobody is forced to get MAID. We, as a government, have invested in a dignified life, and we are going to continue to invest in resources for the disabled and for mental health.

We have disagreed with the opinions offered with respect to the bill's constitutionality. I believe it is constitutional and that it is in fundamental agreement with the Charter of Rights and Freedoms. Also, I believe that there are fundamental errors in the report from the United Nations in the way it has characterized the legislation. Nobody is forcing people with disabilities to get MAID.

[David Lametti, Liberal, LaSalle—Émard—Verdun, QC]

Madam Speaker, I am satisfied that we are still respecting the process we put forward with Bill C-7 that had the general support of Canadians. We have always said that we would be dealing with the question of mental health in a profound way in the parliamentary review that was originally envisaged in 2016. We are still doing that.

We are now benefiting from the work the Senate has done. We will benefit from the work of the committee too. However, at the end of the day, I want to reassure the hon. member for Saanich—Gulf Islands that as parliamentarians, we will roll up our sleeves and work through the mental health criterion. That will bring us within the parameters of the Carter decision and will fulfill the right of all Canadians to have access to medical assistance in dying in a reasonable and safeguarded way.

[David Lametti, Liberal, LaSalle—Émard—Verdun, QC]

Madam Speaker, I assure the House and Canadians that nothing could be further from the truth. We consulted widely and deeply, beginning in January 2020, on this phase of the legislation, Bill C-7. We consulted over 300,000 Canadians online. We spread out across the country, from coast to coast to coast, to listen to Canadians who had experience with MAID and to listen to the disability community. Indeed, the very structure of Bill C-7 takes into account what we have heard from the disability community and builds in safeguards for the non-end-of-life scenario, representing the concerns we heard directly from them.

The leadership in the Senate from a senator who lives with a disability is, quite vigorously, evidence that we have indeed listened to and supported that community. With—

[Erin O'Toole, Conservative, Leader of the Opposition]

Mr. Speaker, the use of closure is quite unprecedented in Parliament, particularly on a topic as important as medical assistance in dying. In fact, the Minister of Justice, in question period today, said that this is a sensitive and important topic, yet he is limiting discussion of this important topic. There are literally hundreds of thousands of Canadians, those disability groups, indigenous leaders and mental health advocates, who have reasonable questions about this bill.

The minister knows the Senate substantively changed Bill C-7. Medical assistance in dying is no longer a standard of reasonably foreseeable death. It is no longer a standard of an irremediable condition. It is now going to include mental health conditions, even though there is the ability for people to get treatment and help, which is not the context first intended by Bill C-7 when the minister introduced it.

Just a month after Bell Let's Talk Day, when we talked about the need to talk when people are struggling, and when mental health advocates and thousands of Canadians have questions about this substantive change to how we address vulnerable people, people in the palliative stage of a disease and our publicly funded medical health system, why would the government limit reasonable questions of concern, particularly when it comes to mental health, and use closure in this way on Bill C-7?

[Catherine McKenna, Liberal, Minister of Infrastructure and Communities]

Mr. Speaker, in relation to the consideration of the Senate amendments to Bill C-7, an act to amend the Criminal Code on medical assistance in dying, I move:

That the debate be not further adjourned.

Business of the House

[Pablo Rodriguez, Liberal, Leader of the Government in the House of Commons]

Mr. Speaker, I thank my colleague and friend for his question and for giving me an opportunity to talk about what we plan to do this week and once we return to the House.

This afternoon we will resume our study of the Senate's amendments to Bill C-7 regarding medical assistance in dying. Tomorrow we will resume debate on Bill C-24, which would increase the number of weeks of EI regular benefits and make international travellers ineligible for recovery benefits during their mandatory quarantine.

I would also like to inform the House that for the week of March 22, Monday, Tuesday and Thursday shall be allotted days.

Until then, I wish all of our colleagues an excellent week working in their ridings.

Employment Insurance Act

[Charlie Angus, NDP, Timmins—James Bay, ON]

Mr. Speaker, I listened with great interest to my hon. colleague. I do not want to challenge him but to correct the record for people listening.

It is not just that the government is pushing through Bill C-7; what it has allowed to happen here is for the unelected, unaccountable Senate to rewrite the law of Canada so that people with depression will be able to ask to die in two years, and this Liberal government is supporting that. This is ignoring what Parliament stands for.

Parliament does the hard work. If members of Parliament went back to their constituents and said that instead of having suicide prevention or mental health programs, they would like to make it easier for people with mental illness to die, there would be an outcry. There would be headlines and there would be debate. That would be democratic. It is the fact that this Liberal government is using the unelected and unaccountable Senate to fundamentally change a basic principle of the right to life in this country that I find appalling, and the fact the Liberals want to rush it through the House.

They say that we have obstructed; they are obstructing the democratic rights of this House.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons]

Mr. Speaker, the member is absolutely wrong. The Conservatives have become a destructive force, playing a destructive role inside the House of Commons in recent weeks and months. Let there be no doubt about that. Even some opposition parties have recently commented on the role the Conservatives have been playing. The only reason we are seeing what we have seen in the last 24 hours is that they have been shamed into doing some of the things that they are currently doing.

The member complained about Bill C-24. There are a number of pieces of legislation the Conservative Party has deliberately attempted to delay or prevent from passing. Bill C-7 is a good example. We attempted to extend the hours in that case.

The member talked about plenty of opportunities to provide due diligence. Will the member take responsibility for the irresponsible behaviour of the official opposition and recognize that it is time we start working together once again—

[Mark Strahl, Conservative, Chilliwack—Hope, BC]

Mr. Speaker, as always, it is a pleasure to speak in the House on behalf of my constituents. We are here today to discuss Bill C-24. Because of the government's failure to manage the House of Commons effectively, we are seeing its has created a crisis through its mismanagement. Once again we are up against a hard deadline, with benefits expiring for Canadians, and the government not managing the House calendar or its legislation so we can consider this fully. The bill before us today would expand the spending of the government by $12.1 billion. Because of how this is going to go, with members debating it for about six hours, that is about $2 billion an hour for every hour we will be able to discuss and review it here.

As has been said, this would fix a problem that is a result of the government's first attempt to provide benefits to Canadians, Bill C-2, which was rushed through the House at that time to meet a deadline the government knew about, but failed to plan for or to present legislation in a timely fashion to the House to address. That because the Prime Minister prorogued the House, shut everything down, eliminated all of the legislation that was on the Order Paper because of the WE Charity scandal. Things were getting a little too hot on that at the time, and it was time to shut down the investigations into the Prime Minister and his involvement in the WE Charity scandal, so he prorogued Parliament, which created this rush to get legislation before an October deadline when the CERB would end.

The bill was rushed through and Liberals did not realize that they had provided in that legislation a $1,000 bonus to people who had gone on leisure vacations outside of the country. People could apply and get $1,000 for the time they were at home during their 14-day quarantine after international travel. The bill passed, as has been said, because we needed to get the benefits to Canadians whose CERB was expiring, but there were no committee studies or debate in the House because of the government's mismanagement of this file. It saw a deadline, it did not care, and it rushed and made mistakes. That is indicative of the government's approach.

We are seeing it again today not only in this debate, but also in another important debate. I would argue that one of the most important debates the House will have in this Parliament is on Bill C-7 and the Senate amendments to it. That debate is being cut short because of the government's failure to plan or provide legislation and opportunities for parliamentarians to intervene on behalf of their constituents. We have a situation where, later this day, debate will be shut down on Bill C-7 and the Senate amendments, which call for the expansion of medical aid in dying to include people who only have mental illness or disabling conditions and who will now have access to medical aid in dying, something that has not been studied by this Parliament or in committee.

Because of the government's mismanagement and failure to respond in a timely fashion to court decisions and legislative deadlines, we now have a situation where yet another bill, in addition to this one, is jammed up against a deadline. The Liberals are forcing parliamentarians to address complex issues, in this case, life and death issues, with almost no time in the House because of their failures and mismanagement. People in my riding are very concerned about this. They are concerned about the government's inability to manage the House and debate on legislation in a way that addresses their concerns.

People have written to me about it, and there is one organization in particular from my riding that I want to highlight. The Chilliwack Society for Community Living signed an important letter from the Vulnerable Persons Standard, calling on members of Parliament to do better. It says, “Bill C-7 sets apart people with disabilities and disabling conditions as the only Canadians to be offered assistance in dying when they are not actually nearing death.... Bill C-7 is dangerous and discriminatory.... Canadians with disabilities are hearing MPs and Senators arguing that lives just like theirs featuring disabilities just like theirs are not livable. This is harmful and hurtful and stigmatizing.”

It goes on to say:

Take your time, start over, and get this right. As you do so, be careful to heed the advice of the UN Special Rapporteur on the Rights of Persons with Disabilities: "Listen closely to the most directly affected. Their antenna is highly attuned to ableism. When they see it, you should pause and reflect before proceeding."

Bill C-7 is not the answer.

This is another example, as is Bill C-24, of a government failing to take the time to allow Parliament to deliberate to get something right. If we had had the time to deliberate on Bill C-2, if the government had not shut down Parliament and rushed that up against the CERB deadline, I am sure that someone along the way, either in debate or as a witness at committee, would have identified this failure to focus the benefits where they were meant to be focused: on people who had to take sick leave because of COVID-19, not on those who needed to take a vacation. Had we had proper debate, that failure would have been identified.

Here again today, with just six hours of debate, it has to be rushed. After two hours, we are accused of being obstructionist and failing to do our job on behalf of Canadians. Only a Liberal government would think the solution to the problems it created by rushing a bill through Parliament previously could be solved by rushing another bill through Parliament again. That is the failure of the government.

What are we doing here? There is $12.1 billion to extend benefits to Canadians, which we have supported. All along we have supported the benefits going to Canadians who, through no fault of their own, have found their workplaces closed and their opportunities eliminated and have been forced into restrictive lockdowns. When governments force people out of their jobs and bring in conditions that restrict them from going to work, they have an obligation to provide them with an alternate income, but this cannot go on forever.

Here we are, and we are again extending it. The Conservatives support extending benefits to the people who need them, but what we also need is a plan to get past this, a plan to address the lockdowns, a plan to show Canadians there is hope for the future. That is why we have been calling on the Prime Minister to present that plan to Canadians. We have introduced a petition. The member for Calgary Nose Hill has called on the Prime Minister to use the tools we have gathered in the last year to help us get past this. We are calling on the Prime Minister to immediately present a clear plan to get Canadians safely out of lockdown. We are calling for it to include data-driven goals, a plan of action, and a timeline to achieve those goals and ensure the plan is articulated to Canadians so that they can have hope about when life and business will return to normal.

We know there have been some problems with vaccine procurement and rollout. We know there have been issues with conflicting advice being given to Canadians during this pandemic. Today we are a year into it; we have commemorated the lives that have been lost, but we also need to think about the lives that are being severely and permanently impacted right now. Some people are experiencing extreme mental health concerns. Others are not getting the health screening they need for cancer and heart disease. Other people are unable to join with others to worship freely, as is protected by the Canadian Charter of Rights and Freedoms.

We need to plan forward so that we are not coming up against deadlines again and again, as the government has, to extend these benefits over and over again. We will be there when Canadians need us, but we also need to start talking about a plan and the way forward to ensure that these are not permanent benefits. The next benefit is to help our economy grow and help people get past these restrictions safely while listening to public health advice. We need a plan from the government, and we have not received it. All we have seen from the government is incompetence, mismanagement of the House, and mistakes being made time and time again. We need to do better.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, I was very precise in saying that Conservatives had been prepared to work with the government on issues such as Bill C-18 and Bill C-24.

The member raises the issue of the government's desire to expedite legislation that would effectively undermine suicide prevention in this country. The government's new position on Bill C-7, which has been barely debated in the House and never studied in a House of Commons committee, would allow those whose primary health complaint is mental health related, who are dealing with depression or other mental health challenges, to be given suicide facilitation by the government.

That is a deadly serious issue. It is dead wrong, and it is strongly opposed by mental health advocates and disability rights organizations. I know that the member and many other members are receiving phone calls from constituents who have been blindsided by this rush to have state-facilitated suicide for the mentally ill. We will oppose that. That is dead wrong and—

Medical Assistance in Dying

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Madam Speaker, I have three petitions to present today.

The first petition is on the prime importance of human life and Bill C-7. The petitioners are calling for the current amendment to protect those suffering from mental illness to be supported. They call on the government to support these measures to protect human life and say that all human life should be respected. We should support Canadians who are most vulnerable and defenceless, not facilitate their deaths.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, the second petition raises serious concerns about Bill C-7, including the government's plan to eliminate the 10-day reflection period. The petitioners are also concerned about the government's plan to allow suicide facilitation for those struggling with mental health challenges.

Notice of Closure Motion

[Bardish Chagger, Liberal, Minister of Diversity and Inclusion and Youth]

Madam Speaker, I unfortunately need to give notice that with respect to the consideration of the Senate amendments to Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), at the next sitting of the House a minister of the Crown shall move, pursuant to Standing Order 57, that debate be not further adjourned.

Alleged Premature Disclosure of Contents of Bill C-22—Speaker's Ruling

[The Speaker, Anthony Rota]

I am now ready to rule on the question of privilege raised on February 19 by the member for Fundy Royal concerning the alleged premature disclosure of the contents of Bill C-22, An Act to amend the Criminal Code and the Controlled Drugs and Substances Act.

During his intervention, the member said that a CBC article posted online at 8:47 a.m. on February 18 described the details of Bill C-22 although it had not yet been submitted to the House. The member referred to the contents of the article, which he said discussed a number of the measures contained in the bill and boasted about the reliability of its sources. The Chair notes that the article had already been updated by the time the issue was raised. To be clear, with regard to this ruling, the Speaker considered the initial version of the article, which was published at the time of introduction and first reading of the bill.

After reviewing a series of precedents on the issue, the member said he also believed that the Minister of Justice's actions were contemptuous and that he had ignored the will of the House.

In response, the member for Kingston and the Islands informed the House that the office of the Minister of Justice had not shared the contents of the bill with the CBC journalist before its introduction. The member explained that he believed that the ministers' mandate letters sometimes allowed journalists to deduce the contents of bills on notice. After reviewing the contents of the article in question and comparing it with Bill C-22, the member argued that the article was sometimes inaccurate and even incomplete. In his opinion, the article was written by using a government source who was not familiar with the contents of the bill or by making conjectures based on previous policy statements. Finally, the member for Kingston and the Islands, basing himself on a ruling made on June 8, 2017, said that it is a prima facie case of privilege in such cases when the government admits that the leak occurred, but not when the government does not acknowledge a leak. In this case, the member stated that if the contents of the bill were disclosed prematurely, the government was not responsible.

As the member for Fundy Royal pointed out during his intervention, it is a recognized principle that the House must be the first to learn the details of new legislative measures. That is why both government bills and private members' bills are confidential from the moment they are put on notice until they are tabled in the House. Speaker Milliken's ruling of March 19, 2001, which the member for Fundy Royal mentioned, provides a good summary of the importance of respecting this rule:

The convention of the confidentiality of bills on notice is necessary, not only so that members themselves may be well informed, but also because of the pre-eminent rule which the House plays and must play in the legislative affairs of the nation.

That being said, when the Chair is called on to determine whether there is a prima facie case of privilege, it must take into consideration the extent to which a member was hampered in performing their parliamentary functions and whether the alleged facts are an offence against the dignity of Parliament.

In the case before us, an exhaustive review of the intervention by the member for Fundy Royal does not reveal exactly which aspects of Bill C-22 were supposedly shared with CBC for the article in question, nor did the member point out any similarities in language between the article and the bill to demonstrate that precise details of the bill were apparently disclosed to the media in a deliberate and premature fashion. The member for Kingston and the Islands pointed out inaccuracies in the article and differences from the bill.

When it is determined that there is a prima facie case of privilege, the usual work of the House is immediately set aside in order to debate the question of privilege and decide on the response. Given the serious consequences for proceedings, it is not enough to say that the breach of privilege or contempt may have occurred, nor to cite precedence in the matter while implying that the government is presumably in the habit of acting in this way. The allegations must be clear and convincing for the Chair.

As well, I believe it is important to mention that the distinction that the member for Kingston and the Islands wishes to make between questions of privilege that are a prima facie case of privilege and those that are not—simply because the government admits or does not admit that a leak has occurred—is not that clear. While there is indeed a well-established practice that a member must be taken at their word, the fact remains that the government's stating that it is not responsible for the premature disclosure of a bill is not in itself sufficient to convince the Chair. I would add that the source of the information is one factor among others and that it is important first and foremost to determine whether precise details were provided before the House was made aware of them. The Chair must thus take into consideration all the information before it and reach a conclusion based on the facts presented by the members.

The two precedents most like the current situation to which the two members referred are those that my immediate predecessor and I rendered with respect to Bill C-14 and Bill C-7 on medical assistance in dying. In these two cases, in light of the facts presented, it was clear that the information had been shared with the media before the bills were tabled in the House. In the case of Bill C-14, the Government offered no competing explanation. In the case of Bill C-7, it was clear that the anonymous source had spoken with the media despite the fact they were well acquainted with our customs and practices in the matter. That is not the case this time with Bill C-22.

Thus, in this case, in light of what has been presented, the Chair is not convinced that the question of privilege raised by the member for Fundy Royal is a prima facie case of privilege.

I thank the members for their attention.

Medical Assistance in Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, my fifth and final petition raises significant concerns about Bill C-7. It objects to how the bill would remove a 10-day reflection period. The petitioners are also deeply concerned about the fact that the government is now trying, through a Senate amendment, to legalize suicide facilitation and euthanasia for those facing mental health challenges. I am sure they would want to highlight to the House that our focus should be on helping people with mental health challenges find recovery, not facilitate their death. I commend all five of these petitions to the consideration of all members.

Justice

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Mr. Speaker, citizens across Canada, including constituents in my riding, have been writing me to express their horror at the Senate amendments to Bill C-7. Canadians affected with mental illness want hope, not death. Why is the government opening the door for their untimely death rather than providing legal protection and hope?

Medical Assistance in Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, the third petition is in opposition to many of the provisions in Bill C-7. The government has piled many things into that bill that are completely unrelated to the Truchon decision. Those things include, for instance, removing the 10-day waiting period, which would create a mechanism by which there could be same-day death in Canada.

The government is now also trying to allow euthanasia for those with a mental health challenge. Petitioners recognize that mental health associations have said that mental health conditions are neither terminal nor permanent, and euthanasia for people in that situation goes against the advice and opinion of experts.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, the final petition expresses grave concern about Bill C-7, the government's decision to try to remove safeguards, to open the door to euthanasia for those who are facing mental health challenges and to do so in all these policy areas in ways that are completely unrelated to the Truchon decision.

The petitioners call on the government to amend or stop this bill and, in particular, to remove those aspects of the bill which are completely unrelated to the Truchon decision, which, frankly, is most of them.

I commend these four petitions to the consideration of the House.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Mr. Speaker, the last petition I am presenting today regarding Bill C-7 is of prime importance, especially given the bill's amendments concerning mental illness and protecting the disabled in Canada. The petitioners call on the Government of Canada to support measures to protect human life, as all human life should be regarded with a great deal of respect, from inception to natural death.

Criminal Code

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, there have been discussions among the parties, and I believe if you ask, you will find unanimous consent to adopt the following motion. I move: That, notwithstanding any Standing Order, special order or usual practice of the House, this evening, after Private Members' Business, the House shall continue to sit beyond the ordinary hour of daily adjournment for the purpose of considering a motion respecting Senate amendments to Bill C-7, an act to amend the Criminal Code (medical assistance in dying), and when no member rises to speak or at 12 a.m., whichever is earlier, the debate be deemed adjourned and the House deemed adjourned until the next sitting day; and during the debate tonight, no quorum calls, dilatory motions or requests for unanimous consent shall be received by the Chair.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, the material change here is that we are now 24 hours closer to a deadline induced by the Superior Court. There is a material change, and given that change, consideration should be given by all members to adopt the following motion. I move: That, notwithstanding any Standing Order, special order or usual practice of the House, this evening, after Private Members' Business, the House shall continue to sit beyond the ordinary hour of daily adjournment for the purpose of considering a motion respecting Senate amendments to Bill C-7, an act to amend the Criminal Code (medical assistance in dying)—

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, there have been discussions among the parties, and I would like to ask for unanimous consent to adopt the following motion. I move: That, notwithstanding any Standing Order, special order or usual practice of the House, this evening, after Private Members' Business, the House shall continue to sit beyond the ordinary hour of daily adjournment for the purpose of considering a motion respecting Senate amendments to Bill C-7, an act to amend the Criminal Code (medical assistance in dying), and when no member rises to speak or at 12 a.m., whichever is earlier, the debate be deemed adjourned and the House deemed adjourned until the next sitting day; and during the debate tonight, no quorum calls, dilatory motions or requests for unanimous consent shall be received by the Chair.

I was—

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, there have been discussions among the parties and I would like to ask unanimous consent to adopt the following motion. I move that notwithstanding any Standing Orders, special order or usual practice of the House that (a) after the deferred recorded divisions scheduled later today and the completion of introduction of government bills during Routine Proceedings, the House shall proceed to Government Orders and continue to sit beyond the ordinary hour of daily adjournment for the purpose of considering a motion respecting Senate amendments to Bill C-7, an act to amend the Criminal Code (medical assistance in dying); (b) when no member rises to speak or at 12 a.m., whichever is earlier, the debate will be deemed adjourned and the House deemed adjourned until the next sitting day; (c) during the debate tonight no quorum calls, dilatory motions or requests for unanimous consent shall be received by the Chair; (d) Private Members' Business hour shall be suspended later today; and (e) the Private Members' Business item currently number one in the order of precedence shall remain for the next sitting day and not be rescheduled.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, on a point of order, there have been discussions among the parties, and if you seek it, I think you will find unanimous consent to adopt the following motion: That notwithstanding any standing order, special order or usual practice of the House, this evening after Private Members' Business, the House shall continue to sit beyond the ordinary hour of daily adjournment for the purpose of considering a motion respecting Senate amendments to Bill C-7, an act to amend the Criminal Code (medical assistance in dying), and when no member rises to speak or at 12 a.m., whichever is earlier, the debate be deemed adjourned and the House deemed adjourned until the next sitting day; and during the debate tonight, no quorum calls, dilatory motions or requests for unanimous consent shall be received by the Chair.

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

Madam Speaker, I want recognize the contributions by the member for Montcalm to the debate and to the justice committee during the study of Bill C-7 as well as Bill C-14.

With respect to the Conservative position, it is one of a free vote both on Bill C-14 and Bill C-7.

I did oppose Bill C-14, because I had some significant concerns at the time that it did not go far enough to protect Canadians who are at risk, and we have seen evidence of that. We heard from witnesses to that effect, including Roger Foley, who was pressured into undertaking medical assistance in dying, because his health care workers determined that he was too much of a burden. I think that case illustrates the fact that Bill C-14 did not provide sufficient safeguards to protect the vulnerable, and the legislation before us does away with them almost entirely.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I have heard my colleague make many interventions on this issue. He took part in the clause-by-clause review of the bill and he is very eloquent.

However, the Conservatives voted against the former Bill C-14. According to my colleague, this bill contained an unbelievable safeguard, but Justice Baudoin declared it unconstitutional. The Conservatives also voted against the current Bill C-7.

Am I wrong to say that the Conservatives' position is that palliative care is the only acceptable option for end-of-life?

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

Madam Speaker, I concur with the hon. member for Victoria that the Senate has exceeded its mandate in going far beyond the scope of Bill C-7.

I have to say that I am shocked that the Attorney General did not reject outright the amendment with respect to mental illness being a sole criterion for eligibility for medical assistance in dying. Despite the fact there are a lot of things we do not know, one thing we do know is that of the 4,000 Canadians each year who die of suicide, 90% of them suffer from mental illness. The question becomes: How many persons with mental illness will suffer a premature death as a result of this legislation?

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

Madam Speaker, I am rising to speak on Bill C-7.

The legislation illustrates the dangers that arise when a government puts blind ideology ahead of evidence-based decision-making. The nightmare of this bill and that road that has led to it today began when the Quebec Superior Court judge issued the Truchon decision. In that decision, that lower court judge determined that the most important safeguard in Canada's medical assistance in dying regime, namely that death be reasonably foreseeable, was unconstitutional.

That decision, again, was by one judge in one province. It is not binding in any other province. It does not bind the Quebec Court of Appeal. Indeed, it is a non-binding decision.

In the face of that, one would have thought that the Attorney General, whose responsibility it is to uphold laws passed by Parliament, would appeal that decision. After all, we are talking about a decision that removes the most important safeguard that was part of the legislation was passed a mere three and a half years prior to the issuance of the Truchon decision.

Instead, the Attorney General put ideology ahead of the interests of vulnerable persons, and did something that is virtually unprecedented. The Attorney General did not appeal the decision and, instead, recklessly tabled Bill C-7, which eviscerates key safeguards, including the most important safeguard, namely that death be reasonably foreseeable. In so doing, the Attorney General seeks to radically transform Canada's medical assistance in dying regime from something where such assistance is deemed appropriate to deal with or address suffering in death to now providing death to deal with suffering in life.

In seeking to so radically transform Canada's medical assistance in dying regime, the Attorney General has pre-empted a mandated parliamentary review provided for under Bill C-14. The Attorney General has preceded with completely inadequate consultation, ignoring important voices that represent vulnerable Canadians and, most importantly, that represent Canada's disabilities rights community.

When 72 national disabilities rights organizations wrote to the Attorney General and pleaded with him to appeal the Truchon decision, he ignored them. Their pleas to this Attorney General have fallen on deaf ears.

Why is the disabilities rights community so concerned with Bill C-7 and, in particular, the removal of the criterion that death be reasonably foreseeable? Very simply, when that criterion or safeguard is removed, it means that someone who suffers from a degenerative disability could be eligible for that very reason, despite the fact they may have years, if not decades, to live.

The disabilities rights community, on that basis, has said, in clear and unequivocal terms, that they believe this bill stigmatizes persons with disabilities.

As Krista Carr, the executive vice president of Inclusion Canada, said, this “is our worst nightmare.” As Catherine Frazee, disabilities rights advocate and former Ontario human rights commissioner, said to the justice committee with respect to Bill C-7, “Why us?”

Why, in asking that question, is the government proceeding to discriminate against the rights of persons with disabilities by depriving them of protections against premature death afforded to all other Canadians outside of an end-of-life context? In so depriving those rights, specifically to persons with disabilities, significant questions have been raised about the constitutionality of Bill C-7 and whether it would, in fact, by discriminating against persons with disabilities, violate Section 15 of the charter. However, those questions and concerns were completely ignored by the Attorney General, who puts the ideology of ableism first.

So blinded is the Attorney General that he ignored not only concerns from the disabilities rights community, but also from the UN Special Rapporteur on the rights of persons with disabilities, who has said that this bill violates international human rights norms. So blinded by ideology is this Attorney General that he ignored the UN Commission on Human Rights, which the government is rather fond of, which has stated that this bill runs afoul of the Convention on the Rights of Persons with Disabilities, in particular article 10.

Just when one thought it could not get any worse, we learnt today with respect to the motion the Attorney General tabled in the House that it would, among other things, essentially accept, with some very minor tweaking, radical Senate amendments, including one that would provide that someone would be eligible for medical assistance in dying for having solely a mental illness. This is a radical change, and, despite the fact this issue has not been appropriately studied, the Attorney General has said it is now a fait accompli. This is despite the fact that we do not know how to predict irremediability in the case of mental illness; despite the fact that we do not know if someone's mental illness is the basis for their request or a symptom of their mental illness; and despite the fact that we do not know whether someone's mental health suffering could be alleviated by health and other social supports.

This bill is a reckless, dangerous piece of legislation that would put some of the most vulnerable persons in Canadian society at risk. It must be defeated.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Madam Speaker, I will be sharing my time with the member for St. Albert—Edmonton.

I have spoken to this issue twice in the House, the last time being December 4. I entitled that speech “Stay safe, my son”, because I do tell the personal story of being a father of a 34-year-old developmentally and intellectually disabled son who lives with us and is cared for by us. His name is Jordan.

In a larger way, my speech dealt with the removal of the safeguards for Canadians with disabilities and how the government is choosing to ignore and dismiss the concerns of disability groups across this country who have joined in arms in opposition to Bill C-7 because it fails to protect them and their safety in the long term. A quote that is most often used and referred to by the disability organizations is that this is the worst possible scenario.

After that speech, I discovered the United Nations office on human rights has stated that legislation extending euthanasia and assisted suicide to persons with disabilities “would institutionalize and legally authorize ableism”. For those who may need help with the word “ableism”, as I did, I went to the Oxford Dictionary and this is the official definition in it: “Discrimination in favour of able-bodied people.”

For full disclosure, I am a parliamentarian who sees Bill C-7 for what I think it is: the next step on the slippery slope in the MAID debate created originally by Bill C-14 in 2016. Today we are being asked by the Senate to make amendments to further remove safeguards for those living with mental illness. The Canadian Mental Health Association's CEO and spokesperson, Margaret Eaton, wrote to all parliamentarians, saying that “The exclusion of mental illness as the sole underlying cause for medical assistance in dying must be maintained to safeguard those living with mental illness.”

Understand that the Canadian Mental Health Association is the most extensive community in mental health across Canada, with a presence in 330 communities across every province and one territory. It provides advocacy, programs and resources that help prevent mental health problems and illnesses, support recovery and resilience and enable all Canadians to flourish and thrive. She goes on to explain the three compelling reasons that the exclusion of mental illness, as the sole underlying cause, was justified and urges all parliamentarians to oppose the Senate amendment that proposes to drop that protection for people with mental illness.

The slippery slope is the continual easing of restrictions and expansion of euthanasia to a day when society will be conditioned to accepting death upon request. Many of—

[Ted Falk, Conservative, Provencher, MB]

Madam Speaker, as I reviewed the amendments to Bill C-7 that have been proposed by the Senate, I was struck by how quickly some legislators have embraced radical, unstudied changes to Canada's medical assistance in dying. In many cases, the direction these amendments take Canada's MAID laws was rejected just a few short years ago.

When Parliament legalized medical assistance in dying in 2016, there was a commitment included in that legislation to review the impacts of the law five years after it received royal assent. That was June 17, 2016. We have not yet arrived at that five-year mark. We have not yet done a proper and thorough review of the original MAID legislation, yet now, before this review is even under way, not only are some in this place pushing to expand the accessibility and availability of MAID without the benefit of that study, but we are also considering amendments that disregard all the thoughtful and considered debate of this House, the Senate and the committees of each place that wrestled with this complex subject matter and initially chose not to go down the road that many of these new untested amendments would take us.

The Council of Canadian Academies considered some of the amendments now being proposed, producing several reports in 2018. Former MP and health minister Dr. Jane Philpott and the member for Vancouver Granville wrote in a Maclean's article about the council's conclusions. The article states, “...there is very limited guidance on these issues because there are not enough places in the world that have allowed broader access to assistance in dying.”

That is the context in which we are having this discussion, so it is troubling that the Liberal government has essentially accepted the amendments to throw the doors wide open to MAID for patients with mental disorders, something the justice minister previously had said there was no consensus on. This is a significant reversal that the Liberals ought to explain to the thousands of Canadians who have expressed concerns about the expansion of MAID to those with mental illness.

I am certainly mindful of the fact that COVID-19 and the restrictions imposed by governments as a result have created a tenuous mental health situation in Canada. Loneliness, social isolation and reduced care for vulnerable populations are all very real concerns.

Law professor Trudo Lemmens and Leah Krakowitz-Broker wrote this in a piece for the CBC:

Introducing a social experiment by expanding MAID when people are more vulnerable than ever is not progressive policy making — it is reckless. In its desire to accommodate some who want to control the timing and manner of their death, it puts others at risk of premature death.

I am reflecting on the question of why we are even here at all. Why are we having this discussion before meeting the five-year commitment for the MAID review? It is because the Liberals chose not to appeal the ruling of a Quebec judge.

As Senator Plett said:

Bill C-7 is a result of the federal government choosing to cave in to the opinion of one judge in one province who decided to unilaterally strike down legislation which had been extensively debated and passed by both houses of parliament.

I am speaking, of course, about the Truchon decision in Quebec. The Liberals could have simply appealed the decision in recognition of the upcoming review. It would have allowed for a substantive and careful discussion about the impacts of opening the door to MAID for seriously vulnerable individuals. Even in the Truchon decision, the assumption was that there would be enforcement of strict requirements that ensure the capacity and informed consent of those requesting MAID. Bill C-7 removes some of those very safeguards, including the requirement that the patient remains competent until the very end.

Truchon was also premised on the conclusion that medical assistance in dying, as practised in Canada, is a strict and rigorous process that in itself displays no obvious weaknesses, but that simply has not been shown to be true. According to the chief coroner of Ontario's review of 2,000 MAID cases, case reviews have demonstrated compliance concerns with both the Criminal Code and regulatory body policy expectations, some of which have recurred over time. As well, according to the Quebec end-of-life commission, at least 62 cases in Quebec between 2015 and 2018 did not fully comply with federal and/or provincial law. How can we move forward like this without properly responding to these serious failings?

In one of our last debates in the House, when I suggested that if Bill C-7 were to pass as it was, even before the amendments by the Senate were added, it would be believed to be the most permissive bill with respect to MAID in any country in the world, one of my colleagues expressed surprise that I did not think it was a good thing, as if being the most permissive jurisdiction was somehow inherently a good thing. A law's success should be judged by its outcome, not its permissiveness.

Any time life is devalued or death is made easy, clearly, is not good. Life is to be valued and treasured as the gift it is, which is why we need to put our energy into supporting positive alternatives, such as strengthening a patient-focused palliative care service for all Canadians. There was unanimous agreement from the special joint committee studying physician-assisted death on the need for a pan-Canadian strategy on palliative care with dedicated funding.

Those suffering deserve the best possible care. After all, there is no real choice for Canadians facing end-of-life decisions without adequate palliative care options available to them.

As parliamentarians, we have a high calling to actively listen. Our obligation is to protect our most vulnerable citizens. Unfortunately, none of the proposed amendments addresses the serious concerns raised by disability advocates. As many in the House have mentioned during these debates, over 70 of Canada's leading disability rights organizations and advocates have expressed deep concerns regarding this bill. Therefore, so should we.

We should be especially concerned for disabled Canadians who lack socio-economic means and face a greater risk of coercion. If there is even a tacit suggestion that their lives are not worth living, we should care about the implications of that. Their lives matter. Canadians should never feel pressured or as though the law perceives their lives as a burden.

The Christian Legal Fellowship writes that by singling out life with a disability as the only existence deserving state-sanctioned termination, Bill C-7 perpetuates ableism in a most dangerous way.

We have already discussed in the House what UN experts have highlighted as a contradiction in Canada's international human rights obligations. We do not want to create a two-tiered system in which some would get suicide prevention and others get suicide assistance based on their disability status and specific vulnerabilities.

The justice committee was faced with very difficult stories where some of our most vulnerable felt pressured to accept MAID. Numerous groups were represented. Fifty religious organizations and faith leaders, including Jews, Muslims and Christians, expressed their opposition. Nine hundred physicians and 145 members of the legal community stated their positions.

It is not just the disabled who are vulnerable. Practising physicians fear that they will face legal charges if they refuse to participate in the deaths of their patients. There are blatant inequities and legitimate anxieties with this legislation.

Let us be clear: any inequities of support, systemic discrimination, family network or specific community should be addressed before people choose death. We need to make every accommodation for people to choose life, which is why I am perplexed by the Liberal government's decision to support the Senate amendments based on race-based data collection.

There is nothing wrong with collecting data to better inform policy, but we are sure going about this in an odd way. Rather than considering how expanded access to MAID would impact marginalized communities today, this amendment suggests we should investigate the impact when it is already too late for those many who have already accessed MAID.

This amendment seems to acknowledge that, but data may have a troubling story to tell us while opting to study that impact on the fly, before we understand what it will mean for the life-and-death decisions of the members of marginalized communities.

That being the case, we should refer back to the Council of Canadian Academies' expert panel, which identified a number of concerns associated with expanding MAID in this way. Its claim suggests that the data is predictable, as having a mental disorder is strongly correlated with certain social, economic and environmental inequalities such as poverty, unemployment, homelessness, social isolation, stigma and discrimination, and that people with mental disorders face impediments to accessing appropriate mental health care in Canada. Let us not wait for people to feel forced to make the choice of death to collect this data.

It has not taken long for us to forget the safeguards that we put in place for the protection of our most vulnerable just a few short years ago. I have expressed my deep concern for this bill a few times in the House. My conviction is that life is a gift to be valued. These amendments only heighten my deep concern.

Life is a gift. I am reminded of when my kids and grandkids brought home gifts that they had made at school. Sometimes they were not very attractive and, quite frankly, perhaps I was not the proudest to put them on my mantle or display them on my fridge, but they were gifts.

Life is a gift. I did not then take those gifts and give them back, saying that I did not really want their gifts because they did not look very nice. No matter what the gift looked like, no matter in what condition it was, it was a gift and I recognized the gift. I showed appreciation to my grandchildren for the expression of their love toward me. For each and every Canadian, life is a gift and we need to appreciate it for what it is. They do not all look the same and some life circumstances put some of our constituents and fellow citizens in situations that are not desirable, yet we have to recognize that life is precious and life is a gift.

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

Madam Speaker, I would like to mention Dr. Sonu Gaind, who is the co-director of the division of adult psychiatry and health systems and an associate professor in the department of psychiatry at the University of Toronto, where he has been a member of the faculty since 1999. During a consultation with medical professionals that I attended this past weekend, he indicated that the number of elderly people requesting MAID since COVID restrictions have been causing isolation and growing depression has grown from 1,200 to 21,000.

Does this not illustrate the exact concern of the member in regard to Bill C-7 being brought forward to this House during such a challenging time for all Canadians, and especially for our most vulnerable?

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

Madam Speaker, one thing we have heard about are the challenges created by the current medical assistance in dying legislation with the requirement for final consent at the time the assistance is rendered. We know that this requirement often forces those who are already assessed and approved for medical assistance in dying to make a cruel choice when faced with the possible loss of competence that would make them unable to give consent. They are either forced to go early or risk not being able to receive the assistance they need to avoid continuing to live with intolerable suffering.

I think about Julie Briese in my riding, who has brought to attention concerns around her husband Wayne, who is challenged with Alzheimer's. In that camp, they are making that difficult decision of whether to go early. We know Audrey Parker campaigned to make Canadians aware of this problem and that Bill C-7 would fix that by creating a waiver of consent.

Does my colleague agree, and do the Conservatives support Audrey's amendment and support helping those facing end of life to avoid this cruel choice?

[Damien Kurek, Conservative, Battle River—Crowfoot, AB]

Mr. Speaker, my hon. colleague did have a fantastic speech just prior to question period and I believe that her time wrapped up with the beginning of question period.

We once again find ourselves debating one of those issues that should cause each and every member of Parliament to take pause. These are literally issues of life and death. We are debating medical assistance in dying. I have had the opportunity to enter into discussion now a number of times on the subject and I am pleased to be able to do so again on the amendment that my colleague made to the report back from the Senate, some of whose changes I would suggest are troubling ones from the deliberations that took place in that other place.

Before jumping into this, I would like to discuss some context, as I do every time I discuss this issue. Early on in the last campaign when I was not even elected, I was door-knocking in a community in my constituency where I happened to knock on the door of a physician. This was pre-COVID times. It is hard to believe that we are now a year into the pandemic. The sort of campaigning we did in 2019 seems such a long time ago.

Nobody actually answered the door. I was walking back down the driveway to the front yard and somebody called out from the backyard. I went to the fence and ended up having a lengthy conversation. What I find very interesting is that this particular physician articulated some of the concerns regarding this and other issues that he faces in the medical profession as a doctor in a small, rural community in Alberta. He outlined some of the concerns regarding medical assistance in dying.

I will not deny that I have positions on this issue that I have developed over my time in both politics, studying this and on many other issues, but what was very interesting as I reflect back on these comments is this physician outlined a whole series of concerns. In politics, they say one should not spend more than a couple minutes at the door, but I wanted to give this gentleman the time to outline his concerns. He outlined to me, ironically, some of the concerns that we are debating today with a suggestion about the slippery slope argument.

I followed closely some of the debates that took place in the last Parliament and issues around the initial court cases that led to Parliament being tasked with creating a framework in the last Parliament, and then some of the continuation of that. What I find very interesting is how accurately this doctor predicted some of the significant challenges that we are now facing. This is me paraphrasing this conversation from a number of years ago now, but he outlined that very activist, vocal causes are skewing the national conversation on ensuring that those who need protection most in our society are protected.

Here we are today. I had the honour of being elected and have a seat in this amazing chamber, the place of democratic discourse in our country. Here we are and I look at both the contents of what came back from the Senate and the various discussions had regarding Bill C-7 over the last number of months. It is very troubling that this gentleman was almost prophetic in the way he talked about these issues and some of the groups of people who are being affected in this framework that could lead to direct discrimination and how some of their voices are being ignored.

I find it very interesting. In fact, I had the opportunity earlier today to ask the Minister of Justice, after his opening remarks, a question about consultations. I was troubled by his response, although it was passionate, and I grant him that passion. We are all passionate about various issues, especially ones of such a personal nature as this. The minister went on to talk about how we need to address the suffering, but failed to truly answer why the government did not go down the path of appealing this decision to a higher court, which would have allowed for greater certainty on the type of legislation that would be enacted and ensure that it could be done in a way that we do not find ourselves here again in maybe a number of years, or sooner than that.

It is troubling, again in the words of the physician back in that driveway during my first campaign running for office about a year and a half ago, that the very vocal activist causes are getting a disproportionate amount of airtime. I bring that up because we have seen an evolution in this debate from what was discussed in the last Parliament and the very valid concerns that some of my current and former colleagues had, some of whom have retired, or whom I count as friends, like the member whose board I sat on while going to university, the late Mark Warawa, all of whom have defended life with passion in this place. However, where we find ourselves today is the definition of a slippery slope, and that is incredibly concerning to me.

It is incumbent upon all of us to ensure that we take seriously our obligation to debate, discuss and try to come up with the best outcome possible to serve, protect and ensure that Canadians are not placed in a position they should not be in. This issue would probably be in the top five and maybe even the top three of the issues I hear about. I hear feedback on every side of this debate, which is good. That is called democracy. It is called discourse and is exactly what the point is. It is why we are organized into parties and represent different regions of the country.

Each of us brings a different level of expertise, and I joke often that the only job requirement for a member of Parliament is that one happens to get more votes than the other guy. It is incredible the strength of our democracy is in the diversity that results from that. It is that diversity of opinions that forces us to take pause and debate these very important issues.

I will go back now to the consultations that the minister undertook on this issue back in the early sitting weeks of Parliament before prorogation. I spoke to many constituents, was sent emails and cc'd on others, and I found it very troubling to hear from a number of them that the so-called consultations were being conducted in a way that would confirm the objective of those who wrote the consultation piece. That is the antithesis of what we try to do here. In some cases, individuals with passionate perspectives on this subject felt they could not even participate in the consultations because of the way they were formatted. I find that was a troubling start to this process.

We have seen saw the Minister of Justice's comments, in addition to those of others in the government, about this as we have been going through this process. It was debated after prorogation, which of course slowed everything down. We lost about 35 sitting days. Whenever the government says that the Conservatives ought to hurry up because they are delaying the process, I will point out that 35 legislative days were lost in this place for it to do its job.

It is not just the two days that the members opposite like to suggest; it is 35 sitting days. The context for that deflates any argument that the other side would suggest on this, that we should simply rush something like this. There was the ability to appeal this to a higher court. When discussing this matter with one of my colleagues, it seems like the Liberals were not even aware that it could have been appealed to a higher court, among some other notable instances where there is a troubling lack of information.

An evolution has taken place from when the minister first stood up. When questions first started being asked last fall, he said that they had found the consensus, making clear definitive declarations, saying that they had consulted, that they had listened to the consultations and they did their job. That was being said by the government and the minister.

As questions were asked and as committee discussions went on both in the House of Commons and the committee, and then the pre-study and debate of the bill in the other place, we saw the government language change quite a bit. There was acknowledgement of a diversity of opinions. A lot of the diversity of these opinions was not respected in the beginning until there was a groundswell of concern. My office received hundreds, maybe thousands, of pieces of correspondence showing concern on this issue.

There are very few issues that garner this type correspondence, but this was one of those issues. In fact, people would call and tell me that they did not vote for me, but that they were concerned with the direction the government was taking. I heard from indigenous people. They told me that this went against the very fundamentals of their world view. Disability advocates are deeply concerned about an ableist-type mentality within the country, which could have very troubling consequences. We have the utmost responsibility to take these things very seriously.

This debate is very personally for a lot of us. I know there has been some emotion expressed in that regard, and this is part of an issue that is as important as this. As Conservatives, we have a free vote on this issue and we see a diversity of opinions within our caucus. That is great; that is democracy.

I do not know exactly where other parties stand on this, but certainly the autonomy of the member of Parliament is a constitutionally enabled thing here, which is often forgotten, certainly by our media and in the education of our parliamentary system. I emphasis for all those listening and on Zoom that the autonomy of the member of Parliament is one of the keystones of our democratic system. It needs to be respected. However, that is a bit of a segue.

This is an incredibly personal issue. Everybody has had an experience. I too have sat with loved ones during some of their last breaths. I have seen the consequences and I understand why this can be so emotional.

When I look at this in terms of the context of what we are debating today and the amendment that has been proposed in the government's response to the Senate amendments, important steps are taken to ensure that those among us who are most vulnerable are protected. My colleague from Leeds—Grenville—Thousand Islands and Rideau Lakes spoke to that. It strikes at a good-faith attempt by the Conservatives to try to move the dial on a host of what many have pointed out are problematic aspects of what took place in the other place.

Let me take a brief moment to commend some of my Conservative colleagues in the other place. I have spoken with them about the process and in some cases their great disappointment and utter surprise at what they hoped to accomplish going into those deliberations and what resulted. I do commend the Conservatives who sat around that table. I will note that they have some of the most personal connections to this issue. When hearing those stories, it certainly strikes right at the heart.

We are now tasked with having to come to a place where we develop a framework. The government likely has the support to get the bill passed. We have introduced an amendment to the government's response to try to address some of the challenges that we have heard. This is not about some ideological parade to try to make our points known. This is about trying to address some of the challenges that we have with the bill and specifically the response.

When we introduce an amendment, it is important for debate in this place to acknowledge the ability to improve upon legislation, to address deeply problematic aspects of it, to try in good faith to add a level of protection to the most vulnerable within our society, to ensure that we are not creating a situation where a medical assistance in dying regime ends up pushing people to a decision that there is no coming back from, trying to take some small steps to help move the bill in a direction that at least addresses some of these very serious concerns. For those who are watching, I would refer them to some of my earlier speeches on the matter.

This is what we are attempting to do today. Specifically, I would mention the irony in which we find ourselves. The House unanimously supported a motion for a 988 suicide prevention helpline, which was absolutely the right thing to do. I was proud to support that. However, this is not just an ideological thing, but many have suggested the bill moves medical assistance in dying, assisted suicide, euthanasia, however it is defined, in a direction that many, including myself, suggest is very concerning. There is an irony between supporting suicide prevention and a regime that may unintentionally, I certainly hope unintentionally, result in what could be catastrophic for our country.

There is a need for palliative care. I mentioned the late Mark Warawa. He is an example of living his faith. He announced he would not run in the next election. He was going to become a chaplain to help people through the end of their life. He ended up being diagnosed with a very fast-moving cancer. He ended up living out the very example of why palliative care is so important.

We find ourselves in the middle of a pandemic where disproportionately those affected are our seniors and those most at risk, yet we are debating something where we need to ensure there are safeguards in place. That the tragic irony is certainly not something I think anyone here would like his or her legacy to be, that while discussing and debating COVID supports in response, that we would also enable something that could be abused and would result in the end of life for vulnerable Canadians.

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.

Alleged Premature Disclosure of Contents of Bill C-22

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, on a point of order, I am rising to speak to the alleged premature disclosure of the content of Bill C-22, an act to amend the Criminal Code and the Controlled Drugs and Substances Act.

My colleague, the hon. member for Fundy Royal, rose in the House on February 19 to allege that the content of the bill was divulged by the government in a CBC news story during the notice period. In his intervention he cited a Speaker's ruling on March 10, 2020, respecting the premature disclosure of Bill C-7 and Bill C-14, both dealing with medical assistance in dying. In those cases, the government acknowledged that some content was disclosed during the notice period, and as a result, the Speaker found there was a prima facie breach of privilege.

The case before the House on Bill C-22 is indeed different. I have discussed this matter with the office of the Minister of Justice, and they have confirmed to me that a CBC reporter did inquire about the content of the bill while it was on notice. The office explained to the reporter that since the bill was on notice, they could not comment on the content of the bill until it had been properly introduced in the House.

The government, in 2015, promised to make public mandate letters for the ministers, a significant departure from the secrecy around those key policy commitment documents from previous governments. As a result of the publication of the mandate letters, reporters are able to use the language from these letters to try to telegraph what the government bill on notice may contain.

I take umbrage with the member for Fundy Royal's assertion: “We are being asked once again to deal with the contemptuous actions of the Minister of Justice and his justice team.” The member should ensure that he has the facts on his side before casting such aspersions on any member of the House. It is neither decorous nor responsible.

Now let me deal with the matter directly.

Bill C-22 has three main policy thrusts: repealing mandatory minimum penalties in the Controlled Drugs and Substances Act and the Criminal Code, increasing the availability of conditional sentence orders and evidence-based diversion from simple possession offences. The article the member refers to and relies on for his argument was not correct in its description of all three elements and therefore resides in the realm of speculation.

When we get into the details of the article in comparison with the bill, the story gets the content wrong. Let me walk members through the content of the article.

On drugs, the article is rife with speculation. The 2019 mandate letter for the Minister of Justice states, “Make drug treatment courts the default option for first-time non-violent offenders charged exclusively with simple possession to help drug users get quick access to treatment and to prevent more serious crimes.” The reporting on this item seems to be speculative based on the title of the bill. Moreover, the bill does not contain measures dealing with drug treatment courts.

I will note for the benefit of members that the evidence-based diversion measures in the bill are entirely distinct from drug treatment courts. Drug treatment courts require non-violent offenders to plead guilty, and judge-mandated supervision has no relation to what is proposed in the bill. In fact, the bill seeks to avoid the laying of charges in the prosecution of simple possession cases in the first place, if appropriate.

The bill also proposes a principled approach for police and prosecutors to consider before laying or pursuing a charge of the offence of simple drug possession. This includes the possibility of referral to various treatment programs or social supports and/or empowering police and prosecutors to provide a warning or to take no action with respect to the potential offender instead.

On mandatory minimum penalties, the article states that the government will revisit the mandatory minimum penalties for drug-related offences. In fact, upon inspection of the bill, the government is proposing to remove all mandatory minimums related to the drug offences, as well as removing mandatory minimums for 14 other offences in the Criminal Code.

There is no mention in the article of conditional sentence orders, which are a key policy element of the bill. In addition, there is nothing in the bill that provides for reforms concerning restorative justice specifically. The article implies that the bill contains elements relating to restorative justice, based on the mandate letter commitment, previous public statements and commitments made in regard to the fall economic statement.

One can only assume two outcomes here based on the fact that the article did not accurately describe the contents of the bill. First, the reporter spoke to a government source who was not familiar with the content of the bill. The second outcome, which is perhaps more likely, is that the government did not publicly comment on the bill during the notice period and, as a result, the reporter had no other recourse but to speculate on the content of the bill based on previous policy statements.

I will turn now very quickly to the relevant precedents on the disclosure of the content of a bill during the notice period. In instances where government has acknowledged that an official of the government prematurely disclosed the content of a bill during the notice period, Speakers have found a prima facie case of breach of privilege. However, when the government has not disclosed the content of a bill during the notice period, Speakers have been reluctant to find a prima facie case of breach of privilege. On June 8, 2017, the Speaker referred to the distinction as follows:

When ruling on a similar question of privilege on April 19, 2016, I found a prima facie case of privilege in relation to the premature disclosure of Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts (medical assistance in dying). In that particular case, the government had acknowledged the premature disclosure of the bill while assuring the House that this had not been authorized and would not happen again. In other words, the facts were undisputed.

That is not the case with the situation before us. The parliamentary secretary has assured the House that the government did not share the bill before it was introduced in the House but conceded that extensive consultations were conducted. Nor is the Chair confronted with a situation where a formal briefing session was provided to the media but not to members.

Finally, it is a long established practice to take members at their word, and the Chair, in view of this particular set of circumstances, is prepared to accept the explanation of the Parliamentary Secretary to the Leader of the Government in the House of Commons.

In conclusion, I submit that if the content of the bill was prematurely divulged during the notice period, it did not emanate from the government side.

Criminal Code

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Mr. Speaker, the member gave a great speech, laying out a very empathetic case for why the Senate's amendments should be rejected. The debate I have heard so far is not about the amendments the House has already made within Bill C-7 to the original Bill C-14. I disagreed with the House and voted in the minority because I felt that our response to the Truchon decision went too far at the time.

What the Senate has done is to go far, far beyond what the original debate was in the House and the witness testimony that we heard and the considerations in the justice committee. Could the member perhaps just comment on that point?

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Mr. Speaker, it is 100% guaranteed that we will kill people who would have gotten better. That is a statement made by a well-respected Canadian psychiatrist this weekend at an emergency Bill C-7 meeting I cobbled together in response to this Frankenstein bill that we are now debating here in the House. How the Senate managed to change the bill from what it was to what it is completely boggles the mind.

The bill is now so deadly that not only are the disability community and the indigenous community crying out against it, but the mental health community and the geriatric professionals have joined in sounding alarm bells against the extreme danger this bill poses to the most marginalized in our communities.

Some in the Senate in the Liberals' group of wealthy, worried well people have decided that their wishes far outweigh any harm that may come to the vulnerable who cannot afford or cannot access the kind of care that powerful individuals can.

Let us take the issue of advance directives. Senator Pamela Wallin stated, “As someone with a history of dementia in my family, I seek the peace of mind that an advance request—and consent to it—will provide.” I would like to pose a question. Does Senator Wallin's peace of mind carry more weight than the premature deaths of frail seniors that will result if this amendment becomes law?

Imagine a person—for example, Senator Wallin—possibly dealing with dementia at some future time who has reached the stage at which her advance directive authorizes her death. Imagine that she is completely unaware of her cognizant deficits and is living happily with her loving family or in a top-notch residential setting somewhere in Canada. Who will give the MAID order? How will Ms. Wallin's caregivers explain this to her? Will that directive take precedence over her current wishes and those of everyone around her?

Imagine now a family that is less loving, one that is fighting over the inheritance while mother is still alive, fighting over how much is spent in paying for nursing care. This is a common scenario, as many professionals witness. Now who will give the MAID order, and in whose interest?

Now imagine there is no family and that the administration at the nursing home is under orders from the ministry to find beds for patients to be transferred from the hospital. There are already horror stories from around the world where advance directives for euthanasia exist as an option, stories of doctors trying to sedate their patients by putting sedatives in their coffee or stories like that of a 74-year-old Alzheimer's patient from the Netherlands whose family had to hold her down as she was struggling so that the doctor could administer the lethal cocktail.

I learned in a conversation with Dr. Catherine Ferrier, who works with dementia patients, that often when a person is suffering with dementia, it is their family who are most distressed. Patients themselves are often content, even happy. The point I am trying to make here is that it is impossible to know the exact wishes of someone who is suffering with dementia. Someone who is young and healthy can imagine what they would want for themselves if they were to decline in that way, but they do not know what that future self, in a state of mind that they do not understand, would actually wish for.

I am terrified for vulnerable Canadians who want to live despite an earlier wish to die. They will not be able to communicate their desires, and their families and caregivers may pressure them to die to remove a burden from their own lives. I implore my colleagues to remember that our duty is to promote the safety and well-being of all Canadians, especially those most marginalized, not to calm the worried well.

The Council of Canadian Academies' expert panel working group on advance requests for MAID found that relatives of patients with dementia generally support euthanasia if an AED exists, but when they are faced with a decision to follow an AED, most decide against it. Many experts now favour, instead of a directive giving specific instructions, a process of reflection on broad health care goals, conversations with loved ones and the designation of a proxy decision-maker.

Listening to those who advocate MAID by advance request for patients with dementia, our first reaction should be horror at the demeaning and discriminatory terms in which they are depicted. To state that people who no longer recognize family members, are bedridden or are dependent for hygiene or feeding have lost their dignity is a marginalizing and ableist depiction. Dignity is never lost, but it can be either affirmed or denied.

Let us tackle the first myth, the myth that people deserve death with dignity and that MAID provides that. The fact is that this debate has distorted what dignity means. Dignity means to deserve honour or respect. What MAID advocates mean by “loss of dignity” is a loss of control, a loss of superficial appearance, a loss of self-critical judgment. They have tragically subverted the most dignified acts of all: unfailing love and deep respect for each other in all life circumstances. Bathing my dying grandmother, whispered conversations on the threshold of death, silent reflection and presence through a long night waiting for a last breath: These are the moments of greatest dignity. Dignity is found within our relationships. It is about whether someone looks at us and treats us with respect, rather than with subtle disdain or prejudice or by making us feel that we are bothering them.

Dignity is not about the means of death. Dying with dignity means dying in a milieu of care, love, kindness and respect. Anyone who says all these things are not present in a natural death setting simply does not understand what dignity is.

However, wait; the senators, the Liberals, Jocelyn Downie and all their friends at Dying with Dignity will cry, “No one will be euthanized under this legislation who has not already freely consented to it.”

The notion of consent by advance directive is not that simple. The vulnerability and power imbalance that is present between the parties is glaringly obvious. However, advertising campaigns and media have been busy creating a fantasy world for Canadians that pretends that the use of a physician in ending the life of someone not near death is compassionate and respects autonomy. We read in the paper about parties being organized to celebrate the last moments of life with balloons and symphony music playing in the background. We can see by the few statistics that are being reported that the glorification of euthanasia provides encouragement for those who are already unsure of their value or feel a burden to their loved ones, regardless of the fact that they are not near death.

In actual fact, what we are able to provide families with amounts to moral absolution. With this bill, we are offering to make legal what is illegal in every other country around the globe. Let me repeat that: There is no other country on the planet that allows death administered by a doctor to someone who is not imminently about to die if they have not first been given treatment. Canada, with the implementation of this legislation, will be the only country in the world where access to alternative treatments is not even required in order to qualify for death by physician.

Not only are the changes to the euthanasia regime that will come with the Senate amendments unprecedented from a legal and moral perspective, but they are also unheard of from a medical perspective. This bill would require doctors who work with patients suffering from mental illness to prescribe death, with no evidence, no data, no statistics to prove that it is an effective or beneficial treatment. There has been no due diligence done by the medical community to support the idea that MAID belongs in the tool box of mental health professionals. It is politicians, motivated by ideology and not by evidence, who have forced it upon them.

I have been told by doctors who support MAID in principle that this bill will force them to act against their conscience and their Hippocratic Oath. It is one thing to conscientiously object, but it is something much worse when there is a lack of faith in the treatment they are forced to provide. To make the concept more clear, they explained that doctors do not prescribe cigarettes to patients because the health risks far outweigh the calming benefits of nicotine. These same doctors know that there is no evidence to support the idea that MAID is an acceptable medical treatment for mental illness. Thus, if this bill passes, doctors will be forced to provide, against their conscience, an unproven treatment that causes the demise of their patient.

Further, allowing MAID for mental illness in this bill makes the bill incoherent. On the one hand, it says that MAID can only be offered to those who are not dying if their condition is grievous and irremediable. On the other, it fails to acknowledge what psychiatrists know to be true; that it is impossible to know if a mental illness is irremediable. There are many cases of doctors who have thought that a patient's condition was irremediable, only to find that the patient got better. This means that the entire entry point of accessing medical assistance in dying is not satisfied for those who suffer from mental illness. That is why doctors are pleading with us, telling us that they are 100% certain that if we accept this amendment, we will kill people who would have gotten better. This bill would ensure that people would no longer be seeking to avoid a painful death, but, rather, to escape from a painful life.

It is also important to tackle the second myth being propagated by the Liberals and their friends at Dying with Dignity, and that is the myth that Bill C-7 is not discriminatory. Here are the facts. Canadian disability organizations, mental health organizations, indigenous organizations and the United Nations all say that Bill C-7 is absolutely discriminatory. The bill singles out vulnerable Canadians and offers them physician-assisted death without offering adequate disability supports or treatment to help them live full lives, free of the suffering caused by poor health care, poverty and stigma. It singles out persons with disabilities who are not terminally ill as fit for suicide completion. This will become a choice of desperation, not autonomy.

Let us understand what discrimination really is. It is pretending that all Canadians are equal in all ways. The obvious reality is that some of us face profound life challenges. We need laws that protect the disadvantaged. A law that offers death to one group and support and treatment to all others is the paradigm of discrimination. This law proclaims that a disabled Canadian or someone suffering with a mental health challenge should consider death instead of recovery. Vulnerable patients need protection from politicians and doctors who want to make it easier for them to die, while simultaneously denying access to appropriate health care supports. This is true discrimination.

Let us face it, there is a myriad of reasons that many organizations have come out opposing the bill.

Take as another example the testimony from Tyler White, CEO of Siksika Health Services, who stated:

MAID with its administration of a lethal substance with the intent to end a person's life is countercultural to our indigenous culture and practices. Our concept of health and wellness does not include the intentional ending of one's life. We recognize the dignity [of life] from its beginning to natural death, and efforts to suggest to our people that MAID is an appropriate end to life is a form of neo-colonialism. Extraordinary efforts have been made in suicide prevention in our communities and the expansion of MAID sends a contradictory message to our peoples that some individuals should receive suicide prevention, while others suicide assistance....

...Bill C-7 in its current form is the absence of protection for individuals working in our communities who do not wish to participate in MAID. We believe that our people should not be coerced to participate in non-indigenous practices against our conscience and will. And it is the kind of oppression that has been the source of much trauma in our history. The Truth and Reconciliation Commission of Canada calls upon those who can effect change within the Canadian health care system to recognize the value of aboriginal healing practices and for respecting indigenous people's right to self-determination in spiritual matters, including the right to practise our own traditions and customs. Bill C-7 should be amended such that those who opt to abstain from participating in MAID directly and indirectly will be protected to do so without discrimination in their employment in the health care system.

How about Margaret Eaton, national CEO of the Canadian Mental Health Association, who stated the following in a recent press release:

Anyone living with mental illness knows it can absolutely be grievous and...unbearable. However, what sets mental illness apart from all other types of suffering is that there always remains the hope of recovery. That’s why the Senate’s amendment to C-7, the assisted dying bill, is so concerning.

People with a mental health problem or illness need assistance to live and thrive, not hasten death.

The Canadian Mental Health Association...is urging MPs to vote against the amendments made by the Senate to C-7. In particular, the clause to start the clock on eventually allowing people to seek medical assistance in dying...with mental illness as a sole underlying cause.

Then there is the petition I received this morning from 130 psychiatrists, psychotherapists and mental health professionals, calling on us to reject the amendment which would include mental illness as a sole criterion for medical assistance in dying. It states:

Some persons with mental illness, that often includes symptoms of hopelessness and suicidal thinking, have long been recognized as potentially vulnerable to suicide inducement and, until now, have rightfully been excluded from eligibility for MAiD. Suicide prevention is recognized as a critical mental health service necessary to preserve life. Review of evidence...found that, unlike with MAiD for terminal illness, we cannot distinguish between those seeking MAiD for mental illness and suicidal individuals.

Over and over again, we have heard from medical professionals how disastrous the bill will be to the safety and security of their patients.

Therefore, the question begging to be asked is this. Why the rush? During the pandemic, the Liberals have made the passage of Bill C-7 their priority. However, the bill is not a high priority for Canadian citizens and it is safe to assume that the majority of Canadians know very little about Bill C-7 or its implications.

Canadians have been preoccupied with more pressing matters, such as keeping themselves and their loved ones alive during this pandemic. They have been concerned with keeping financially afloat, making rent and mortgage payments, keeping their jobs and keeping their businesses from going under.

However, throughout this time, the Liberals have been concerned with driving Bill C-7 to the post, perhaps with the hope of slipping one by a distracted public. This is one of the most serious changes of legislation in law undertaken in a long time, with far-reaching implications. It will surely change the character of the country and how life and death are viewed. It has, at the very least, the potential to cause individual and social harm and open up abuses that no safeguards can guarantee against.

I will end with one final quote from the Washington Post this week under the title “Canada is plunging toward a human rights disaster for disabled people”. It said:

This month, the Journal of Medicine & Philosophy found that in the 18 years since Belgium permitted this sort of euthanasia, the laws and regulations meant to protect patients from abuse “often fail to operate as such.” Much like in the Netherlands, the eligibility criteria had steadily expanded to the point where more and more people pursued it not for medical reasons but simply for “tiredness of life.”

Legalizing assisted death for disabled people only fortifies the underlying problem: Canada has long mistreated its disabled citizens. This bill is a workaround for that problem, not a solution.

I ask this one more time. If this bill is so good, why are the vulnerable, the poor, the disabled, our indigenous brothers and sisters feeling so threatened? Why do we want our hospitals to offer suicide prevention programs through one door and doctor-assisted suicide through the other? I beg my colleagues to hear the cries of those most vulnerable among us and reject the discriminatory and dangerous bill, Bill C-7.

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

Mr. Speaker, I want to thank the hon. parliamentary secretary for a very helpful, thorough review of the government's views on what has now come to this place from the other place.

I also wanted to focus, as his last remarks did, on some of his personal beliefs around the situation and the context for people in the disability community, the context for people who are experiencing extreme depression. We have to put that context in economic terms. We know that people who are in the disability community are far more likely to fall below the poverty line than able-bodied Canadians. It is a really significant crisis.

We experienced in CERB the ability to send a cheque for $2,000 to people across the country. I want to ask the hon. member if it is not time to look at guaranteed livable income as part of the package of public health measures, because poverty is the single largest component of health. As a social determinant of health, poverty is the largest measure. I know it is slightly unrelated to the debate on Bill C-7, but can we not move to eradicate poverty?

[Arif Virani, Liberal, Parkdale—High Park, ON]

Mr. Speaker, I know this is personal for others, just as it is personal for me. Obviously mental health touches all of us and all of our families, and it has touched my family.

That is a difficult question to answer, but what I would say is that I am comfortable trying to proceed incrementally as we have done, starting with Bill C-14 and now with Bill C-7, but doing it on the basis of having a lot of input from those in the medical community whose jobs are to diagnose, treat and provide support to those who are suffering from a mental illness.

What I cannot do, obviously, is put myself in the shoes of another person who, in terms of manifesting their autonomy, might be contemplating and considering taking such a step. That is difficult for me to do personally, but what I can do is ensure that I, as a parliamentarian, try to provide equal access to different options, including end-of-life options, to Canadians, should they choose to end their suffering.

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

Mr. Speaker, I am very pleased to participate in the consideration of the amendments proposed by the Senate to Bill C-7, which seeks to amend the Criminal Code provisions on medical assistance in dying.

Our colleagues did a lot of work on Bill C-7 and proposed reasoned amendments following careful deliberations. The Standing Senate Committee on Legal and Constitutional Affairs heard from a variety of witnesses as part of two different studies. I followed the debate at second and third reading and thought that the speeches given in the Senate reflected the range of perspectives shared by the many witnesses.

It is therefore with great respect for the work of the Senate that we are examining the amendments it is proposing to Bill C-7. As the minister explained, there are three amendments that we plan to support, with some adjustments.

The first relates to the collection and analysis of data about the race of persons seeking MAID. Let me say here that we have heard extensively in the House of Commons and the Senate about the need for better and more robust data collection with respect to MAID. That data has been collected since MAID first entered into the legislative landscape, but certainly improvements can be made.

It is important now, especially during Black History Month, to note that one of the Senate amendments proposes tracking the analysis of data on the race of persons who are accessing MAID. This is important because we have clearly seen a light shone on the important issue of systemic racism in Canada, North America and around the planet. We need to understand how racialized persons, because of their inherent vulnerability, may be disproportionately impacted by MAID and address that vulnerability with our legislative response.

I would say, however, as articulated by previous speakers, including the minister, that the amendment the government proposes to make to this portion of what the Senate is suggesting would make it more inclusive in light of all of the witness testimony given in both the House and the Senate. By that I mean in addition to race-based data, data about disability and indigenous identity would be collected and analyzed. This, of course, is important, especially and specifically as we broaden the MAID regime to circumstances where death is not reasonably foreseeable, in response to the Truchon decision, which creates the real possibility that people will seek and obtain MAID because of vulnerabilities in their lives as opposed to their health conditions. I am grateful to the Senate for proposing this important legislative change.

The second Senate amendment the government supports, with some adjustments, is the sunset clause that attaches to the mental illness exclusion. We heard extensively about this from the previous speaker and in other interventions that have been made. The Senate amendment proposes a sunset clause of 18 months. The government is suggesting that the sunset clause be extended to 24 months.

Second, and very importantly, we are requiring that the Minister of Justice and the Minister of Health ask a group of experts to make recommendations on safeguards, protocols and guidance for MAID on the basis of mental illness alone. Those experts would be required to report back to the ministers within one year, which would leave an additional year for the government to consider what safeguards should be legislated and for Parliament to consider things when enacting any subsequent legislation.

I want to give some context surrounding the sunset clause because it is obviously a pressing matter for today's debate and a pressing issue for all parliamentarians.

The government's position is that it needs more time to consider and enact safeguards for the population of people whose sole underlying condition is a mental illness. The Minister of Justice was always clear that the questions of whether MAID for mental illness should be allowed and, if so, what safeguards were needed would be studied in the course of an upcoming parliamentary review.

What the sunset clause would do, in combination with a requirement for an expert review, is commit to a definite timeline for eligibility of persons whose only medical condition is mental illness. This would reduce the risk that some Canadians would feel the need to challenge the exclusion before the courts should they believe it is unconstitutional. It would also provide them with the certainty that two years following royal assent of Bill C-7, eligibility on the basis of mental illness would be considered with the requisite safeguards attached.

This point about potential constitutional challenges is not an academic point alone. We know this is a complicated issue that balances competing constitutional rights. Obviously we know from the Truchon decision that there has been litigation with respect to the old Bill C-14, and virtually all observers recognize that there is very likely to be constitutional challenges related to the current bill, Bill C-7, should it be enacted. In fact, we heard testimony about this at a House of Commons standing committee. Some witnesses said the exclusion of mental illness alone could perhaps give rise to a section 15 challenge. We are trying to ensure that Canadians who are concerned about this exclusion would have a remedy that is not via the court process, but rather through the task force of experts and the parliamentary study that would follow therefrom.

We heard a lot from the previous member about evidence and whether the government believes in evidence-based approaches. I would reiterate for the record that absolutely we do, and some of that evidence relates to a very specific document in the submissions that were made by the Association des médecins psychiatres du Québec.

In November 2020, the Quebec association of psychiatrists, or AMPQ, published a very informative discussion paper on access to medical assistance in dying for people with mental illness, which underscores the reasons that the government believes that a 24-month sunset clause is needed.

The work of this association will no doubt be foundational to the expert review of this issue. It points to some possible solutions, but they are fairly complex. That is why we need to carefully consider solutions that could work nationally.

The association is of the view that whether a mental illness is incurable or not can “only be determined at the end of a long process, after attempting several treatments and assessing their effects.” The association further notes that before coming to a conclusion on eligibility a psychiatrist “should explore other aspects that shape the patient’s life experience and consider strategies to improve the social circumstances that add to the suffering.” This dovetails exactly with some of the interventions made in the last portion of the debate by members of the NDP, who talked about supports that surround a person's life circumstances, such as income security, housing security and so on.

Going back to the submission from the association, it notes, “Psychiatrists must be involved as both the first and second assessors”, and also notes, “access to psychiatric care varies significantly from one region to the next.”

In light of all of these considerations, the Association des médecins psychiatres du Québec suggests that we create a new administrative body with regional offices dedicated to MAID on the basis of mental illness that would coordinate such requests, identify MAID assessors and providers, and ensure access to psychiatrists. It also suggests that such an administrative body could monitor the assessment process in real time instead of after the fact.

I highlight this in some detail because I believe the association's discussion paper is focal to why we as a government believe that a 24-month sunset clause is needed. The work of the association will no doubt be foundational to the expert review of this issue. The paper points to possible solutions, some of which are fairly complex in nature, which underscores the need for careful consideration of what could work nationally. Further, I underscore that government and Parliament will need time to make decisions about which safeguards should be codified in federal MAID legislation as a matter of criminal law relating to mandatory access across the country.

I will now turn to the third amendment.

The third amendment being proposed by the Senate, which the government proposes to support with some modifications, relates to the notion of the parliamentary review. The government has repeatedly committed to facilitating the start of the parliamentary review required by Bill C-14 as soon as possible following the adoption of the current Bill C-7. Our proposed adjustments to the amendment proposed by the Senate would ensure that all of the relevant issues are front and centre for the joint parliamentary committee that would undertake this work. I underscore the notion that it is joint, because it would be a combined study by the Senate and the House of Commons, similar to what we saw prior to the advent of the original Bill C-14. Its mandate would look at things that were contemplated by the original intended review of Bill C-14, such as requests by mature minors and issues that relate to advance directives.

In addition, we would include palliative care and safeguards for persons with disabilities within the scope of that mandatory joint parliamentary review by the Senate and the House. We also proposed to adjust the timelines, so they are both realistic in a pandemic environment but still ambitious, given the seriousness of the issues at hand. These are important features we feel would enable us to move forward in a collaborative manner involving the work of both Houses of Parliament, as well as the work of all legislators from various parties.

I would note parenthetically that, obviously, the member for Esquimalt—Saanich—Sooke has been very instrumental in leading the charge and a call for a study in Parliament of the previous bill, Bill C-14. Some of what we are proposing incorporates his views on the scope of what that review should look like.

Finally, there are two Senate amendments that, in the government's view, cannot be supported.

The first is the amendment to the mental illness exclusion itself. While I appreciate that some have advocated for greater clarity around what mental illness means in this context, the government is concerned that this particular amendment, as drafted by the Senate, implies that neurocognitive disorders are ordinarily understood as being mental illnesses, which, in fact, may not be the case. The federal government will work with its provincial and territorial counterparts to ensure a consistent application of the mental illness exclusion until it sunsets.

The second Senate amendment we propose to reject is the amendment to expand the waiver of final consent. Providing MAID in the absence of final consent is extraordinary and carries risks, and we acknowledge that. The Senate amendment goes beyond the scope and principle of Bill C-7, which would permit the waiver of final consent only in narrow circumstances that present the fewest risks. Any expansion of advance consent or proposal for advance requests, which are sometimes called advance directives, will involve greater risks and should be the object of careful consideration by the parliamentary review.

It has always been the notion that the issue of advance directives should be contemplated only after consideration by the broader parliamentary review. This was the case with the previous Bill C-14, and it is certainly the case now with what we are proposing as a government with respect to the parliamentary review that should ensue herefrom.

In the time I have remaining here, I would like to canvass a couple of points.

One is the notion that has arisen during the discourse of today's debate that somehow the government and de facto the Senate are somehow pursuing a route that is putting undue focus on facilitating an end of suffering, including facilitating the passing of an individual, as opposed to making the condition of life more viable and also more supported. That assertion is categorically false. The government's record over the last five and a half to six years speaks for itself in terms of the supports we have put in place, whether they are in long-term care, home care or supports for mental illness.

It relates to, as the previous member mentioned, a unanimous consent motion being passed regarding a suicide hotline. The supports we have put in place, such as the Canada health and social transfer, and a few intensive efforts to address home care and palliative care, are significant investments. We are ensuring that people are making such significant decisions based on the full understanding of what options are available to them and what supports are available to them. Can more be done? Of course, more can be done. I think that is what is important about what arises from a debate such as this.

The second thing I want to underscore is something that arose many times when Bill C-7 was in our chamber the first time, meaning its second and third readings prior to being sent to the Senate, which has again arisen today in the context of today's debate, and that is this idea that persons with disabilities are somehow being victimized, targeted or unfairly treated by this particular bill. I will raise a couple of important points, which I think are really important for all members of Parliament to understand. I have raised these points before, but I will reiterate them.

What we are talking about here is autonomy and the autonomy of individuals to make choices about the end of their lives and their passing, and that butts up against the need to protect vulnerable people. It is an important balance, and that is what is at the heart of this. This makes it probably the most difficult issue any of us have dealt with, at least it has been for me in my five and a half years as a parliamentarian. That being said, people need to understand that the case that was brought before the courts that we are responding to now was brought by two individuals: Monsieur Truchon and Madame Gladu.

Both suffered from disabilities, but because they were not near the end of their lives, they were prevented from accessing the MAID regime under Bill C-14. This is because it was, at that point and even now, until the law is potentially changed, an end-of-life only regime.

I want to read for members what the court analyzed with respect to that, because we have heard a lot in this discussion that somehow what we are trying to do in Bill C-7 is discriminatory of persons with disabilities. The notion of discrimination under section 15 was squarely in front of the court in the Truchon case, and what the court said is quite the opposite. I am quoting from paragraph 678 of the Truchon decision. The court said:

The requirement at issue reveals a legislative regime within which suffering takes a back seat to the temporal connection with death. Where natural death is not reasonably foreseeable, the consent in suffering of the disabled are worthy only of the sympathy of Parliament, which has adopted a protectionist policy toward every such person, regardless of his or her personal situation. As soon as death approaches, however, the state is prepared to recognize the right to autonomy. This is a flagrant contradiction of the fundamental principles concerning respect for the autonomy of competent people, and it is this unequal recognition of the right to autonomy and dignity that is discriminatory in this case.

The judge went on, in paragraph 681:

By seeking to counter only one of the stereotypes that the disabled face—vulnerability—the challenge provision perhaps perpetuates another probably more pernicious stereotype: the inability to consent fully to medical assistance in dying. Yet the evidence amply establishes that Mr. Truchon is fully capable of exercising fundamental choices concerning his life and his death. As a consequence, he is deprived of the exercise of these choices essential to his dignity as a human being, due to his personal characteristics that the challenged provision does not consider. He can neither commit suicide by a method of his choosing nor legally request this assistance.

I read this into the record to remind parliamentarians that discriminating against anyone in Canada should not be countenanced. However, what was squarely before the court was whether the old regime was discriminatory against persons with disabilities who want to make autonomous choices about their passing, but were not near the end of their lives. The court found, conclusively, that the old regime was discriminatory. That is what prompted this and other changes to the legislation.

I think it is very important to understand that. When I, and others, talk about the heterogeneity among people with disabilities, that is what we are driving at. It is not for Parliament, in my respectful view, to impede, limit or curtail the competence and autonomy of persons, including persons with disabilities, who want to make significant choices about how and in what manner to end their suffering.

I think a compassionate response by this Parliament, a response that entrenches dignity, requires us to do the opposite. I know it is difficult. I know it is moral. I know it is an issue fraught with a lot of personal conviction, and that it is a difficult task for many of us, but that is the task before us as parliamentarians. As somebody who is familiar with discrimination law, I wanted to correct the record, in terms of what I have heard in today's debate and previous debates, about how discrimination plays into the analysis.

[Denis Trudel, Bloc, Longueuil—Saint-Hubert, QC]

Mr. Speaker, I am having a hard time figuring out exactly where my Conservative colleagues stand this morning.

They think the process is being rushed and that things are moving too fast, yet the process itself includes a two-year period to thoroughly examine issues related to people with mental illness. I cannot tell if things are moving too quickly or too slowly for the Conservatives.

The other thing that is so exasperating about my Conservative friends is their use of the word “euthanasia”. In a debate on a topic this delicate and sensitive, people need to be careful about their word choices. Medical assistance in dying is a comprehensive approach to caring for people. The word “euthanasia” has a harsh, cruel connotation.

Here is my question. The Conservatives seem to think we should not pass Bill C-7 now. However, there are people suffering from very serious neurodegenerative diseases who are waiting for the go-ahead from Parliament to move forward in a complicated, complex and sensitive process. What does my colleague have to say to those people today?

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, miracles never cease. Maybe this is the beginning of a dramatic change in things. Time will tell.

Regardless, the specific comments by the member for Timmins—James Bay that really were kind of “aha” moments for me was when he said that Bill C-7, even as previously written, and certainly with these proposed amendments, would make people living with disabilities in some sense second-class citizens when accessing our health care systems, as we would put them on a different track. He said it would create “a second track of humanhood in this country”, which is something that all of us should be seized with, especially in response to the repeated testimony of many organizations that represent Canadians with disabilities, as well as organizations representing Canadians dealing with mental health challenges.

We are here debating Senate amendments to Bill C-7, and specifically debating an amendment by my colleague that would try to change the government's response to the largest substantive amendment by the Senate that the government is proposing to agree with. I will delve particularly into the issues of that amendment. However, first of all, the government is using all kinds of arguments today, and previously, about how this has been a long time coming, that it has been debated extensively. I want to respond specifically by commenting a little on the journey that brought us here with this legislation, because we have really taken all kinds of twists and turns far from where this conversation on this particular bill started.

Allegedly, the genesis of this conversation was a lower court decision in Quebec that dealt specifically with the issue of reasonable foreseeability, and not the issue we are talking about today. It is a different issue that dealt with the issue of whether somebody should be able to access euthanasia if their death is not reasonably foreseeable. This court said that a person should be able to access euthanasia in that case. The government, contrary to advice from us, decided not to appeal that ruling. Importantly, the government could have proceeded with appealing that ruling and then used the window of time available to consider a different legislative response. However, the government created for itself a sharp timeline through its decision to not repeal that ruling.

Subsequent to that, this justice minister brought forward a piece of legislation that deals with many issues related to euthanasia far beyond the parameters of that court decision. The court decision dealt with reasonable foreseeability. I believe that if the government had proposed a piece of legislation that dealt with, and only with, the question of reasonable foreseeability and left other issues for other pieces of legislation, then that bill would have long passed and we would not be talking about fourth extensions, new court deadlines and so forth.

The reason we are in a situation where the bill has not yet passed is that, effectively, the government created an omnibus bill by tacking onto the issue of dealing with reasonable foreseeability many other, unrelated issues: questions of advance consent, questions of removing existing safeguards, questions around the 10-day reflection period. There were many different issues that had to be discussed as the result of the government's decision to put forward legislation, most of which were completely unrelated to the Truchon decision.

I think that, in a very misleading way, the government tried to create this artificial timeline link to the Truchon decision for all sorts of issues that have absolutely nothing to do with the Truchon decision, and there is very little basis for debating that reality. The government could have focused its response to the Truchon decision on the issues raised by that decision, and likely would have been able to justify a more aggressive timeline with respect to the bill, because there would not have been so many issues that needed to be discussed.

The government put all of those additional issues into Bill C-7 while failing to move forward with a mandated legislative review. The previous bill, Bill C-14, had mandated that there would be a legislative review. The government has not moved forward on that at all, and instead packed all of these other issues into Bill C-7. Then we had debate in the House, we had committee hearings and all the way along the government was trying to create as much urgency as it could, saying that “We have to move this forward because of the Truchon decision”, even though there was extra content riding on that issue, far more than was dealt with in the original Truchon decision.

The justice committee held a very limited number of hearings, I think it was only four, on all of the issues raised by Bill C-7. Despite that limited time, many people came forward to express significant concerns and opposition. There were physicians, mental health experts and people representing those in the disability community, and not a single stakeholder representing the disability community expressed support for this legislation. Not only were so many people coming forward to those committee hearings, but there also were over 100 written briefs submitted to the justice committee by individuals or groups who took the time to express their perspective and, generally, their concern about this legislation.

The justice committee moved so quickly that it is a veritable certainty that members did not have any reasonable opportunity to review those briefs. In fact, many of those briefs were initially rejected by the committee; then subsequently, thanks to the good work of my colleague from St. Albert—Edmonton, those briefs were formally received, but the committee then immediately proceeded into clause-by-clause consideration of the bill without allowing time to review the content of the briefs.

We had this urgency created by the government's decision to pile issues on top of the Truchon decision that were unrelated to the decision. Then we had extremely limited consultations by the justice committee, as the government tried to use this trick as a justification for pushing the legislation through as quickly as possible.

However, throughout those conversations at the justice committee, the government was clear that its bill and its policy was not to allow euthanasia when the primary underlying complaint is mental health challenges. The Parliamentary Secretary to the Minister of Justice and others have repeatedly spoken about this aspect of the legislation, namely, that it includes an exception clearly specifying that mental health challenges should not be a basis to receive euthanasia.

On that point, the government was right, and even if members have questions about the substantive value of that position, they should appreciate how the question of whether those dealing with mental health challenges as their primary complaint should receive euthanasia is a completely separate question from the issues raised by the Truchon decision.

The bill then went through committee, came back to the House and Conservatives expressed their perspective. The vast majority of our caucus voted against this legislation. We voted in favour of report stage amendments. There was an extension of hours to accommodate the speeches. The bill then went to the Senate and the Senate has now tried to dramatically further expand the bill.

As we all know, the unelected Senate, made up now overwhelmingly of individuals who have no party affiliation and who were appointed by the current Prime Minister, undertook a study that went far beyond the scope of the existing bill and recommended a radical expansion, certainly beyond what stakeholders and the public were looking for, and beyond what had ever been considered or debated by the House of Commons.

Whatever very legitimate criticisms one might have of the old model of the Senate, made up of non-elected people with strong party affiliations and who are not directly accountable, at least there was some mechanism of accountability through political parties. However, now we have in the Senate a vast majority of individuals who are not connected to any political party, who are not identifiable in terms political affiliations, and who are appointed by the Prime Minister without any consultation with other parties, without any kind of oversight, and who then exercise a defining power over legislation. That is a huge problem that we have to grapple with.

Part of how we could grapple with it in the House of Commons is by having the courage, when we receive amendments from the Senate that go far beyond the scope of anything considered in the original debate on the bill, never mind what was in Truchon, to say “no” to them. We could say that we appreciate the review work that has taken place, but at the end of the day, Canadians elect members of the House of Commons who are empowered to study issues in detail and to hear from Canadians and to come to conclusions.

The Senate can study and make recommendations, but, at the end of the day, what the government is now proposing by adopting the amendment proposed by the Senate with respect to mental health as its position is that the people's House, the House of Commons, should adopt in a single day something that the government had up until now said was not its policy, something that is clearly very complex and requires further study.

Not only is it unrelated to Bill C-7, but it is also completely unrelated and light years away from anything contemplated in the Truchon decision, which dealt very narrowly with the question of reasonable foreseeability.

We have this particular issue of the Truchon decision, with Bill C-7 piling many other issues on top of it, and now we have the Senate piling so many additional issues on top of that, including its proposed amendment on advance directives for those who are healthy. Somehow we, in the House of Commons, are supposed to change our position on this fundamental issue, with no study and no review at committee and the government seems to want this to happen in a single day.

I will go further than that in terms of the process. I was up last night preparing information, looking for the data. It was certainly well after 9:30 p.m. Eastern time, closer to 10:00 p.m. that the Order Paper was published. It was only then that it was evident what the government's position was. The government expects that if it takes a position on this substantive, really earth-shattering issue for Canadians dealing with mental health challenges and their family members, that members will see it and adopt that position, or in any event vote on it, all within a single day.

What a profound degeneration of our democratic institutions the government is trying to preside over. There are many other examples that we could talk about. We could talk about the lack of respect by the government for motions passed by the House of Commons on various other issues.

What we see before us right now is a government, that did not win the popular vote in the last election, telling us to, in a single day, adopt a series of changes that were proposed by a Senate made up of independents that the Liberals appointed primarily, and is complaining about members wanting to engage in these issues at greater depth.

The direction the government is taking our democracy is very troubling. I hope that members would stand with us, at least members from all opposition parties, in insisting that the government do so much better on this and support the amendment put forward by my colleague that we are debating right now that rejects this very substantive amendment from the Senate and, instead, say that if the government wants to change its policy with respect to euthanasia for those dealing with mental health challenges, it should at least propose that as part of a legislative package not constrained by a court timeline, and that the House could take the time required to study it at committee, to assess those issues and to move forward, instead of this artificial timeline created by the pairing of the Truchon decision with all of these other issues.

Those issues of process are of critical importance, but I now want to comment on the specific issues raised by this amendment, that is, the government's proposal now to allow euthanasia for people whose primary and only health challenge is a mental health challenge.

All of us, including me, have people in our lives who are close to us, either friends or family members, who have suffered from or are suffering from mental health challenges. I am sure many, if not most, if not all members of the House have had a conversation with someone in their life who comes to them and says, “I don't think I can go on. The pain I am experiencing....”

In those situations, I think for all of us, how we love those people and try to support them is by trying to show them that are loved and valued and that their lives are worth living.

We invest so much time and energy into suicide-prevention education. We try to tell younger people, older people and people of all ages that their lives are valuable, that they are loved and that their lives are worth living. We recognize that for those who are really in the depths of experiencing mental health challenges, it may feel like there is no treatment and there is no going on. However, mental health authorities have said in this country that mental health challenges are not incurable, that it gets better, that there are ways forward and that there are ways of managing, responding to and even fully addressing these kinds of challenges. We as individuals try to send the message to others in these moments of real, existential pain that they are loved and valued, and that there are ways of managing and addressing their pain.

This amendment would radically change that reality. It would take us from a world in which the emphasis is on suicide prevention for those who experience these challenges to a world in which a person who feels that they are in the depths of despair can go to a health care practitioner and say, “This is what I am experiencing. I think I cannot go on.” Instead of affirming to the person that life is worth living, that they can be supported and that it does get better, the person would be told that their options are having a practitioner work with them to try to make things better or having the state facilitate their desire for suicide.

What message does it send if we go from a dynamic of suicide prevention to one in which some people experience suicide prevention and others experience suicide facilitation? What if somebody who is in the real depths of existential pain and going through deep challenges is called upon to choose between suicide prevention and suicide facilitation?

We had a unanimous consent motion adopted by the House to have a national 988 suicide prevention line. What message would it send to people if Parliament were to pass the amendment proposed by the Senate? What message would it send to people in that situation? I wonder what message it would send to young people who are dealing with these challenges.

Of course, the current legislative framework is that euthanasia is only available to those who are 18 years of age and older. That is also being considered as part of a review, so we cannot bank on that remaining a reality if this passes.

I asked what kind of message it would send to young people facing these challenges if we told them that it was acceptable to society for the state to facilitate suicidal ideation for adults, and that the solution was some kind of state-coordinated suicide facilitation. It really is horrible, in terms of the direction it would take us and the example that it would send.

Former Liberal MP Robert-Falcon Ouellette spoke eloquently and shared his perspective, from his indigenous culture and values, about what was so wrong about the government's original Bill C-14. He and I had a town hall in my riding together: a Liberal MP and a Conservative MP. We talked about many issues, most of which we disagreed on but some of which we agreed on. He made the point of asking what message it would send to younger people when older people are told that death is the solution. The values that he brought to the table underline the need for listening to Canadians on this issue. They underline the need for stronger consultation with indigenous communities.

As one previous witness told the committee on Bill C-7, indigenous Canadians are looking for medically assisted life. People with disabilities and mental health challenges would say the same thing: What they are looking for is medical assistance in living, not this rushed track, for those who are dealing with mental health challenges, toward suicide facilitation.

This needs more debate. I believe the amendment from my colleague should be supported to defeat the Senate amendment so that we can do more to protect people in vulnerable situations across the spectrum of challenges, and so that we do not, as the member for Timmins—James Bay spoke about, create a dynamic in this country where those living with disabilities are viewed or treated by our medical system as second-class citizens.

I look forward to the continuing conversation and to questions from my colleagues. Again, we need to do something like that.

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

Mr. Speaker, I would like to first recognize that the member for Timmins—James Bay is such a stand-up MP for his constituents, and I always appreciate his interventions, especially on this subject matter.

He is very right that we are not here to relitigate the main provisions of Bill C-7, but we do have to discuss what is a very substantive amendment to the bill by the unelected and unaccountable Senate, and that essentially is what is provoking debate on whether or not we agree as a House that the mental health exclusion section of this bill needs to be sunsetted.

If Liberals and Conservatives honestly cared so deeply about the plight of persons with disabilities, they would have agreed to the letter sent by the member for Elmwood—Transcona and the member for Esquimalt—Saanich—Sooke when they wrote to the minister asking that a monthly amount of $2,200 be awarded to all persons with disabilities to make their lives measurably better.

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

Mr. Speaker, when we look at the disability community and persons suffering from mental health issues, it is important for us to remember that they are not one solid bloc of people. There are a variety of opinions and approaches to this subject, both within the disability community and among persons who suffer from mental health challenges. I am very wary when a group says it speaks on behalf of an identifiable group, because we know that opinions on the subject are quite varied.

In terms of how we go forward, I am not ultimately going to be able to decide that. That decision is going to be up to the House, but I would refer my hon. colleague back to the answer I gave to the parliamentary secretary: The government chose to bring in a motion that agrees with a substantive amendment, and I think that in itself is going to provoke much more debate and may even serve to ultimately delay the passage of Bill C-7.

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

Mr. Speaker, I certainly appreciate the parliamentary secretary's comment about the many hours of debate on both Bill C-14 and Bill C-7 and I am also sensitive to the court deadlines.

That said, it was the government's choice to bring forward a motion that is going to, in my view, substantially alter Bill C-7 with the sunset clause on mental health. By that very action, the government is probably going to provoke much more debate in the House because, as the parliamentary secretary will know, the House already took time to pass a version of the bill. The very fact that the government chose to bring in a sunset clause is going to provoke a lot more debate. That is beyond my control.

The other thing I would note is that I wish the government had been a bit more respectful and had introduced this bill for debate tomorrow so that individual caucuses could have had the opportunity to have a thorough discussion of their concerns around the table.

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

Madam Speaker, we certainly are dealing with a very sensitive subject matter with today. This Parliament and the last Parliament both have had quite a long journey in dealing with the substance and subject matter of medical assistance in dying.

I know that I along with many of my colleagues in all parties have been recipients of a huge amount of correspondence on this subject matter, both from organized groups across the country and our very own constituents. It can be hard as a member of Parliament to find one's own way through all of that, because the feedback we receive and the strong passions are evident on both sides of the argument. I was a witness to that with Bill C-14 and, of course, it has been replayed for Bill C-7.

There have been difficult conversations with constituents. I have constituents who feel the government legislation does not go far enough. They felt that way for Bill C-14 and some feel the same way for Bill C-7. Others feel it goes too far and establishes dangerous precedents. It can be tough, but in those conversations I have had with my constituents, I have always tried to guide myself with the difference between sympathy and empathy. With sympathy, we can feel sorry for one's situation in life, but we are still looking at another person's situation with our own biases and world view, whereas true empathy, which is very much required when we are dealing with medical assistance in dying, is to try to put ourselves into that other people's shoes, to try to see the world from their point of view, to see exactly why these issues and matters are so important to them.

I also try to use section 7 of the charter to guide myself, the fact that it is explicitly written that everyone has the right to life, liberty and security of the person and the right not to be deprived thereof, except in accordance with the principles of fundamental justice. Essentially it means that people have a right to control their own bodily integrity. It is engaged whenever the state tries to interfere with personal autonomy.

This is really the crux of the matter. It is personal autonomy, a person's decision on how he or she is going to meet the end of his or her life. For those of us who are blessed to lead healthy lives, who are not intolerably suffering from a grievous and irremediable medical condition, we really cannot know what other people's lives are like. We do not know what it is like for those people to not have autonomy over their own bodily functions or their bodily integrity, so to speak.

In today's debate, one thing should be very clear. The House of Commons has already spoken to Bill C-7. We have already decided on what we want to do as the people's elected representatives. Of course, the Senate has reviewed the final third reading version of the bill that we sent to it and the Senate sent it back to us with some of its recommendations. This is not the time or the place to go over old arguments that were already dealt with by the House. This is really a time for us to focus exclusively on what the Senate has brought to us.

It is important to note that nothing in Bill C-7 is going to change the very high standards set out in the original Bill C-14. To receive medical assistance in dying, patients need to have a condition that is incurable. They must be in a state of irreversible decline and they must be facing intolerable suffering. The door is not being opened wide, as some have suggested. Those basic parameters are still in place.

When we are dealing with this subject matter, it is important to note that most Canadians know someone who has been affected by intolerable suffering at the end of his or her life. Generally, my caucus has been supportive of this bill because it does respond to the need to reduce that unnecessary suffering at the end of life. As I alluded to, section 7 of the charter helps to preserve the autonomy of decision-making for individuals.

I made reference to the fact that most Canadians know someone who has been affected by a disease and intolerable suffering. I have had that personal experience as well with a close family member, and that happened at a time before we had medical assistance in dying. It was a long-drawn-out battle with cancer. It can be hard on the family members too, because they have to watch a beloved family member suffer, in some cases for several months, before the end mercifully does come.

It is a very weighty subject matter, and I want to approach today's debate with that firmly in mind.

I was first elected in 2015, so I was a member of the 42nd Parliament. I was there for all the Bill C-14 debate, which was forced upon Parliament at the time by the Supreme Court of Canada's decision in Carter. We, as New Democrats, ultimately did not support Bill C-14, because we felt the bill at the time was too restrictive. I remember referring to the fact that the courts would force this bill back before Parliament, and that happened with the Quebec Superior Court.

I do not want to dwell too long on this history, but one thing that is very important to mention, in the context of today's debate, is that Bill C-14 had a provision in clause 10, which mandated that a legislative review had to happen at the beginning of the fifth year. I will read it out for my hon. colleagues. Clause 10 reads as follows:

At the start of the fifth year after the day on which this Act receives royal assent, the provisions enacted by this Act are to be referred to the committee of the Senate, of the House of Commons or of both Houses of Parliament that may be designated or established for the purpose of reviewing the provisions.

That is very clear language, and the beginning of the fifth year was in June 2020. We are almost at the end of February 2021.

The reason I raise this is that this important legislation review would have dealt with a lot of the questions the House is now considering and debating. It almost feels like we are building parts of the plane as we are flying. Many of these debatable items that are going on with Bill C-7 need a very careful study. They need to have the timeline afforded to them so we can hear from Canadians across the country, from expert witnesses and actually craft a law that responds to those very important bits of feedback.

I also want to take this opportunity to recognize my friend and colleague, the member for Esquimalt—Saanich—Sooke, a neighbouring riding of mine. He has long recognized this legislative requirement of Bill C-14. He has raised it with the Minister of Justice on several occasions.

Due to his frustration at the government's inaction on this front, he introduced Motion No. 51, which would establish a special committee of the House to include a review that would not be limited to but would expand on several issues. It would have looked at requests for medical assistance in dying by mature minors, advanced requests and, most important, requests where mental illness was the sole underlying medical condition. The committee would also be charged with looking at the state of palliative care, the adequacy of safeguards against pressure on the vulnerable and so on. If we had such a committee in place, already looking at these issues, then we may have had some answers to these important questions by this point.

I will move on to what the Senate has sent back to the House. I was reviewing some of the transcripts from the Senate, some from its legal and constitutional affairs committee, but also from its third reading of the bill.

The Senate legal and constitutional affairs committee decided to report back to the main body of the Senate with no amendments to the bill but some observations. The substantive amendments to the bill all came at third reading. For example, there was a proposed change to the wording of subsection 1(2) for mental illness to include a neurocognitive disorder, looking at advanced requests and so on.

Today, we are dealing with the government's response to those amendments. The government has crafted a motion for the House to consider on what amendments it agrees with, those it does not and those it wants to amend. The Senate disagreed with the expanded definition for the exclusion of mental illness. The government's motion disagrees with the advanced request part of it.

However, as a quick summary, the government motion agrees to the sunset clause for the mental health exclusion. Instead of 18 months, the government has proposed it be expanded to two years after royal assent. Essentially this legislation, once it becomes a statute of Canada, if passed in this manner, will have a ticking clock of two years for a committee to come up with the appropriate safeguards in place.

The government's motion in response to the Senate also mandates that the minister is to set up a committee of experts to work on mental health protocols. It requires a voluntary collection of data based on indigenous identity, race and disability. It sets up a joint committee to do the legislative review, starting 30 days after royal assent.

The most substantive part of the government's motion that really stands out to me is the fact the government is agreeing to the sunset clause on the mental health exclusion. The reason it stands out for me is because when Bill C-7 was originally proposed to the House, the government's own charter statement made some very strong references to why mental health, as an underlying condition, was to be excluded. For the government to backtrack on that and agree to a sunset clause stands out to me.

I acknowledge that we will have two years, but with such a substantive change to the law, it would make sense to me as a legislator to have a specific committee set up to look at all the things we need to look at to make this bill appropriate and proper so it fits will all the important safeguards we need to have in place. I am a bit wary of having that timeline put on the House and forcing us to do these things.

My Conservative colleague before me has now proposed an amendment to the government's motion. Basically, the Conservatives are proposing to get rid of the sunset clause. That is the most substantive thing. At first glance, that seems reasonable, but because I have only really had about 10 minutes to adequately review what the Conservatives have proposed, I would like more time to refer back to that in later days.

I mentioned the charter statement the government initially brought out for Bill C-7. I would like to read a highlighted section of that charter statement where it reasons why it wants to exclude the mental health provisions in the bill. It says, “evidence suggests that screening for decision-making capacity is particularly difficult, and subject to a high degree of error.” It further says, “mental illness is generally less predictable than physical illness.” It also highlights some concerns from other countries that permitted medical assistance in dying for mental illness, namely Belgium, the Netherlands and Luxembourg.

I want to make it clear that I am not necessarily of the opinion that mental health should be excluded, full stop. What I am saying and what I am arguing is that we need to have an appropriate review of all of this incredibly weighty subject matter before we dive into actually changing the legislation.

This is backed up by the work that was done in the House of Commons' very own Standing Committee on Justice and Human Rights. The justice committee heard that the protocols and safeguards for medical assistance in dying for those with mental illness do not exist and that it would take a significant amount of time to develop them from a clinical perspective. The fact is that if the committee's work on mental health is not complete within two years, that clause will be sunset. I have a real problem with us putting that part up front before we do the hard work at committee.

If I were to summarize my speech, the real issue I have is that I do not believe we should have a substantive expansion of what Bill C-7 purported to do when the bill was passed by the House. I do not think we should have any expansion to it before we have had those reviews in place.

I realize that in some cases, the Senate does like to provide feedback to the House, and there have been several instances of amendments being proposed by the Senate. The real issue I have, the elephant in the room, is that the Senate is still an unelected and unaccountable body.

As members of Parliament, we have to face our constituents. We are accountable to the people who elected us. Whenever the next election comes, the people of my riding of Cowichan—Malahat—Langford are going to judge me on how well I did my job. It is the same for every single member of Parliament who sits in the House of Commons. We have to be accountable for the things we say in the House and how we vote. Senators do not have to do that. I know there are a lot of honourable people who serve in that institution, but they are free from that accountability mechanism. The real problem I have is that I firmly believe the House must always be the final arbiter in the decisions that are made, because the people of Canada elected us to make the laws on their behalf.

In response to the many concerns I have heard raised, both in the House and in correspondence from the disability community, I would like to leave my colleagues with some thoughts. If we are rightly concerned about how persons with disabilities are currently living in Canada and what their quality of life is like, rather than focusing so much on Bill C-7 and medical assistance in dying, why do we not take this opportunity to start enacting reforms and enacting policies to make their lives better? If we look at the income supports that are out there for persons with disabilities and the amount of money they get to scrape by every month, we see a shameful record on our country, and it is something that we need to fix.

We have already acknowledged through the pandemic and through COVID-19 response measures that individuals should be receiving $2,000 a month to get by, but we do not afford that to persons with disabilities. Even when the House had an opportunity to get financial aid to that group of people in Canada, it took us over six months to do so. That is a shameful record, and it is something that the House really needs to concentrate on if we are going to adequately and meaningfully address that issue.

I appreciate having had this opportunity to speak to Bill C-7 and I welcome any questions and comments that my colleagues may have.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, without presuming what the committee will find, I think that advance requests for neurocognitive diseases will be possible, but we will also be able to make some technical amendments to the existing law to make it fairer.

That is what I would say, since Bill C-7 was a closed bill that could not be used to make amendments to Bill C-14. We can now look at this issue and see how the law can be improved. The concept of advance requests can be dealt with, with all of the necessary safeguards to reassure everyone, including practitioners, because this is a new practice—

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I believe we must move forward.

Bill C-7 already makes it possible to cover situations such as those of Ms. Gladu, Mr. Truchon and Ms. Parker. We can go further by trying to specifically address the delicate issues not resolved by Bill C-7.

I know we can do it especially since we will be informed by a panel of independent experts that will also table its report and that we will be able to invite to committee. Given the terms of the motion, I believe that we can do this in one year.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I do not want to keep members in suspense for too long. The Bloc Québécois will support the government's motion, and I will explain why.

I would like to tell all my colleagues that we need to work across party lines on these sensitive issues and find a way to move forward.

I remind my colleagues that Quebec's end-of-life legislation has often been cited as an example, not only because it is a good system, but also because of the way all members of the Quebec National Assembly worked together to create that system. Quebec's act came into force in 2015. The Select Committee on Dying with Dignity was created in 2009. The legislation was passed in 2014 and assented to in June 2014. This means that there was a process that ultimately involved debate. The Quebec National Assembly was able to consider all the differences and find common ground, which served as the foundation for the act. At the end of the process there were very few people against the act. There was broad consensus on this piece of legislation, both in the National Assembly and among Quebeckers.

In Ottawa, members have always taken action in response to court rulings. The amendments that need to be made to the Criminal Code in order to incorporate all of these sensitive issues are related to a court ruling. In this case, the legislators finally need to take action because the law has been deemed unconstitutional and found to violate fundamental rights.

According to Baudouin and Carter, Bill C-14 deprives people of the right to life. For example, it was depriving Ms. Carter, Ms. Gladu, Mr. Truchon and Ms. Taylor of their right to life because they were being forced to shorten their lives. That is not a trivial matter. It is serious.

My Conservative colleagues are saying that we need to protect human dignity and life. I completely agree, but it is important that we not create the opposite effect of what we claim to defend through government paternalism. Vulnerable people are capable of defending and exercising their rights.

However, it is rather appalling to see that, since Bill C-14 was introduced and since a decision was rendered in Carter, we have placed on the shoulders of vulnerable people, people with irreversible diseases, people who are enduring unbearable suffering, the burden of defending their case before the court in order to get access to medical assistance in dying.

Why are we agreeing to vote in favour of the motion? We are doing so because we need to make progress in a debate like this.

I have said this before and I will come back to it again later. Even though we said that we agree with the underlying principles of Bill C-7, we would have liked for the bill to go a little further. However, we still need to recognize that Bill C-7 responds to situations like those of Ms. Gladu, Mr. Truchon and Ms. Parker.

Bill C-7 also makes it possible for people in the terminal phase of life—I am not talking about the terminal stage of an illness when death is not foreseeable—to avoid waiting the mandatory 10 days with two witnesses before finally proceeding. Many people with cancer go through a long process. Even in the most aggressive cases, it takes a few months. People wait until the last minute to proceed because nobody wants to die. Everyone wants to wait until the last minute and push the limits of what they can tolerate. Once they reach that limit, these people want help.

Once in the terminal phase of life, a person who had been receiving palliative care at home may be taken to the hospital urgently, where health workers will note their rapidly deteriorating condition. Consider a person who, for the past two years, six months or three months, has always told their therapists that they want medical assistance in dying because they do not want to suffer. This person has been receiving palliative care and medication at home, but their condition is deteriorating. Why should they have to wait 10 days for access to medical assistance in dying in the terminal phase of life when the process of dying has begun and is irreversible? Bill C-7 covers this situation and offers this option. That is a step in the right direction.

There are of course other sensitive issues to be addressed, such as mental illness as the sole underlying medical condition. In my remarks last December, I had the opportunity to say that, as a parliamentarian and legislator, I did not have the expertise to reach a decision on that point. I think it is wise that the motion implies two things and that an independent panel of experts is being set up. The panel will have to look at the recommended protocols, guidelines and safeguards for MAID requests from patients with mental illness as their only condition.

Earlier, my Conservative colleague was talking about the requirement to have safeguards that protect the individual and help prevent abuse. Our Conservative colleagues would have us believe that we are in some sort of house of horrors, as though the health care system itself were inherently evil, and we need to protect persons with disabilities because our prejudices about these individuals might cause health care professionals to give up, as though people are going to be coerced and euthanized without their consent. I find it very difficult to understand that kind of rhetoric.

A similar independent panel of experts was set up in Quebec and a report was prepared. I think we should carry on with this work to get a clearer picture. Not only will the panel of experts deal with this issue, but there will also be something else we have been asking for for a long time, and that is the creation of a review committee for the entire body of work. Bill C-7 could have included amendments to C-14, An Act to amend the Criminal Code, which could have led to a new review of the legislation in two, three or four years. In just 30 days a special joint committee will study the issues of mature minors, advance requests, mental illness, palliative care in Canada and the protection of Canadians with disabilities.

Whether or not an election is triggered and there ends up being a change in government this committee is enshrined in law and will begin sitting in 30 days. It will work for a year before tabling its recommendations. We may reach a consensus or hold discussions for at least 12 months, which the court-imposed deadlines did not allow Parliament to do in relation to Bill C-7 and its previous version, Bill C-14. I think it is necessary.

To come back to the social acceptance of Bill C-7, I would point out to my Conservative colleagues that an average of 80% of people across the country approve it, from 88% in Quebec to 77% in Alberta. I think moving forward is a reasonable compromise. If in 24 months MAID is made available to people with mental illness, this deadline will help determine the necessary safeguards to make practitioners comfortable with this as well. In fact, we need to hear their point of view on this.

On the issue of advance requests for medical assistance in dying, I find it timely that the committee will start sitting in 30 days and that its members will work hard across party lines for the benefit of people who are suffering, like Sarah Demontigny. We will not forget these people, and we will establish a process to ensure that the advance requests they are drafting today will apply once our work is done. That is my hope.

Without making assumptions about the results of our efforts, I think we can come up with something better than the amendment proposed by the Senate if we have meaningful discussions and hear from witnesses. This would make it possible for Quebec, which is responsible for implementing this practice of advance requests, to properly regulate it. We could identify how to best amend the Criminal Code to allow for this.

I spoke about the legal aspect, but I will now come back to the fundamental principles. We are in the process of reaching a compromise because reason dictates that we must move forward. Bill C-7 represented a step in the right direction with the official commitment of an expert panel on mental health. I think it would be a good idea that the special committee I mentioned be a joint committee. This would ensure that everyone is doing the same work and hearing the same witnesses at the same time to eventually arrive at a conclusion, rather than having a game of ping pong between the two chambers—one of which is outdated, in our opinion. Let us rally together.

We are doing this for those who are suffering, who have waited too long and who, today, have hope that we will finally complete this work. I believe that the government's motion represents the light at the end of the tunnel for these people, because there is a deadline and we will get there if we all act in good faith and without partisanship.

Bill C-7 already contains fundamental principles, which I will repeat. First, death—my death, just like my life—belongs to me. Why did I say that and why did I say earlier that the Conservatives are practising government paternalism?

I said those things because my own death is a very personal thing, and the state must not tell me what to do or make decisions for me. The state should be creating a framework to protect my decisions. I do not think people should be pressured or forced to go into palliative care until their last breath or to request medical assistance in dying.

During any clinical study, the patient is the standard. When someone who is ill has determined their own limit of what is tolerable, we need to listen to what they are telling us and what comes out of their suffering. This allows us to provide support.

I find it very disturbing that in the debate on medical assistance in dying, MAID and palliative care are always pitted against each other, but in reality, it is a continuum and they complement each other. Later in my speech I will define the notion of human dignity.

Who would not want to receive palliative care before dying from a serious degenerative disease that causes intolerable suffering? We all want relief; no one wants to suffer.

When it comes to end-of-life care, the least you can give someone is palliative care. Unfortunately, for the past 50 years, palliative care has not been the only answer for everyone, unless one is ideologically committed and determined to prove it. At that point, someone comes to the patient's bedside and imposes some religious or other ideology. No, that is not it.

We are in a process where it is imperative that we consider that palliative care can be successful even when a patient's request for MAID emerges. Why? Because the patient is at peace and ready to let go. In fact, I hope all my colleagues are at peace and able to let go when the time comes. This could also be an example of very good palliative care. Palliative care is about support when someone is dying, the easing of suffering and psychological support. It is possible that some will die after suffering until the end, but it is also possible that some are ready to let go. That is when they can be supported.

It is not up to the family or the state to make decisions on behalf of the dying patient or the person suffering from a serious and irreversible condition causing intolerable suffering. The underlying principle of Bill C-7 puts into perspective what is enshrined in law for every human being, namely self-determination.

The law guarantees everyone the right to self-determination. Why take this right away from me at the most intimate moment of my life, meaning my death? Why should the state be allowed to take away my right to self-determination in my decision to suffer until I die in palliative care or to seek MAID? It would be utterly absurd for the state to assume that power.

The state must provide us a framework to be able to do this. I often hear members talk about human dignity. Human dignity implies that we must absolutely—

[Michael Barrett, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

Madam Speaker, the original legislation that came before Bill C-7 required that a review be exercised by the government. That was not a suggestion: That was the instruction of this place, of parliamentarians, to the government. The Liberals did not complete the review the first time. It is concerning when we are being asked to advance legislation under the commitment that there will be a committee, there will be more review and more study.

Why do we not get it right before we pass the legislation? The government has tools in its toolbox to review this and to get it right in advance.

[Michael Barrett, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

Madam Speaker, today I am speaking again to the government's bill, Bill C-7. I join my Conservative colleagues in being the voice for those who do not have one, those who have been thoroughly ignored and cast aside. Throughout this bill's debate, many people from the disability community have cried out in fear that they will be victims of this deeply flawed bill. That is why we are here today. We are here to stand up for them and be the voice that the government cannot ignore.

The Liberals are in such a fevered rush to pass this bill that they completely rejected amendments Conservatives offered at committee that would have seen safeguards in place for the vulnerable among us. They are in such a rush because they want to meet some arbitrary deadline to avoid political embarrassment. When there are lives on the line and the stakes could not get any higher than life or death, the Liberals are worried about embarrassment. They are not worried about the people who stand to be victimized by this bill and the unnecessary deaths it would lead to, but about political embarrassment.

We might remind the Liberals that it was their government that prorogued Parliament and locked the doors to this place, all in the name of covering up for the Prime Minister's corruption and blocking the investigations happening across multiple committees. Where was the need for great haste then?

One might have thought that when the Liberals missed their first arbitrary deadline it might have given the proponents of this dangerous bill time for pause and reflection about what this means for the most vulnerable Canadians, but it seems to have had the opposite effect. We are now looking at yet another arbitrary deadline and a vastly expanded bill that would see exponentially more Canadians victimized when they are at their lowest.

The government had a second chance to reform this bill and do what needed to be done to protect the vulnerable. Instead, it tossed protections to the wayside. This legislation, by its very nature, requires caution and constant monitoring to ensure that vulnerable Canadians are not being coerced, neglected or abused because of Bill C-7.

We need to offer Canadians our best when it comes to important legislation. That means listening to their concerns, considering them, offering them multiple options and avenues, and continuing to refine the legislation. This is especially the case with Bill C-7 because we can never bring back those people who have received MAID. This is something that is final.

The previous MAID legislation required a parliamentary review of the law five years after it was passed. This review was to provide the opportunity to hear from Canadians about how MAID is working and to see if any changes should be made. It was expected that this review would start in 2020.

I would point out that 2020 has come and gone. We now find ourselves in 2021. We have not seen any such review, and we are here debating a wide expansion of eligibility for MAID with the removal of safeguards for the vulnerable. The government has acted hastily and ignored the legislative review process in which safeguards for the vulnerable could have been strengthened. It chose to not undertake a proper review and went ahead with removing important safeguards.

We have heard from several witnesses who have attested to the fact that under the current MAID legislation they have been taken advantage of and made to feel increasingly vulnerable. We heard from Roger Foley. He is a man living with serious disabilities, a caretaker for his father when he battled cancer, who became subjected to coercion into assisted death by abuse, neglect, lack of care and threats.

We also heard from the national executive director for the DisAbled Women's Network Canada, who told Ruth's story. It was a story of a woman living with a disability who is not dying, but her inability to access proper care has left her considering MAID.

Moreover, the executive vice-president at Inclusion Canada told us that Bill C-7 is the disabled community's worst nightmare. Their biggest fear has always been that having a disability would become an acceptable reason for state-provided suicide. The disabled community has made it clear time and time again that they feel directly targeted by this new MAID legislation, that their lives are worth so little that they are better off to be dead than to live with a disability.

Despite the review of the MAID legislation never happening, here we are debating its expansion through Bill C-7, with the rationale being this bill is stated to reflect a societal consensus informed by views and concerns raised by Canadians, experts, practitioners, stakeholders, indigenous groups as well as provinces and territories during public consultations undertaken in January and February 2020. As Bill C-7 was originally proposed in February 2020, how could we have accessed a societal consensus on this in such a short period of time?

This brings us to the actual survey the Minister of Justice so often references in defending this bill. Many Canadians were deeply concerned about the ambiguity of the survey and online consultation that took place. Many of the questions were very ambiguous, and some people had an incredibly difficult time answering the questions, as they had to consent to different premises from what they believed.

Dr. Heidi Janz of the Council of Canadians with Disabilities gave her thoughts on the consultation process, stating:

I believe the consultation was moderately extensive; however, I believe that the consultation was geared towards a predetermined outcome. That is evident by the types of questions that were asked in the online survey and which seemed to be assuming that MAID would be expanded.

The government has missed the review of its prior legislation, having removed safeguards, and according to Dr. Janz, had consultations that seemed to have a predetermined outcome. We really have to wonder if proper consultations took place and the feedback given was acted on, or if the outcomes may have been predetermined.

The government must know that this is a deeply flawed piece of legislation by now. We know that the Minister of Employment, Workforce Development and Disability Inclusion realizes the serious issues with this bill in reference to Roger Foley's story and of other vulnerable Canadians when she said before the Senate committee:

I absolutely acknowledge and am quite preoccupied by the power imbalance between practitioners and patients, particularly patients who have been in systems that have discriminated against them and ignored their voices their entire lives. I have grave concerns with the particular circumstances of the individual that you spoke of. Quite frankly, I can tell you, he is not alone. I regularly hear from families who are appalled by the fact that they take their child, potentially their older child [in] and are offered unprovoked MAID. I think that has to stop. That’s a matter of practice, I would suggest, and we need to get at that through our regulations, through working with our medical associations.

What does it say when the minister tasked with inclusion of the disability community in Canada makes a statement like that, yet the government carries on full steam ahead with this bill while rejecting good amendments? What does that say to Canadians who are living with a disability? Does it reaffirm their inherent human dignity or does it say that we do not particularly care about them or their opinions?

It seems like the member for Thunder Bay—Rainy River, who sits on the government side of the House, gets it. He is concerned for the well-being of the vulnerable and the potential victims of this bill. He said, “I don't like voting against my party, but as someone with a medical background and somebody who has dealt with this issue over the years a lot, I think morally it's incumbent upon me to stand up when it comes to issues of health and life and death.”

He went to say:

My biggest concern, as somebody who has spent my whole life trying to avoid accidentally killing people, is that we don't end up using MAID for people who don't really want to die.... I think, with a bit of time, people may come around to the fact that there are reasons they want to live.

Members can see that Kristine Cowley, who injured her spine 33 years ago, now has a doctorate and is a professor at a university, was a wheelchair track Paralympian, is married and has three children and has travelled extensively, all of which was done after her accident. She shared that it took her five years after her spinal cord injury to feel great again. She said:

To all outward appearances, I am a ‘successful’ person living and contributing to our community. But I’d be lying if I told you...that I was good to go within 3 months of my injury when I was discharged from the hospital. In fact, it was a few years before I was able to open my eyes in the morning and feel good.

Then there is the story of David Shannon. David suffered a spinal cord injury in a rugby scrum when he was 18 years old. After his accident, he said that he lay in bed close to death more times than he wished to contemplate. David has gone on to have a career in non-governmental organization leadership and a law practice focused on human rights and health law. David wrote:

...I have accomplished a lot in my life. I've crossed our great country by the power of my wheelchair—coast to coast. I've jumped out of an airplane at over 25,000 feet. I've made it to the North Pole and planted an accessible parking sign. I’ve written a book, performed in plays and on TV. I’ve received my law degree and been a Human Rights Commissioner. And I am an Order of Ontario and Order of Canada recipient. I’ve loved and been loved. My proudest accomplishment is that I lived.

How many stories like those of Kris or David will not happen because of this dangerous bill? How many stories of resilience and great Canadian comebacks will not happen because people will be offered death before proper care when they are at their lowest?

The Minister of Justice called my colleagues and me who are standing up and speaking for the voiceless and the vulnerable a “rump element” of the Conservative caucus. Now, that rump represents nearly one-third of this Parliament and represents Canadians from the Maritimes to the west coast and all points in between who will always stand up for the vulnerable. I would remind the minister that he and his colleagues have silenced the voices that we are speaking for. He can try to silence the disabled community who cry in fear for their future, but he cannot silence our voices. He will not silence my voice.

Does the minister believe that the people we are fighting for are also a rump of Canadian society? Does he believe that Canadians living with a disability are a rump element? That is what it looks like to me. The disrespect and the eye-rolling coming from the Liberals when the disability community has tried to voice their concerns really is something to behold.

Death will be offered to Canadians before they are given proper access to meaningful care, the care they need to feel good again. We need to re-evaluate our priorities and shift our focus to reaffirming the inherent human dignity of all people, and especially those who are vulnerable. It is our duty to keep their preferential option in mind as we make decisions in this place. It is quite clear that Bill C-7 does not have the preferential option for the vulnerable in mind and does absolutely nothing to affirm the human dignity of the vulnerable.

We will offer death to people when they are at their lowest, after an injury resulting in a disability when hope seems lost and they are in the depths of despair. Instead of offering help and treatment and care, we will offer death. Despair can be transient. It can come and it can go. During the low points, people need support. Really, it is as simple as that.

We must ensure that people have access to the care they need first, to ensure that they can make an informed decision when it comes to life and death. Anything short of that is not just, and may be a form of coercion in and of itself. That says nothing of the damage that will be done by the sunset clause added to this bill, that demands that provisions be made to administer MAID to those who have mental illness.

This came as a shocking revelation, given the difficulty people have in accessing mental health treatment across this country. Without adequate care, illnesses that are treatable can appear not to be. We, again, are seeing people being offered death before they are being offered care. Right now, 6,000 people with the most severe forms of mental illness are waiting up to five years to get the specialized treatment they need to reduce symptoms, learn to cope and to feel better.

Instead of working to better those systems, to give people the help they need when they need it most, the government is striving to offer them death. When appearing before the Senate, Dr. John Maher, a psychiatrist who works only with people who have the most severe and persistent mental illness, said:

Clinical relationships are already being profoundly undermined. My patients are asking: “Why try to recover when MAID is coming and I will be able to choose death?” Some of my patients keep asking for MAID while they are getting better but can’t recognize that yet.

That speaks to the need for better and more accessible mental health treatments in this country. People with mental illness should not feel the need to end their lives for lack of treatment and the hope this can bring.

Dr. Maher went on to say:

Determining whether a particular psychiatric disease is irremediable is impossible; people recover after 2 years and after 15 years. I have repeatedly [have] psychiatrists refer patients to me where I am told they will never get better; yet they have all improved symptom control and reduced suffering when they finally get intensive care.

We need to help people get better and to give them hope, not do everything we can to make death the easiest path for them.

I urge my colleagues on all sides of the House to reaffirm the dignity that is inherent and inalienable in all people, in every person, and to keep the preferential option for the vulnerable in mind. That option is care and support, not death.

I will continue to fight and speak up for the voiceless and those who will be victimized by this bill. We must ensure that someone's worst day is not their last.

At this time, I move:

That the motion be amended by:

(a) replacing the words “agrees with amendment 1(a)(ii) made by the Senate” with “respectfully disagrees with amendment 1(a)(ii) made by the Senate because, in the Justice Department's own words, it 'could be seen as undermining suicide prevention initiatives and normalizing death as a solution to many forms of suffering'”;

(b) deleting all the words beginning with the words “as a consequence” and concluding with the words “receive the report”; and

(c) replacing the words “section 6 be amended by replacing the words '18 months after' with the words 'on the second anniversary of'” with “section 6 be deleted”.

[David Lametti, Liberal, Minister of Justice]

moved:

That a message be sent to the Senate to acquaint Their Honours that, in relation to Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), the House:

agrees with amendment 1(a)(ii) made by the Senate;

respectfully disagrees with amendment 1(a)(i) because this matter, including questions of most appropriate precise definitions, whether those definitions should be included in the Criminal Code or elsewhere, and whether any consequential amendments or protections relating to issues such as consent and capacity are necessary in relation to such an amendment, will also be addressed by the expert panel and the upcoming parliamentary review, and the Government will collaborate with provincial and territorial health authorities to ensure a consistent approach;

respectfully disagrees with amendment 1(a)(iii), 1(b) and 1(c) because it would permit advance requests for medical assistance in dying before an individual has a grievous and irremediable medical condition, a change which goes beyond the scope of the bill, and further, this expansion of the medical assistance in dying regime requires significant consultations and study, including a careful examination of the safeguards for persons preparing advance request and safeguards for practitioners administering medical assistance in dying, all of which could be part of the parliamentary review undertaken to study this important type of advance request to reflect the crucial input of Canadians affected by the medical assistance in dying regime;

proposes that, with respect to amendment 2:

the portion of paragraph 241.31(3)(a) before subparagraph (i) be amended by replacing it with the following:

“(a) respecting the provision and collection, for the purpose of monitoring medical assistance in dying, of information relating to requests for, and the provision of, medical assistance in dying, including”;

clause 241.31(3)(a)(i)(B) be amended by adding after the words “respecting the race” the words “or indigenous identity”;

subparagraph 241.31(3)(a)(i) be amended by deleting “and” at the end of clause (A), by adding “and” at the end of clause (B) and by adding the following after clause (B):

“(C) information — other than information that must be provided in relation to the assessment of eligibility to receive medical assistance in dying and the application of safeguards — respecting any disability, as defined in section 2 of the Accessible Canada Act, of a person who requests or receives medical assistance in dying, if the person consents to providing that information,”;

paragraph 241.31(3)(b) be amended by replacing it with the following:

“(b) respecting the use, analysis and interpretation of that information, including for the purposes of determining the presence of any inequality – including systemic inequality – or disadvantage based on race, Indigenous identity, disability or other characteristics, in medical assistance in dying;”;

as a consequence of amendments 1(a)(ii) and 3, proposes that the following amendment be added:

“1. New clause 3.1, page 9: Add the following after line 20:

“Independent Review

3.1 (1) The Minister of Justice and the Minister of Health must cause an independent review to be carried out by experts respecting recommended protocols, guidance and safeguards to apply to requests made for medical assistance in dying by persons who have a mental illness.

(2) A report containing the experts’ conclusions and recommendations must be provided to the Ministers no later than the first anniversary of the day on which this Act receives royal assent.

(3) The Ministers must cause the report to be tabled in each House of Parliament within the first 15 days on which the House is sitting after the day on which they receive the report.”;”

proposes that, with respect to amendment 3:

section 5 be amended by replacing it with the following:

“Review

5 (1) A comprehensive review of the provisions of the Criminal Code relating to medical assistance in dying and their application, including but not limited to issues relating to mature minors, advance requests, mental illness, the state of palliative care in Canada and the protection of Canadians with disabilities must be undertaken by a Joint Committee of both Houses of Parliament.

(2) The Joint Committee shall be composed of five Members of the Senate and ten Members of the House of Commons, including five Members from the governing party, three Members of the Official Opposition, and two Members of the opposition who are not Members of the Official Opposition, with two Chairs of which the House Co-Chair shall be from the governing party and the Senate Co-Chair shall be determined by the Senate.

(3) The quorum of the Committee is to be eight Members whenever a vote, resolution or other decision is taken, so long as both Houses and one Member of the governing party in the House and one from the opposition in the House and one Member of the Senate are represented, and that the Joint Chairs be authorized to hold meetings, to receive evidence and authorize the printing thereof, whenever six Members are present, so long as both Houses and one Member of the governing party in the House and one Member from the opposition in the House and one Member of the Senate are represented.

(4) The Committee must commence its review within 30 days after the day on which this Act receives royal assent.

(5) The Committee must submit a report of its review – including a statement of any recommended changes – to Parliament no later than one year after the day on which it commenced the review.

(6) When the report, referenced in paragraph (5), has been tabled in both Houses, the Committee shall expire.”;

section 6 be amended by replacing the words “18 months after” with the words “on the second anniversary of”.

Mr. Speaker, I would like to begin my remarks today by acknowledging the comprehensive study and debate on Bill C-7 in the other place. I applaud their diligence in holding a pre-study of Bill C-7 this past November and an in-depth committee study of the bill earlier this month, and a thematic third reading debate two weeks ago.

The matter of medical assistance in dying, or MAID, is a serious and complex one. The Senate has given it serious thought, and I believe we have given it serious thought in our response in this motion.

Before discussing the amendments, I want to remind hon. members of the process that got us here.

As members will recall, the bill proposes a legislative response to the Superior Court of Quebec's Truchon and Gladu decision in which the court ruled that it was unconstitutional to limit MAID to persons whose death was reasonably foreseeable.

To develop this bill, my colleagues, the Minister of Health and the Minister of Employment, Workforce Development and Disability Inclusion, our parliamentary secretaries and I held round table discussions across Canada with over 125 experts and stakeholders.

The government also ran a public online survey, to which over 300,000 Canadians across the country responded. A report summarizing the consultations was released in March. Our government fulfilled its mandate by creating this legislation. The whole process resulted in the bill that was introduced in the House last February.

As hon. members know, we had a thorough debate on this bill before the work of the House was suspended.

The objective of the bill is to recognize the autonomy of individuals choosing MAID as a means of relieving intolerable suffering regardless of the foreseeability of their natural death, while at the same time protecting vulnerable persons and affirming the inherent and equal value of every person's life.

Bill C-7 proposes important changes to the Criminal Code's provisions on MAID in response to the Truchon decision and informed by the results of the January and February 2020 consultations. We recognize these changes represent a critical shift. Our government has been working very hard since the Truchon decision on responding to this important court ruling and remains committed to doing so as quickly as possible.

After months of review of Bill C-7 in both the House of Commons and the Senate, we are now at a critical stage. There are Canadians who are suffering intolerably and would become eligible for MAID under the government's proposed changes, but they are currently unable to access the medical assistance in dying regime. This matter has been thoroughly examined, and Canadians need to be able to access the regime. We are renewing our commitment to the parliamentary review to look at the wide variety of other issues related to MAID outside of Bill C-7, but it is essential that we pass this legislation.

Following its thorough debate, the other place has adopted five amendments to Bill C-7. The most significant amendment is the sunset clause that would repeal the mental illness exclusion 18 months after Bill C-7 receives royal assent. I know that many senators and some witnesses from whom they heard believe that the exclusion of mental illness unjustifiably infringes the equality rights guaranteed by section 15 of the charter. I do not share that view. It is my opinion as Minister of Justice and Attorney General of Canada that the mental illness exclusion is constitutional because it serves a protective purpose and is narrowly crafted.

I have spoken before about the 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, the impossibility of predicting whether in any given case symptoms will improve or not and the increased difficulty of capacity assessments. These are the concerns that led the government to exclude mental illness as the sole condition for MAID eligibility, given the proposal to broaden it beyond the end of life context. This decision was accompanied by a commitment to further consider the issue of MAID for mental illness in the parliamentary review required by former Bill C-14.

We heard from witnesses who share those concerns, but we also heard from several others who said that excluding everyone with mental illness as a sole underlying condition could be stigmatizing and pointless.

Some mental health experts believe that practitioners can assess the eligibility criteria case by case, particularly the voluntariness of each request and each patient's decision-making capacity.

In November 2020, the Association des psychiatres du Québec released a discussion paper exploring safeguards and procedures that could be put in place for the provision of MAID on the ground of mental illness alone.

While I do think the exclusion is constitutional, and I do not believe that we are fully prepared to safely proceed with the provision of MAID on the ground of mental illness alone, I also hear the concern expressed by Canadians that this exclusion fails to address the issue of whether and when the provision of MAID will be permitted to alleviate intolerable suffering due to mental illness.

That is why I propose that we support the sunset clause, but with an amendment so that it would repeal the mental illness exclusion after 24 months instead of after 18 months, after Bill C-7 comes into force. In combination with this amendment, I am also proposing the enactment of the requirement that the Minister of Health and I establish an expert panel to review safeguards protocols for guidance for such cases. We would give this group of experts 12 months to consider these difficult questions and make their recommendations to us, which we will make public by tabling their report in Parliament. The government and Parliament would then have 12 additional months to consider what safeguards should be legislated before the exclusion is repealed.

We hope this compromise can be acceptable to the other place. While some work has begun on potential safeguards for this group of persons, the work is far from complete and enacting legislation takes time. We think 24 months is still an ambitious timeline to implement such an important change in Canada's MAID policy, but it still provides a fixed timeline in the relatively near future for considering MAID eligibility on the basis of mental illness.

We also welcome the Senate's amendment concerning the parliamentary review. We suggest making a few changes to the timetable for completing the work, and we think it is appropriate to include key issues that this review will address.

The parliamentary review should address important issues, most of which were highlighted during the procedures and committee debates on Bill C-7 in both chambers, including palliative care in Canada, protecting Canadians with disabilities, safeguards for persons with mental illness, medical assistance in dying for mature minors, advance requests for medical assistance in dying and the legislation on medical assistance in dying more generally.

The spirit of the amendment aligns with the government's commitment to make it easier to call for a parliamentary review as soon as possible following royal assent to Bill C-7. This review is absolutely essential for the future of medical assistance in dying in Canada.

During consultations and the committee process in the House and in the Senate, we noted that a certain number of issues should have been reviewed and addressed, but they required a more in-depth study than was possible to carry out within the court-imposed deadline.

Bill C-14 calls on Parliament to conduct that review, and we are using this message today to initiate the process. While the motion sets out important issues that need to be examined, I do not expect the list to be limited to only those issues. Medical assistance in dying is a very broad subject, and we hope to hear from many Canadians on a wide variety of subjects related to it.

Having heard from many witnesses and spoken to many Canadians about Bill C-7, I know that people have different views on these issues. They are challenging issues, and I look forward to the parliamentary review, to hearing from many more Canadians on the subject and to seeing what comes out of this review.

I will let other colleagues speak in greater detail about the Senate amendments to the MAID monitoring regime. I will say that I am proud to support this Senate amendment, with some modifications to make it more inclusive, as a necessary step in the right direction toward gathering better data to inform us all, going forward, about the operation of MAID in Canada. Good data is what grounds good policy, and by knowing more about who requests MAID and why, we can assess the impact of broadening the MAID regime and provide Canadians with the transparency and public trust that such a regime requires.

That brings me to two Senate amendments that I do not believe we can support.

The Senate adopted an amendment that will enable people whose death is not reasonably foreseeable to sign a waiver of final consent. Bill C-7 set out a general policy on the waiver of final consent that intentionally limited it to the most obvious cases with the least amount of uncertainty, specifically when a person's death was reasonably foreseeable and the person was ready to receive medical assistance in dying.

Since the question of expanding the circumstances in which medical assistance in dying can be administered in the absence of contemporaneous consent requires more in-depth study, it is best if it is addressed by the parliamentary review. I know that many people will be disappointed with that decision.

Last year, I had the opportunity to meet Sandra Demontigny, who was diagnosed with early onset Alzheimer's at 39 years of age. She is an advocate for advance requests for medical assistance in dying. We had a long conversation. I was very touched by her story, her beliefs and her book. We will soon begin an in-depth study of this important issue during the parliamentary review.

Finally, while I appreciate the efforts at clarifying what constitutes a mental illness in the MAID context, this is a matter that can and will be addressed by the expert panel and the upcoming parliamentary review, and the government will collaborate with provincial and territorial health authorities to ensure a consistent approach. Through this work, I am confident there will be consistency on the scope of the exclusion, going forward.

Medical assistance in dying has always been a difficult issue that generates a variety of opinions on all sides of the issue. It is an issue that strikes deeply to every Canadian's personal morals and sensibilities. As such, it requires different interests to be considered. I firmly believe that Bill C-7 does so. The law would continue to require informed consent and a voluntary request made by a person with decision-making capacity, while also creating a more robust set of safeguards when the person's natural death is not reasonably foreseeable. These safeguards would require significant attention to be paid to all of the alternatives that might help alleviate suffering on the part of a person whose death is not reasonably foreseeable.

I believe that Bill C-7 is one important and prudent step in ensuring greater respect for the autonomy of a broader category of Canadians who are suffering intolerably. Our legislation would make only the necessary changes to ensure a MAID regime that is responsive to our experience to date and respects the charter rights and freedoms of Canadians to autonomy and safety. In Carter the court said, “the risks associated with physician-assisted death can be limited through a carefully designed and monitored system of safeguards”, and that is exactly what Bill C-7 would continue to do.

I look forward to working with all members of Parliament to pass these reasonable amendments prior to the court deadline on Friday. If the suspension period expires without the passage of Bill C-7, Truchon would come into effect without the benefit of the protection, safeguards and exclusions of our proposed bill. I encourage all members of the House to support the government's motion on the Bill C-7 amendments.

Medical Assistance in Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, the fifth and final petition is with respect to Bill C-7. The petitioners are very concerned about how the government's Bill C-7 would make people living with disabilities effectively second-class citizens when they are accessing our health care system. They are deeply concerned about provisions in this bill and want the bill to be either defeated or significantly amended.

I commend all these petitions to the consideration of the House. I hope the government will take very seriously the concerns raised by Canadians and people living with disabilities with Bill C-7.

Persons with Disabilities

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

Madam Speaker, medical assistance in dying is a complex and difficult issue. It calls on us to reflect on some fundamental interests and values, such as the protection and support of our most vulnerable. We need to reflect on the meaning and inherent value of life, and we need to consider how to balance an individual's right to make important decisions for themselves with the responsibilities we all have to others.

Many aspects of Bill C-7 generate opposing views. We have just heard some of them from my hon. colleague from the official opposition. The witnesses who appeared before the Standing Committee on Justice and Human Rights took different views on proposed amendments, such as the exclusion of persons whose sole medical condition is a mental illness and the proposal to allow for the waiver of final consent, to name just a couple. This is to be expected on an issue as complicated as this one. It is also a reflection of the vibrancy of our public discourse in the health care sector and of our civil society.

The potential impact of the bill on persons with disabilities is another issue that has received significant attention, and that is entirely appropriate. It is clear that national disability rights organizations do not support the core aspect of Bill C-7, which is the removal of the eligibility criterion of death that is reasonably foreseeable. Their view is that medical assistance in dying must be limited to persons at the end of life. They call the end-of-life criterion the great equalizer: Everyone will one day reach that stage. At the same time, ineligibility is also equitable: Everyone who is not at the end of life, in their view, is protected by the criminal law prohibition against people helping others to end life.

The removal of the end-of-life requirement raised the grave worry that persons with disabilities would be steered towards medically assisted death by subtle medical and societal pressures and that disabled individuals would choose medical assistance in dying not because their disability was causing them unbearable suffering but because the care they needed was not forthcoming, as was highlighted by the member opposite.

There was also the worry that the proposed amendment discriminates against persons with disabilities by singling them out as a category of persons who could obtain medical assistance in dying on the basis of their suffering.

I think what is important is to be reflective and responsive to the positions of these very important organizations and the thousands of Canadians they represent. At the same time, we need to be responsive to the views and wishes of other persons with disabilities and other serious illnesses who take a different view.

I would remind the member opposite and this chamber that in the actual Truchon decision, Monsieur Truchon and Madam Gladu were themselves persons with disabilities. They felt that their autonomy, their independence, and indeed their rights to equality under the charter were discriminated against by virtue of not being able to avail themselves of medical assistance in dying because of the requirement of needing to be at the end of life. The court in that case found in their favour, finding that the previous regime was itself discriminatory against persons with disabilities. That is the court's determination. That is what we were responding to here.

Clearly, there are many others in that camp as well, including the Senate sponsor of the bill and including a former Conservative cabinet minister, Mr. Steven Fletcher, who has echoed the exact same concern: that the rights of autonomy and dignity of all people, including all people with disabilities, must be respected and entrenched in whatever legislation is coming forward. Compassion requires that we consider their views as well.

I agree that disability groups in this country raised extremely grave and serious concerns. We must turn our attention to ways we can address them. In my view and the view of the government, there are ways to address those concerns that do not have the effect of denying others the medical service that they feel is right for them. Yes, we must do more to support persons with disabilities in this country to ensure that they have equitable access to all forms of excellent medical care, such as what was listed by the member opposite, and including things like proper housing and the different kinds of supports that they need to thrive.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Madam Speaker, the parliamentary secretary said, back in late November, that “the issue of sensitivity toward persons with disabilities is central for all parliamentarians in the House.” I could not agree more. He also stated that the Liberals “are crafting a piece of legislation that ensures the autonomy, dignity and competence of individuals.” I wish that were the truth.

What has been crafted is a bill that declares that some lives are not worth living. In fact, Bill C-7 has shocked and terrified those in the disability community. Why has a policy generated so much fear among so many vulnerable citizens?

First and foremost, it is because they understand the inherent discrimination in this bill. To state that people who are bedridden or are dependent on others for hygiene or feeding have lost their dignity is a marginalizing and ableist myth. This is the perspective of the “worried well,” such as my hon. colleague and his friends at Dying With Dignity. Dignity is never lost, but it can be either affirmed or denied.

Speaking of myths, let us deal with the idea that Bill C-7 is not discriminatory. The fact is Canadian disability organizations, mental health organizations, indigenous organizations and the U.N. all say that Bill C-7 is discriminatory. This bill singles out vulnerable Canadians and offers them physician-assisted death without offering adequate disability supports or treatment to help them live full lives free of the suffering caused by poor health care, poverty and stigma. It singles out persons with disabilities who are not terminally ill as fit for suicide completion. This will become a choice of desperation, not autonomy.

Let us understand what discrimination really is. It is pretending that all Canadians are equal in all ways. The obvious reality here is that some of us face profound life challenges. We need laws that protect the disadvantaged. A law that offers death to one group, and support and treatment to all others is the paradigm of discrimination.

This law proclaims that a disabled Canadian should consider death instead of recovery. Vulnerable patients need protection from politicians and doctors who want to make it easier for them to die, while simultaneously denying access to appropriate health care supports. This is true discrimination.

The second myth that needs to be countered is the idea that Bill C-7 must be passed right away, because suffering Canadians need relief through MAID as fast as possible. Let us face it: if this were true, then it is also true that adequate palliative care, disability supports, and mental health care must be available as fast as possible, because it is the absence of these that makes people suffer so much that they want to die rather than live.

If it were not for the COVID pandemic, Parliament Hill would see the largest protest of disabled Canadians ever assembled. If it were not for poverty and marginalization and the fact that most Canadians are unaware of the shocking push for state-sanctioned suicide, those protesters would be joined by millions more.

I have listened to the wealthy and healthy politicians opine on what they would wish for if it were them in such a terrible position. They say, with a straight face, that we must hurry to act to stop this horrible suffering, not because they are suddenly seeing what has always been in front of their eyes, but because of the realization that it could be them some day.

This bill would ensure that disabled Canadians would be treated as second-class citizens. I beg the parliamentary secretary, for the love of God, will he join me in voting firmly against this Frankenstein bill?

Economic Statement Implementation Act, 2020

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Madam Speaker, I do not think any of my colleagues, from either side of the aisle, would disagree with me when I say that this bill is incredibly important to Canadians.

We are now over a year into this pandemic. I know that the first case in Canada was confirmed in January 2020, and the first recorded case of COVID-19 in Alberta was in March of last year. However, I do not know when the first plan to get back to normal will be presented, either to Canadians, or to the House of Commons. I honestly cannot believe that I had to say those words.

We are now over a year into this pandemic, and the government has not yet presented a plan. I do not think there is a way for anyone to easily describe how disappointing that is, and how disappointing it is that the bill before us does not present any sort of plan either. Of course, this raises the question of what the government would do if it did have a plan.

I am not asking about policies here. I am asking about how the government expects to get its plan through the House of Commons. While I and many of my colleagues appreciate the time we have had to go through the contents of the bill before us, I have to seriously ask what the government is thinking. The fact is that we are debating the 2020 fall economic statement in the winter of 2021. Obviously, we had our winter break, which contributed to the delay, but the government has a bit of a secret that I would like to let members in on.

The Liberals are big procrastinators. They love to leave some of their most important bills, the ones Canadians are asking for, until the last minute. They will also introduce a bill, have the first reading, and then sit on it for weeks on end until it finally goes to second reading. That is the tactic of this government.

There are far too many examples of this for me to list. However, there are plenty of examples from this very parliamentary session. I will start with a big one, which I know my colleagues from the Standing Committee on International Trade have heard me ask about plenty of times. I am referring to Bill C-18, an act to implement the agreement on trade continuity between Canada and the United Kingdom of Great Britain and Northern Ireland.

As the title of the bill so clearly lays out, it would implement a trade deal worked out between Canada and our close friends and allies the United Kingdom. Originally, we were going to lose many of our preferential tariff levels with the United Kingdom by the end of last year, and we had to pass the bill to ensure that would not happen.

What did the government do? It introduced the bill about a week before we rose for the winter break. As I am sure members are aware, we only voted on the second reading of the bill on Monday, February 1, 2021. The only reason we still have those preferential tariff levels with the United Kingdom is because the government realized its folly and signed a memorandum of understanding that temporarily extends those levels until we pass Bill C-18. Believe it or not, this is not the only bill the Liberals have delayed on.

I am sure all my colleagues, and of course many, many Canadians, are very familiar with Bill C-7 by now. We had a court-imposed deadline to pass this bill, which was December 18, 2020. I am sure my colleagues opposite will try to blame the opposition for it taking a long time to get to the other place, but it was nearly two weeks between the Speech from the Throne that kicked off this session and the bill being introduced. I wonder why.

This was not a surprise. The court decision that mandated the law be changed was made back in 2019, but it took two weeks to reintroduce this bill. On top of that, last February was the last time we looked at Bill C-7, an act that would amend the Criminal Code with respect to medical assistance in dying. That is right, it was February of 2020.

Why was this not introduced right after the 2019 federal election, as soon as we returned in December of 2019? Why not in January of 2020, or early February? The answer is that the government loves to delay the introduction and debate of important pieces of legislation. The bill we are debating today, Bill C-14, is no different.

Obviously she needed some time to be introduced to the job, but why did the Minister of Finance wait until November 30, 2020, to introduce this bill? By that point, Canadians had been asking for a plan for eight and a half months, if not longer, depending on the province. Why did she wait for two whole months after the start of the second session to introduce this bill?

It was certainly not to give my colleagues in the opposition and I time to study the bill. The Minister of Finance complained on Twitter that we were allegedly delaying this bill, but I think the answer is a little different. I think it was simply another example of Liberals leaving important business until the 11th hour.

I know my Conservative colleagues and I welcome some of the parts of this bill, such as the Canada child benefit top-up, which our leader has been calling for, but we want to make sure we have time to discuss it. The Liberal government has had plenty of poorly written legislation during this pandemic. How else does one explain that this bill would do such things as amend the rent relief legislation for the second time? This is the third try for the rent relief legislation. I know Canadians across the country are hoping this third time will be the charm, but I am not sure.

Liberals like to blame Conservatives for everything, and I know they love blaming former prime minister Harper for everything too, but in the case of Bill C-14, I am pretty sure any and all problems are their fault and theirs only. At this point, it is unacceptable that the Liberals still cannot get anything done.

I know all my colleagues in this House want to support Canadians who are still struggling against this pandemic, but the Liberals are still playing their classic game of delaying and blaming the Tories, and it is doing anything but helping Canadians. The Prime Minister and his party are just busy preparing for a snap election. They are not busy making sure the lives of Canadians are better. A fiscal update has to be in place so we know where we are going in these tough times.

Alleged Premature Disclosure of Contents of Bill C-22

[Rob Moore, Conservative, Fundy Royal, NB]

Mr. Speaker, I am rising on a question of privilege concerning the recent premature disclosure of the contents of Bill C-22, an act to amend the Criminal Code and the Controlled Drugs and Substances Act.

Yesterday, the CBC posted online, at 8:47 a.m., an article that outlined details of Bill C-22. Bill C-22 was introduced in the House later that morning. The article outlined several measures contained in the bill, including amendments to the Criminal Code and the Controlled Drugs and Substances Act and the elimination of several mandatory minimum penalties. The article also boasts a reliance on sources, not unlike in the case I raised with you, Mr. Speaker, on another matter of privilege almost one year ago.

On February 25, 2020, I was on my feet in the House defending the privileges of the House on the matter of the premature disclosure of the contents of Bill C-7, an act to amend the Criminal Code (medical assistance in dying). In that case, The Canadian Press posted an article that disclosed the details of the bill before it was introduced in the House and after the bill went on notice.

On March 10, 2020, Mr. Speaker, you came back to the House with your ruling. You said:

First, based on a reading of the Canadian Press article on Bill C-7 on medical assistance in dying, and in the absence of any explanation to the contrary, I must conclude that the anonymous sources mentioned were well aware of our customs and practices and chose to ignore them. It seems clear to me that the content of the bill was disclosed prematurely while it was on notice and before it was introduced in the House.

The rule on the confidentiality of bills on notice exists to ensure that members, in their role as legislators, are the first to know their content when they are introduced. Although it is completely legitimate to carry out consultations when developing a bill or to announce one’s intention to introduce a bill by referring to its public title available on the Notice Paper and Order Paper, it is forbidden to reveal specific measures contained in a bill at the time it is put on notice.

As everyone knows, the Department of Justice, unfortunately, has a history of leaking the contents of government bills. On April 19, 2016, the Speaker found that there was a prima facie case of privilege regarding Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts (medical assistance in dying). At the time, he said:

As honourable members know, one of my most important responsibilities as Speaker is to safeguard the rights and privileges of members, individually and collectively. Central to the matter before us today is the fact that, due to its pre-eminent role in the legislative process, the House cannot allow precise legislative information to be distributed to others before it has been made accessible to all members. Previous Speakers have regularly upheld not only this fundamental right, but also expectation, of the House.

Another question of privilege was raised on March 19, 2001, regarding, once again, the Department of Justice briefing the media on a bill before members of Parliament. In that ruling, Speaker Milliken said this at page 1840 of the House of Commons Debates:

In preparing legislation, the government may wish to hold extensive consultations and such consultations may be held entirely at the government’s discretion. However, with respect to material to be placed before parliament, the House must take precedence. Once a bill has been placed on notice, whether it has been presented in a different form to a different session of parliament has no bearing and the bill is considered a new matter. The convention of the confidentiality of bills on notice is necessary, not only so that members themselves may be well informed, but also because of the pre-eminent rule which the House plays and must play in the legislative affairs of the nation.

The Speaker found another case of contempt on October 15, 2001, once again involving the Department of Justice, which does not seem to learn, after it briefed the media on the contents of a bill prior to the legislation being introduced in the House.

We are being asked once again to deal with the contemptuous actions of the Minister of Justice and his justice team. We have had countless rulings from the Speaker. The House has expressed itself on numerous occasions. We have had three debates and extensive committee studies.

The message is crystal clear, yet the responsible minister continues to draft bills and then leak those bills to the media, ignoring the will of the House. I ask, Mr. Speaker, that you find a prima facie case of privilege, and I am prepared to move the appropriate motion.

Business of the House

[Pablo Rodriguez, Liberal, Leader of the Government in the House of Commons]

Mr. Speaker, if I understand the question correctly, my colleague wants to know what the legislative agenda will be for the next few days.

Tomorrow morning, we will continue with second reading debate of Bill C-14, which would implement certain provisions of the economic statement. In the afternoon, we will begin debate on Bill C-19, which would provide for temporary rules to ensure the safe administration of an election in the context of the COVID-19 pandemic.

Then, Monday and Wednesday of next week, we will continue the debate on Bill C-19. On Tuesday, we will consider Senate amendments to Bill C-7, the medical assistance in dying law. I would also like to inform the House that Thursday, February 25, will be an allotted day. On Friday that same week, we will begin second reading of Bill C-21, the firearms act.

I thank my colleague for his question.

Medical Assistance in Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, the third and final petition raises concerns about some of the provisions in Bill C-7. In particular, it echoes the concerns of people in the disability community that Bill C-7 increases vulnerability and focuses on pushing people who are disabled toward death instead of providing them with the means and support to live their lives. The petition also raises concerns about same-day death: the possibility that someone could request and receive euthanasia on the same day as a result of the elimination of the 10-day reflection period. The petitioners want to see that reflection period left in place.

I commend all three of these petitions to the consideration of members.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, the third petition is respecting Bill C-7, the government's bill that seeks to dramatically expand euthanasia, or medical assistance in dying, in Canada. Concerns have arisen, especially from the disabled community, about how some people are eligible for suicide prevention, whereas others, as a result of their physical disability, may be subject to suicide facilitation. All disability communities that have spoken about this issue have raised significant concerns about it. Petitioners call on the government to restore important safeguards, which it is proposing to eliminate as part of this bill.

I commend these three petitions to the consideration of the House.

Economic Statement Implementation Act, 2020

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Madam Speaker, our day-to-day commitment and what we have achieved so far in this Parliament mean that we can honestly say that the Bloc Québécois caucus is reliable and proud.

This strong, heartfelt preamble to the main topic of my speech will help my colleagues better understand the scope of my comments and recognize the amount of time I spent poring over Bill C-14, an act to implement certain provisions of the economic statement tabled in Parliament on November 30, 2020 and other measures, which was tabled in the House on December 2 by the Deputy Prime Minister and Minister of Finance and came before the House this morning. To summarize, this bill outlines and gives details about some of the measures announced by the federal government in the speech that the minister gave when presenting her economic statement aimed at supporting Canadians and fighting the COVID-19 pandemic.

Members will recall how long the government waited before bringing this bill before the House for an in-depth study. In fact, in December, the government did everything it could to fast-track the study of Bill C-7 on medical assistance in dying, which was being systematically blocked by the socially conservative fringe of the Conservative Party. Everyone has their own battles to fight. I will not say what I think of these petty delaying tactics that put the interests and fundamental rights of hundreds of our fellow citizens in peril. Unfortunately, these people must wait for the government to legalize a situation they have considered carefully and an important decision that they want to make calmly, rather than witness an interminable, agonizing debate dragged out for crass partisan reasons.

To return to my speech, this bill, short as it is, makes major changes to several existing laws. I hope that these changes will contribute significantly to effectively advancing the welfare of all of our constituents. The Bloc Québécois does not take this approach lightly. If the government introduces a bill that makes sense and that is in the interest of Quebeckers, we will support it. However, the government must demonstrate that the bill is neither partisan nor pandering to particular groups, which is what we have been seeing for far too long from the Liberals, even in a minority government.

As everyone knows full well, and as the Bloc Québécois reminds the House on a daily basis, the Liberal Party has in its DNA an outrageous obsession with centralization that undermines the spirit of the Constitution that it shoved down Quebec's throat in 1982. Our NDP colleagues have always blindly followed the Liberals' lead in this matter. They act like the Liberals' lackeys, always eager to gather the crumbs that their masters leave behind in exchange for an ideological promiscuity that changes with the political winds.

To get back to Bill C-14, the government intends to amend a wide range of existing laws, enhancing them in some cases, but in an unfair way, as the Quebec governments of the past six decades would agree.

Regarding the best interests of Quebec taxpayers, most of the legislative amendments proposed by the Liberal government to the tax laws will have little or no effect on the current situation in Quebec. In fact, by amending the Canada Student Financial Assistance Act, the government is merely confirming the soundness and relevance of Quebec's student financial assistance program, which was established by Daniel Johnson Sr.'s government in the late 1960s. Premier Johnson was only continuing the work of the Lesage government, whose most imposing and important figures were undoubtedly Paul Gérin-Lajoie and René Lévesque.

Quebec offers one of the best student loan and bursary programs in the western world. This extraordinarily progressive approach has made our researchers, engineers, thinkers and numerous creators famous the world over, all thanks to the excellence of our university network.

Take, for example, my alma mater. The Université du Québec à Rimouski is internationally recognized for its marine acoustic research and the number of world-renowned researchers it has doing cutting-edge research on ecosystems like the unique, majestic St. Lawrence River. The same goes for Université Laval, the Université de Sherbrooke, the Université de Montréal and McGill University for medical and pharmaceutical research. Quebec ingenuity continues to grow. It is because of the student funding program developed by the Quebec government that we can be proud of the major breakthroughs in the medical research that is so important to us today.

During this devastating pandemic, I know that my counterparts in other provinces understandably envy Quebec for the prominent place that our researchers, scientists and doctors have on Canada's team.

For decades, the Quebec government has stood up to the federal government and demanded that Ottawa respect Quebec's constitutional prerogatives. The pride of a people gives rise to the significant benefits and advantages that forge a true nation.

If the government wants to make up for the weaknesses in its legislation concerning financial assistance for students in the rest of Canada, it should consider fair compensation for young Quebeckers who are treated well by Quebec, but not so well by the federal government. It is a simple matter of fairness.

Speaking of fairness, I would be remiss if I failed to mention a fundamentally unfair aspect of the government's action during the pandemic. Despite the billions of dollars in financial support that were announced and given to the Prime Minister's friends and family, we know that those who have clearly been the most unfairly and personally affected by COVID-19 are seniors, that is, our parents, grandparents and great-grandparents, if we are lucky.

It is unfortunate that the government has once again failed our seniors, when they are the ones whose financial situation has seriously deteriorated because of the many protective measures put in place for them by the various levels of government. I am very concerned about the fact that, apart from a single lump-sum payment last summer, the Liberal government failed these people who came before us and literally built a society of which we can be proud. To me, that is a slap in the face to an entire generation who, it seems to me—

COVID-19 Emergency Response

[Daniel Blaikie, NDP, Elmwood—Transcona, MB]

Mr. Speaker, today is Human Rights Day in the House, and we will soon be voting on the third reading of Bill C-7.

Whatever the outcome, the debate on that bill has shown beyond a shadow of a doubt the urgent need for Canada to respect the rights and dignity of people living with disabilities.

It is in that spirit that I hope, if you seek it, you will find unanimous consent for the following motion: that, in the opinion of the House, in the context of a medical assistance in dying regime that does not require a reasonably foreseeable death, it is more important than ever that the government provide the resources Canadians with disabilities need to live with dignity; and therefore the House call upon the government to properly fund services, like home care and palliative care for people across Canada; and ensure that people living with disabilities have an income that keeps them above the poverty line, including by transitioning people living with disabilities who currently qualify for federal, provincial or territorial disability income support or pension program to a federal benefit of $2,200 per month.

Justice

[Brenda Shanahan, Liberal, Châteauguay—Lacolle, QC]

Mr. Speaker, Bill C-7, which amends the Canadian framework for medical assistance in dying, is the result of a detailed consultation process involving over 300,000 Canadians, including health care professionals, people with disabilities and caregivers. The deadline set by the courts to pass Bill C-7 is quickly approaching.

Can the minister explain why it is so important to all Canadians for the government to meet the deadline set by the Quebec Superior Court?

Physician-Assisted Dying

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

Mr. Speaker, I have three petitions to present.

The first is a petition from citizens who are concerned about Bill C-7's further removing safeguards from the current euthanasia regime. They are calling on the House of Commons to restore the 10-day reflection period for people whose death has been determined to be reasonably foreseeable, restore the original requirement that a person must give consent for the life-ending procedure immediately before it is performed, restore the original requirements for the signature of two witnesses, require medical professionals to do everything possible to enable a person to access life-affirming services and accommodate persons with communication disabilities by clarifying refusal or resistance to administration of physical-assisted death.

Medical Assistance in Dying

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, the third petition is with respect to Bill C-7.

Specifically the petitioners would like to restore the 10-day reflection period for people whose deaths have been determined to be reasonably foreseeable and to require medical professionals to do everything possible to enable the person to access life-affirming services to review their suffering, other than physician-assisted death.

[John Williamson, Conservative, New Brunswick Southwest, NB]

Mr. Speaker, the final petition is on Bill C-7.

The petitioners are requesting that the Government of Canada return the safeguards it has removed specifically related to the 10-day reflection period and the number of witnesses, so someone is properly consoled and consulted.

[Damien Kurek, Conservative, Battle River—Crowfoot, AB]

Mr. Speaker, the third petition is to ensure that safeguards are put into the deeply flawed Bill C-7.

[Eric Melillo, Conservative, Kenora, ON]

Mr. Speaker, the third petition calls on the House of Commons to ensure there are safeguards in place to protect the most vulnerable in our society when it pertains to Bill C-7, medical assistance in dying.

[Brad Redekopp, Conservative, Saskatoon West, SK]

Mr. Speaker, the second petition is about Bill C-7, medical assistance in dying.

The petitioners call on the House of Commons to discontinue the removal of safeguards for people requesting euthanasia and put in place additional measures to protect vulnerable persons. Some of the reflections are restoring the 10-day reflection period, restoring the original requirement that a person must give consent and restoring the original requirement for the signature of two witnesses, among other things.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Mr. Speaker, I am pleased to present two petitions to the House today.

Many Canadians were shocked to see that in the middle of a pandemic, while the government takes months to fix bungled support programs and provide our hardest-hit industries with the support they need, their government was more focused on pursuing an ideological agenda than actually helping Canadians.

The first petition I am presenting addresses Bill C-7.

The petitioners recognize that the Canadian government should invest in palliative care and support for people with physical and mental disabilities and should seek to preserve life rather than end it. They also recognize that the current MAID safeguards in place are necessary to protect people with disabilities and those who cannot consent from having their lives prematurely terminated.

The petitioners are asking the House to preserve the necessary safeguards for euthanasia that are in place to ensure that vulnerable Canadians are protected.

Justice

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, the Quebec Superior Court ordered the government to fix the MAID legislation by December 18, but Bill C-7 has stalled.

The Liberals prorogued Parliament for six weeks. They have only themselves to blame if time is running out. Still, it is appalling that the religious right is holding our work hostage. Vulnerable people who are suffering are waiting.

Will the government ensure that Bill C-7 is passed in time, without a gag order, and does the government think the Conservative leader should call his fanatics to order?

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

Madam Speaker, the Liberals are frustrated that my colleagues and I have been so diligent in vocalizing the concerns of disabled Canadians and medical professionals in regard to Bill C-7. However, the Liberal government ignored its own legislation to review Bill C-14; held the House hostage in May and June; prorogued Parliament in August; limited the justice committee to four hearings, blocking written submissions; and chose not to appeal the deadline imposed by the Quebec superior court.

Why does the Prime Minister not want to create legislation that shows compassion for all Canadians?

Government Programs

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

Mr. Speaker, I would emphasize that Bill C-7 strives to ensure we have a regime that protects vulnerable persons with adequate safeguards, and all the time respects individual autonomy and competence.

With respect to supports for persons with disabilities, this is something that the minister and the entire governmental team has been working on diligently. We will continue to hear those voices and those calls for support, and we will continue to work to deliver that important support.

[Daniel Blaikie, NDP, Elmwood—Transcona, MB]

Mr. Speaker, the Truchon decision has caused a lot of real worry for people living with disabilities in Canada.

In the wake of that decision and the changes to medical assistance in dying, we have to ensure that all Canadians with disabilities have enough resources to avoid the terrible choice between a life of poverty and suffering or premature death.

Yesterday we called on the government to establish a bold new income support program that would lift all Canadians living with disabilities out of poverty.

Will the government work with us to deliver that support to people with the same urgency it gave Bill C-7 instead of repeating the unacceptable delay we saw with the emergency one-time payment earlier this year?

Business of the House

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

Mr. Speaker, we applaud the government House leader's acknowledgement that you will soon be celebrating the first anniversary of your election as Speaker, and I echo his sentiments.

However, I vehemently disagree with what he said about our parliamentary work. With respect to Bill C-7, we have followed parliamentary rules. Our work has been rigorous and thorough. Parliamentarians never filibustered in any way, unlike Liberal MPs who filibustered systematically in every committee where they faced ethical questions related to WE Charity.

With respect to Bill C-7, if the government had not prorogued Parliament this summer, we could have immediately continued our work, since it was at second reading. If that had been done instead, we would have had at least 25 more sitting days than we have now.

If we are rushing to meet a court deadline, the Liberal government has no one but itself to blame.

[Pablo Rodriguez, Liberal, Honoré-Mercier, QC]

Mr. Speaker, once again, if the Conservatives stop filibustering and allow a stand-up vote on Bill C-7, then next week the government expects to call the following bills: Bill C-8 on the Truth and Reconciliation Commission's call to action number 94; Bill C-10, an act to amend the Broadcasting Act; Bill C-12, the net-zero legislation; and Bill C-13 on single-event sport betting.

Mr. Speaker, I would like to take this opportunity to congratulate you because December 5, two days from now, marks one year since the House elected you and placed its trust in you. You oversee House proceedings fairly, impartially and with dignity. Thank you on behalf of all members.

[Pablo Rodriguez, Liberal, Leader of the Government in the House of Commons]

Mr. Speaker, I thank my hon. colleague for his question.

Monday will be the last supply day for the financial cycle ending on December 10. At the end of that opposition day, we will proceed with the consideration of and votes on the main estimates and the supplementary estimates (B).

I would also like to mention that, on Monday, the Minister for Women and Gender Equality and Rural Economic Development will give a ministerial statement to mark the 50th anniversary of the report of the Royal Commission on the Status of Women.

With regard to legislation, tomorrow we will resume debate on Bill C-7 on medical assistance in dying. We are in this position because our Conservative friends continue to filibuster the passage of this important bill. I get the impression that they do not really care about the deadline imposed by the Quebec Superior Court, which I think is unfortunate.

If the Conservatives stop filibustering and allow a stand-up vote on Bill C-7—

International Trade

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Alexandra Mendes]

Pursuant to an order made earlier today the motion to adjourn the House is now deemed to have been withdrawn and the House will resume consideration of Bill C-7 at report stage under government business.

Persons with Disabilities

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Madam Speaker, I remain confident Bill C-7 is the right approach for Canada now. It would advance the interests of individual choice and autonomy in medical decision-making. If an individual determines for themselves that they are suffering intolerably and make a voluntary request for MAID as well as receive all the information they need to make an informed decision, including being offered alternative treatments and services, I believe we owe it to them to respect their decision.

At the same time, it would ensure requests from the newly eligible, whose death is not foreseeable, would be handled with great care and attention, with the input of experts and time to identify and explore other treatment options. We trust practitioners will do more than the minimum standards set out in the safeguards in all appropriate cases.

[Darren Fisher, Liberal, Parliamentary Secretary to the Minister of Health]

Madam Speaker, as members of the House well know, there are few issues as complex and as personal as medical assistance in dying. Medical assistance in dying forces us to reconcile many fundamental values: equality, respect for life and individual autonomy. We accept that reasonable people can disagree on the best way to achieve balance in respect of all the implicated interests and values.

As a government, we must make choices on behalf of Canadians that we believe are the right ones for each individual and for all of us collectively. Bill C-7 reflects our best assessment of sound policy that is constitutionally valid. We believe it is consistent with the views of most Canadians who participated in our consultation processes. We further believe it is responsive to many of the concerns and recommendations of numerous and varied experts whose opinions were shared in round tables, expert panel reports, academic articles and other sources.

We certainly know some members of the House believe the safeguards in the existing law reflect a more appropriate balance. We respect these differences of opinion. That is what we are here to do. We are all here to reflect the diversity of views of the Canadians we represent. However, we believe our chosen course of action is the correct one. It is the product of deep reflection and significant consultation, and puts the interests of each individual at the centre of their own medical choices.

We remain committed to the removal of the 10-day reflection period for persons whose death is reasonably foreseeable. We heard over and over again that this safeguard does not provide the protection it was intended to and that instead it aggravates these already difficult situations.

We are also committed to the proposal that would enable those whose death is reasonably foreseeable to make arrangements with their MAID provider for a waiver of final consent in the unfortunate eventuality that they lose their capacity to consent to MAID before the scheduled day. Without this change, some who are found eligible will choose to die sooner than they want, depriving themselves of precious remaining time with their families, rather than risk losing the option to die by their preferred manner of death.

While we understand the ethical and philosophical concerns with the idea of administering MAID to persons who are no longer able to consent, the practical reality of those who wish to spend a little more time with their families is of prime importance. Any expression of resistance would put a stop to the administration of MAID. This is clear in the bill. All that would be permitted is for the practitioner to carry out the person's own clear and precise wishes as to the date and manner of their death.

I would also like to take this opportunity to encourage my colleague to help us limit the unnecessary suffering of Canadians and help us ensure this important legislation receives royal assent prior to the December 18 court deadline.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, I appreciate having this opportunity tonight to address the government's very irresponsible and dangerous legislation, Bill C-7. This is the government's effort to expand euthanasia and to remove many safeguards that people in the disability community, as well as experts, have said are vital.

The government prorogued Parliament limiting debate and now is rushing through this legislation. We are hearing many concerns from people across Canada and even from people in the government's own caucus. The member for Richmond Hill said he supports leaving in place the 10-day reflection period, but it is not just members. There are actually ministers who have concerns about the impact that the legislation will have on people with disabilities.

I want to read a quote from the minister whose responsibilities include disability inclusion. The minister said, “I absolutely acknowledge and am quite preoccupied by the power imbalance between practitioners and patients, particularly patients who have been in systems that have discriminated against them and ignored their voices their entire lives. I have grave concerns with the particular circumstances of the individual that you spoke of. Quite frankly, I can tell you, he is not alone.” The minister further said, “I regularly hear from families who are appalled by the fact that they take their child, potentially their older child, in and are offered unprovoked MAID. I think that has to stop.”

We are hearing concerns from people in the disability community, reflected by the minister, that already people with disabilities, when they are having interactions with the health care system, are getting proactively proposed and encouraged toward euthanasia. They are even told if they reject those pushes, they are being selfish. This is very concerning.

We have heard from the disability community how this bill would enshrine in law discrimination against people with disabilities. It would create a situation where a person without a disability who is experiencing suicidal ideation might be offered suicide prevention, but a person with a disability who presents with the same challenges and sense of existential angst would be offered suicide facilitation, and in fact, encouraged in the direction of euthanasia even if they have not asked for it.

Conservatives proposed reasonable, common-sense amendments to try to leave in safeguards. They are safeguards we know members of the government caucus would actually support if they were given the freedom to vote their real convictions on this.

We proposed amendments to leave in place a 10-day reflection period. That reflection period can already be waived, but as a default, we think a reflection period makes sense so that we do not have same-day death and we do not have people who make the request and die the same day. That is why a reflection period, which can be waived in certain circumstances but is provided as a default, is important.

We have proposed that people be asked on the day they receive euthanasia whether or not they want to go through with it. Right now with the mechanism for advance requests that the government has put in place, there is no requirement that patients would be consulted on the day they receive euthanasia.

We propose specifically an amendment that the Minister of Disability Inclusion seems to support, even if the Minister of Justice does not. It is an amendment that requires that it be the patient who brings it up, not the physician, so that someone does not go into the hospital, a person with a disability, and get told they should think about taking their life. If that conversation is going to happen, it has to be the patient who starts it.

These are reasonable, common-sense amendments and the government rejected 100% of the common-sense Conservative amendments. They were not just Conservative amendments. They were amendments put forward by experts, by people in the disability community and by people who have been ignored in the government's rush to move this forward after it prorogued Parliament.

This is an issue of life and death and of how we respect people living with disabilities, how we recognize and ought to affirm the value and dignity of all human life, and the fact that people living with disabilities ought not be pushed in one direction, which people who are able-bodied are not.

That is what is in front of us and I implore all members of Parliament to look at the details, consult their own conscience, consult their own constituents, maybe even talk to members of their own caucus who have concerns, and support common-sense—

Health

[Erin O'Toole, Conservative, Leader of the Opposition]

Mr. Speaker, Bill C-7 does not strike the right balance, and in fact, those diverse voices the Prime Minister has been talking about have said that: disability groups, indigenous advocates, physicians.

In fact, the Prime Minister can just ask his Minister of Employment. Last week, she told the Senate she agreed with the concerns being advocated by disability advocates, Conservative MPs and many other Canadians for weeks.

I want to thank the government for providing more time for us to speak on this issue, but I want the Prime Minister to heed the advice of so many Canadians. Let us make the changes that protect the most vulnerable in medical assistance in dying.

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

Mr. Speaker, the government refuses to hear the voices of Canadians with disabilities and ignores the input of physicians. A growing list of doctors from every province provided a strong statement, with over 1,000 signatures, for the study of Bill C-7, so I was shocked when I learned the following. Medical assistance in dying has been deemed an essential service under the Canada Health Act, yet palliative care has not.

Does the Prime Minister recognize that this is a big problem?

Justice

[Rob Moore, Conservative, Fundy Royal, NB]

Mr. Speaker, there is a consensus that the government's latest MAID bill lacks safeguards and puts persons with disabilities at risk. Witness after witness said this at justice committee. We heard from disability advocates who say this bill is unfair to persons with disabilities. Krista Carr, of Inclusion Canada, described it as “our worst nightmare.” I am sure many Liberal members are also concerned about the gaps in Bill C-7.

Will the government allow a free vote among Liberal MPs so they may vote against this flawed bill?

Persons with Disabilities

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

Madam Speaker, this week at the justice committee, Liberal MPs, incredibly, rejected all amendments to Bill C-7 to protect the vulnerable.

In its reckless rush to ram through this shoddy bill, why is the government ignoring the pleas of virtually every national disability rights organization, more than 1,000 physicians and other important voices for vulnerable and marginalized Canadians?

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Madam Speaker, during the justice committee hearings on Bill C-7, Minister Qualtrough admitted that it is easier to get—

Business of the House

[Pablo Rodriguez, Liberal, Leader of the Government in the House of Commons]

Mr. Speaker, that question was really well put, probably the best question today.

This afternoon, we will continue debate at second reading of Bill C-12 on net-zero emissions. This evening, the committee of the whole will study the votes under Department of Health. Tomorrow and Monday, we will be debating Bill C-7 on medical assistance in dying.

We hope to complete third reading of Bill C-7 on Monday to give the Senate enough time to pass the bill before the court-imposed deadline of December 18.

On Monday afternoon, at 4 p.m., the Deputy Prime Minister and Minister of Finance will deliver the fall economic statement in the House of Commons.

Tuesday and Thursday shall be allotted days.

On Wednesday, we will resume debate on Bill C-12, the net-zero legislation.

Lastly, next Friday we will resume debate on Bill C-10, concerning the Broadcasting Act, and Bill C-11, concerning personal information protection.

Justice and Human Rights

[Iqra Khalid, Liberal, Mississauga—Erin Mills, ON]

Mr. Speaker, I have the honour to present, in both official languages, the fourth report of the Standing Committee on Justice and Human Rights in relation to Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying. The committee has studied the bill and has decided to report the bill back to the House with amendments.

Persons with Disabilities

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, experts and leaders from the disability community have been overwhelming in their call for reasonable amendments to Bill C-7: Leave in place the 10-day waiting period, which can already be waived; ensure that people will actually be consulted on the requested date and still be free to withdraw consent and change their minds; and ensure that people do not have death pushed on them by someone else.

These are reasonable modest amendments to support autonomy while protecting the vulnerable. Why will the government not support these reasonable amendments?

Medical Assistance in Dying

[Rachael Thomas, Conservative, Lethbridge, AB]

Mr. Speaker, I stand here today on behalf of Canadians who are very concerned about legislation that is currently before the justice committee, Bill C-7, which has to do with medical assistance in dying.

The legislation would unnecessarily expand the definition. It would take away the need for a 10-day reflection period and would also make it so that only one witness would need to be present when an individual requests euthanasia. This is of concern to a growing population in Canada, particularly those who live with a disability, because it puts them at risk and makes them vulnerable.

In this place, we have a responsibility to stand on behalf of the vulnerable. It is the government's primary responsibility to look after the safety and security of its citizens. Therefore, I call upon the government, along with those signed this petition, to do that.

[John Williamson, Conservative, New Brunswick Southwest, NB]

Mr. Speaker, I have two petitions to table today.

The first petition focuses on Bill C-7. The petitioners are urging the House of Commons to maintain the safeguards to protect people who request euthanasia. They call on the House of Commons and the Government of Canada to maintain the 10-day reflection period as well as the second independent witness.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Mr. Speaker, I am proud to stand here on behalf of many Canadians who are very concerned with Bill C-7 and the safeguards that would be removed in the legislation. It is very important for the government to understand that the concerns, such as a 10-day waiting period as well as the number of witnesses who need to be there to designate this as medical assistance in dying, are really important for all Canadians. The petitioners say that we should ensure we do our best to save those who are vulnerable and disabled and ensure that they understand their lives matter too.

[Glen Motz, Conservative, Medicine Hat—Cardston—Warner, AB]

Mr. Speaker, I am honoured to rise on behalf of Canadians today who are petitioning the government in regard to Bill C-7, which is currently before the justice committee.

The petitioners are concerned about the safeguards that would be removed from that legislation, including the mandatory 10-day reflection period and the number of witnesses required for it to be carried out. The removal of the second requirement of independent witnesses would reduce the oversight of the procedure, leaving vulnerable persons at risk.

Therefore, the petitioners are asking the House of Commons to immediately discontinue the removal of safeguards for people requesting euthanasia and put additional measures in the bill, which is being proposed and amended at the justice committee.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, I am pleased to be presenting three petitions in the House today.

The first petition deals with the government's bill, Bill C-7, which is currently before the justice committee. The petitioners are calling for amendments to the legislation that would leave in place reasonable safeguards. Those amendments have been proposed, but the government has continually rejected these very reasonable amendments.

Amendments that the petition specifically references are for the 10-day reflection period. The petitioners want that left in place. They recognize that already the 10-day reflection period can be waived with the consent of the doctors involved.

The petitioners highlight their concerns with respect to Bill C-7 and the need for amendments to protect vulnerable people, which is what the committee has been hearing from experts and disability advocates.

Justice

[Jody Wilson-Raybould, Independent, Vancouver Granville, BC]

Mr. Speaker, why is Bill C-7, medical assistance in dying, abolishing the safeguard of a 10-day reflection period and reconfirmation of consent, thereby introducing advance requests for MAID?

Nothing in the Truchon decision of the Quebec Court of Appeal, which the government chose not to appeal, requires this, and the Supreme Court of Canada, in Carter, insisted on the requirement of clear consent. Palliative care physicians, disability advocates and other experts insist that this is an important safeguard, and, like other legislated MAID reports on mature minors and mental disorder, advance requests also raise significant challenges.

There is no clear—

Judges Act

[Chris Lewis, Conservative, Essex, ON]

Madam Speaker, I never thought I would be able to speak for 20 minutes and not even get to some of my other points.

In days past, I flew into two indigenous reserves in Manitoba. One of the elder's homes that I went to actually had a victim present. I have been speaking about this by way of Bill C-7, specific to people with disabilities and indigenous peoples.

I would strongly suggest that this should not stop in the House, but should be for all people across Canada, be they indigenous or people of colour.

Broadcasting Act

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, it is a pleasure for me to be able to join the debate today on Bill C-10, the government's bill that purports to modernize Canada's Broadcasting Act. It raises many issues.

I have certainly enjoyed listening to the debate and seeing the passion that colleagues from all parties on all sides of the House have for Canadian culture and for the particular linguistic or regional identities that animate their corner of what constitutes Canadian culture. I want to start by identifying the objectives of the bill and then highlighting some of the challenges and some of the concerns that we have in the Conservative caucus with respect to Bill C-10.

As I said, Bill C-10 proposes to modernize the Canadian Broadcasting Act and certainly Conservatives recognize the need for change, modernization and updating, but we have some significant concerns about the way the bill fails to live up to its stated objectives. I am struck again and again by this.

I think a particular thing about the government and the way its members speak about their proposals is that they often want to focus on the objectives of what they are doing instead of on the substance of what they are doing. Regularly, government members talk about the objective being this or the objective being that, but it falls to us in the opposition to then point out that good intentions are not enough. It is not the intention but the text of the bill that becomes law, and the failure of the text of the bill to live up to the intention of the bill creates big problems for those who are then impacted by the measures that have been put in place.

More precisely, under the ambit of modernization, the bill confirms that online broadcasting is covered under the act. It seeks to introduce additional provisions for encouraging more diverse content in Canadian broadcasting, including content that is reflective of the experiences of Canadians around gender equality, as well as those of LGBTQ2+, racialized communities, persons with disabilities and indigenous peoples. That is one of the identified objectives.

It purports to create a more flexible approach to regulation that would allow the CRTC to establish rules for all broadcasting services that operate in Canada. I will speak more about this in a few minutes, but, when the government talks about a more flexible regulatory approach while in the process of giving powers to an external agency, this should be a red flag for all of us.

Effectively, what this gets at, in coded language, is the fact that vaguely worded legislation is giving powers to the CRTC. These powers are not as clearly or precisely described as I think most Canadians would expect them to be. The language that the government uses around regulatory flexibility is something that I think we should watch out for and understand what is underneath it.

The legislation also purports to “modernize the CRTC's enforcement powers [and] update oversight and information sharing provisions to reinforce the CRTC’s role as a modern and independent regulator”. What is the context in which we see this legislation, and what do we make of these purported objectives?

One thing that all of us as members of Parliament should think about is how we are defining broadcasting in the world of changing technology. In a sense, as a member of Parliament, I am a broadcaster. While I do not think this speech is being livestreamed on my Facebook currently, although obviously sometimes we do that, it is likely that clips of what I am saying will end up being broadcast to my some 30,000 followers on Facebook, as well as possibly on Twitter and Instagram. Therefore, I am a small broadcaster. There are many people out there who have podcasts or YouTube channels who are using the unique power they have through social media and other channels to broadcast their own opinions. This is really a revolutionary power for everyday citizens to have.

Historically, when we spoke about regulating broadcasting, it was because there was a limited amount of bandwidth in terms of radio and television air waves. Decisions had to be made collectively about who had access to that bandwidth. There was a hope that certain content would be broadcast in that way.

However, now we are living in a world of unlimited broadcast capacity on the Internet, where people can access more of the different kinds of content that they want. That world of unlimited broadcast capacities lowers the barriers to entry in terms of becoming a broadcaster and being a person who is broadcasting their views to a wider and wider audience. This is the new world we are living in.

There are many cases where somebody working out of their basement on their own YouTube channel may have far more views and importance as a voice than certain “mainstream” networks and channels, so how do we define what constitutes a broadcaster? If somebody is running a very popular YouTube channel where they express their own views, are we going to expect them, through the CRTC, to have a certain proportion of a certain kind of content? Is that where we want to be going with modernizing this act?

I think most members would accept that it is not particularly reasonable for that to happen, and that the idea of prescribing parameters around broadcasting is aimed at only the very large producers and purveyors of content, but that is a slippery space to be in. It raises, I think, some questions on the regulations around the parameters of content in a world where the barriers to entry are so low. We are not dealing with the same limited supply of bandwidth in terms of television or radio that we dealt with historically.

Under the label of modernization, this bill brings the online world into the existing legislative framework, but I do not think that it engages enough with this question of whether or not the current frameworks are aligned with the kind of world we find ourselves in today. I would be concerned about the possibility that Canadians who are not running big budget operations, who are just broadcasting their views and making content of different kinds, would become subject to CRTC intervention if the level of public attention crossed a certain threshold.

I want to flag as well a continuing issue concerning broadcast regulation, and that is this issue of market demand and how we define Canadian content. It is my observation and my contention that there is actually a strong market demand for more and more diverse content. There is a great deal of interest among people I talk to in learning more about indigenous culture and indigenous communities. I think there is a real demand for that content, and that is good to see.

I think there is growing interest among people in my Alberta constituency to learn French and consume content in French. That market demand is really necessary for the increasing knowledge of those things, because if there is no market demand for these shows and messages to be produced, then people will not consume them.

It is one thing to say someone may want more diverse content on a major online video platform. The question comes down to, though, whether people will consume that content. If people are eager to consume that content then, presumably, the incentives will exist for there to be increased production of that content. As parliamentarians, I think we all want to see increasing diversity and to see that reflected in media.

I also think we should recognize there is demand for that content and some of that increase in diversity is happening. It will continue to happen, naturally, but I think it is something we should be aware of and looking at. We should be seen putting in place policies to reasonably incentivize that development, without giving the CRTC powers that are excessive, in terms of its intervention.

Then there is the question of how we define Canadian content, or how we define content in terms of whether it is reflective of different diverse communities. Something that I looked at in university was precise definitions of what Canadian content is. It always struck me as a little odd that we could have a story that takes place in California, and that is the film, but then we have an actor who was born in Canada playing a prominent role, or we have a director who is Canadian, or maybe it was filmed in a location in Canada, even though the story purports to take place in California. However, by some definitions, that film is defined as Canadian content because of the national backgrounds of some of the people involved, even though the story that is being told is not actually about Canada.

When we talk about indigenous content, I think there are some questions that perhaps should be looked at by the committee in terms of what is meant by this. If we have an indigenous actor, but the story does not show that character as being indigenous, is that indigenous content? If we have a story that purports to be about indigenous culture, but does not represent that culture accurately, and that particular show was not created through engagement with indigenous communities, does that still constitute indigenous content?

The challenge is that at an individual level we might be able to look at whether a particular representation qualifies or not and come to our own conclusions. When we have regulatory definitions of these concepts, it can raise some significant problems in terms of whether the regulations, in the way they are applied, actually achieve the intended objectives. I think that is something that members need to think about as well, as we study and go deeper into this legislation.

I think there many problems with this vague bill, which seems to be typical of Liberal bills.

The bill is vague with regard to the powers of the CRTC. First of all, it does not guarantee that foreign tech giants like Google and Facebook will follow the same rules as Canadian tech companies. Some people have accused these foreign tech giants of misusing Canadians' personal information and censoring some Canadians' opinions. Unfortunately, this bill will allow the tech giants to continue their unfettered reign over Canadians.

I am also concerned about the lack of specific guidelines regarding Canadian content and the distribution of funding to Canadian media. We know that the French language is under threat in Canada, as my colleagues have emphasized in recent days. Canada is a proudly bilingual country, and our French culture, which has such a strong presence in Quebec, is the key to Canada's bilingual future.

Canadian French-language media outlets have a wealth of unique cultural content. That is why the Conservatives will work to preserve and maintain funding for French cultural programming once we are elected.

I am proud to be speaking in French today, even though it is not my first language. Many people in my province of Alberta enrol their children in French immersion programs because they want their children to proudly speak both official languages.

I am also concerned that this bill does not modernize copyright. At a time when the Internet dominates our lives, it is crucial that content produced by Canadians be protected against unfair use such as plagiarism.

Canadian artists work hard to produce high-quality content, and we ensure that their rights are fully protected. Unlike the Liberals, we Conservatives believe in modernized copyright legislation, new measures to preserve the French language, and protecting Canadians from foreign tech giants that need to assume their responsibilities.

Once our leader is elected prime minister after the next election, our Conservative government would eliminate the GST on Canadian digital platforms to support and promote Canadian media content that showcases the beauty of Canadian culture. We understand that proper CRTC legislation is important for the benefit of our nation and its people, and we wish that the Liberals understood that too.

The Conservative Party is a national party that is there for all Canadians. We are the only party with MPs in every region of the country. We are proud to have Alberta MPs who, like me, stand up the French language, and Quebec MPs who stand up for oil workers. We are the party that unites all Canadians and respects the unique characteristics of each region.

The French language is important not just to Quebec. There is a strong francophone community in my riding in Alberta, and I love working with that community. There are francophones as well as francophiles. There are communities of francophones who have been there a long time, and there are francophone communities full of newcomers.

I invite my francophone colleagues, especially those in the Bloc Québécois, to come to Alberta to discover our vibrant francophone community, as well as to visit Fort McMurray.

I would like to reiterate some of those points in English.

I am very proud to be part of a Conservative Party that is studying these issues carefully, diligently and recommending amendments, identifying problems and looking at the text as well as the intentions. I am proud to be part of a Conservative Party that is serious about uniting Canadians from coast to coast. We have MPs all across the country, anglophones and francophones, who recognize and defend the importance of English and French in all regions of the country. Also, we are a party that stands up for jobs and the economy in all regions of the country.

As a final note, I want to briefly touch on this. It is striking to me that the legislation speaks about the representation of people with disabilities, and it is very important it does that. However, people from all kinds of disability organizations are descending on Parliament Hill. They are deeply concerned about how the poorly drafted Bill C-7 entrenches discrimination against people with disabilities.

At the justice committee, so many different disability organizations have spoken out about those problems, calling for real and meaningful changes. The best the government can do for people with disabilities is to include in an amendment to the Broadcasting Act an expectation for representation of people with disabilities.

Sure, that is a nice to have, but if the government were really listening to people from diverse communities facing particular challenges, including people with disabilities, it would be doing far more than including a line in the Broadcasting Act. It would be taking the steps that are necessary, and that groups have been calling for, to support the dignified life for people living with disabilities. It would support reasonable amendments that have been put forward by disability organizations. It would be engaging in proper consultation instead of shutting it off.

I look forward to continuing debate on the bill.

Persons with Disabilities

[Erin O'Toole, Conservative, Leader of the Opposition]

Mr. Speaker, if the Prime Minister is listening, he has heard from physicians who have referred to Bill C-7 as a massive failure of compassion. He might have heard from disability advocates from across the country who have raised alarms that the bill goes too far and devalues their lives. One of the witnesses at committee said that she believed all her doctor saw when looking at her was a woman alone, sick, tired and probably tired of living.

Let us get the balance right. Why is the Prime Minister rushing the bill when so many people fear the vulnerable will be impacted? Can he listen and have amendments that will protect society's most vulnerable?

[Rob Moore, Conservative, Fundy Royal, NB]

Mr. Speaker, recently at the justice committee we heard moving testimony from individuals in the persons with disabilities community who are gravely concerned about the government's Bill C-7 and its impact on their community. Krista Carr, executive vice-president of Inclusion Canada, said that if Bill C-7 passes, discrimination on the basis of disability would once again be entrenched in Canadian law.

Will the Prime Minister do the right thing, listen to the voices of Canadians living with disabilities and support our amendments that would reinstate safeguards to protect vulnerable Canadians?

Justice

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

Mr. Speaker, the bill that is being studied, Bill C-7, in front of committee heard very compelling testimony from a series of stakeholders, including persons with disabilities. All of those submissions are being carefully considered by the committee and were also carefully considered by the Minister of Health, persons with disabilities and the Minister of Justice during the consultations that took place in January.

This bill is an important one. It balances the need to protect those who are vulnerable with ensuring the autonomy of Canadians who are making choices about their own bodies and their own capacities. We will endeavour to listen to all stakeholders to craft a carefully balanced bill.

[Kyle Seeback, Conservative, Dufferin—Caledon, ON]

Mr. Speaker, support for people with disabilities is inadequate. There is a problem when medically assisted death is easier to access than disability support. Krista Carr of Inclusion Canada, an organization that works with people with disabilities, called Bill C-7 “our worst nightmare”. Dr. Gallagher from U of T is concerned that Bill C-7 would single out our elderly and could lead to preventable deaths.

Why will the Minister of Justice not listen to these concerns and accept our reasonable amendments to protect the most vulnerable in Canadian society?

Health

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

Mr. Speaker, Roger Foley was born with a severe neurodegenerative disease. He gave moving testimony last week on Bill C-7 at committee. Roger helped take care of his father, who is suffering with cancer, until his own disabilities got worse. The health care system has now failed him. It denied him the supports that provide him the dignity of living at home.

Roger would like to know if the Liberal government thinks it should be easier for him to end his life than to access the supports to affirm and enhance his life.

Physician-Assisted Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, the second petition deals with Bill C-7, currently being considered at the justice committee. Petitioners highlight, as witnesses have also highlighted, the significant problems with the elimination of the mandatory 10-day reflection period and the elimination of other safeguards. The petitioners want the government to leave in place the 10-day reflection period, so that we do not have the possibility of same-day death taking place in Canada.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, the second petition deals with Bill C-7.

The petitioners are concerned with how Bill C-7 removes a number of safeguards associated with the euthanasia regime that are unrelated to the Truchon decision. They highlight the elimination of the 10-day reflection period, which introduces the possibility of someone requesting and receiving euthanasia on the same day.

The petitioners call for Bill C-7 not to pass or to be amended to remove those changes.

Business of the House

[Pablo Rodriguez, Liberal, Leader of the Government in the House of Commons]

Mr. Speaker, I am equally happy, pleased and enthusiastic to answer my colleague's question.

This week, we wrapped up debate at second reading of Bill C-6, on conversion therapy, and Bill C-7, on medical assistance in dying. I would like to thank the opposition members for their co-operation on these bills.

This afternoon, we are continuing the debate on the Bloc Québécois opposition motion.

Tomorrow, we will resume debate at second reading of Bill C-5, regarding a national day for truth and reconciliation.

On Monday, we will start second reading debate of Bill C-8 concerning the implementation of Truth and Reconciliation Commission's calls to action 94.

I would like to inform the House that Tuesday, November 3 and Thursday, November 5 shall be allotted days.

Criminal Code

[Mario Simard, Bloc, Jonquière, QC]

Mr. Speaker, I congratulate my colleague from Rivière-du-Nord. I very much admire his ability to make such measured speeches. I have a quick question for him.

I get the impression that, as with Bill C-7, people will vote to please certain religious groups. I do not believe that to be the best approach.

Could my colleague from Rivière-du-Nord talk about the right way to vote on a bill that has this kind of moral impact?

[Majid Jowhari, Liberal, Richmond Hill, ON]

Mr. Speaker, that is an important question. It is fair to acknowledge that we are living in very difficult times. COVID-19 has left an impact on not only Canadians but across the world. That is the reason we had to take a pause and really reflect on what we had learned since March or early February, when we became aware of this pandemic. We did that and we did it effectively.

We came back with a very strong Speech from the Throne that talked about mental health. We also now have the opportunity to reintroduce bills such as Bill C-6 and Bill C-7.

[Eric Duncan, Conservative, Stormont—Dundas—South Glengarry, ON]

Madam Speaker, I am pleased to rise today as the first speaker at second reading from our caucus on Bill C-6, an act to amend the Criminal Code regarding conversion therapy, formerly Bill C-8 before COVID-19 changed our model here and we lost a few months on this legislation.

I am honoured to stand in the House of Commons today to provide some comments and feedback on the bill and at times a personal perspective, as we all share a common goal to eliminate the harmful practice of conversion therapy across Canada.

I want to start on a personal note about the debate in this chamber. In the last few weeks many colleagues have stood to ask questions and offer commentaries in the debate around Bill C-7, on medical assistance in dying. As I mostly watched that from my office on television, I want to commend members on the tone and the civility of the debate. The questions and the debate going back and forth have been very civil, constructive and very worthy of the House and the debates that we hope to have similarly on a piece of legislation such as this.

I want to acknowledge the work of the provincial partners, as the minister mentioned in his comments, that did work in provincial jurisdictions before we were dealing with this piece of legislation in Ottawa. In Ontario in 2015, a law was passed, and in Manitoba in 2015 and Nova Scotia in 2018.

I may be a bit biased, being from Ontario, but I want to acknowledge the work that was done at Queen's Park in the provincial legislature. It is my understanding that it was the first in Canada, but also that all the parties worked together to get unanimous support for that bill, which proceeded to ban conversion therapy in the province of Ontario.

It shows how legislatures and parliamentarians from different parties can work together on issues of common concern. I believe we can achieve the same goal here in Ottawa. We all agree with the common goal, calling out conversion therapy for what it is: a terrible, inhumane, dangerous practice against the LGBTQ community that needs to be eliminated in Canada.

As I start my comments here today, I want to acknowledge the many organizations that have worked for years to raise awareness of this issue. As we debate and discuss the details of the legislation, we need to always remember the stories and the scars of those who have suffered through some form of conversion therapy.

There are many who have come forward to share their stories, to help educate us and to bring light to this issue. Unfortunately, there are some who have not been able to share their stories with us, because they are not with us anymore. The torture, the pain that they faced was too much to handle. Many suffered in silence. Too many have taken their lives because of the harms that conversion therapy caused them.

We often talk in the House about making our Parliament more diverse and reflective of Canada, by gender, by race, by profession, by sexual orientation and by lived experiences. As we debate this legislation, this is exactly why we aspire to that goal: to bring perspective from across the country, and to share stories and experiences that could help guide us all. I want to do that today for a few moments.

I have said a few times over the last year that I have talked more about my sexual orientation this past year than I have in my entire 33 years. I am a proud gay man who lives in rural eastern Ontario, and I have come to realize that my story matters. If I could get personal here for a moment, I want to talk about my story and my coming out.

It was back in 2017, in my hometown of Winchester, Ontario, a small town with lots of churches and a mix of bedroom community people working in Ottawa and people who have called the rural community home for their entire lives. People coming out maybe was not as common as it would be in downtown Ottawa or downtown Toronto or other places. I served as the mayor of my community at that time. I was out to my family and friends, and I had decided that it was important for me to let my community know that I am a proud gay man so that I could live my life openly, happily and freely.

I wrote a letter on a Sunday morning at about nine o'clock, posted it on Facebook and it went viral. I was not expecting the reaction. It was the lead story on the news channel the next day, and it went viral on Facebook.

What I was hoping from that was indifference, that people would just move on and not care, in a good way, showing how far we had come. However, what I got was the absolute opposite. The love, compassion and support I got from people was overwhelming, people from all different backgrounds and different life experiences. I find that as more people share their stories, it becomes a degree of separation.

I went to bed that night very happy and on a high. Unfortunately, it did not last too long. A couple of days later, in a community just south of my hometown, a young gay man only a couple of years younger than I was took his life. The high I had felt a few nights previous was equally emotional a couple of days later in the struggles he had faced, a variety of struggles. If that were not enough, there was a further degree of separation that broke my heart.

A friend of mine had let me know that a friend of his was a closeted gay man who had married a woman but was actually gay and struggling with his sexual orientation. He was nervous about coming out to his family, friends and community, and he hid it. He suffered and suffered in silence until he could not take it anymore.

I share these stories not because I know that any of the individuals were subject to conversion therapy, but it shows the struggles that people still face. Even with the positive experience I had with my family, friends and community, we need to acknowledge that it is not the same for everybody. We need to show compassion and care and understanding, whether someone is coming to terms with their sexual orientation or their gender identity.

Adding on something like conversion therapy to a child, any sort of therapy in that regard to change somebody, would be devastating for them to go through. What they would have to go through and what they are subjected to is so fundamentally wrong and dangerous. Subjecting a child to it to change them to be who they are not is wrong. It is dangerous and it must end.

I want to talk about the first speech our new leader gave here in the House when there was an opportunity to speak to this legislation when it was tabled by the minister. I have to say I am really proud of his response, his compassion and his understanding of the issue. He spoke of his military service. He spoke about how a fundamental part of his job, of that service, was to defend the rights of all Canadians wherever his service took him. He did that proudly in our military and he has done that as a member of Parliament here in this chamber when legislation has come forward. The NDP legislation a few years ago on gender identity was a key example of that.

I want to reflect on and put back on the record a quote from what our leader said that day, which really stuck with me. He said:

I stood and was counted for rights that day. As a parliamentarian, I am here to secure the rights of every Canadian, including those in the LGBTQ community, and to build an inclusive and prosperous country for all. Now, as leader of the Conservative Party, I pledge to continue this work.

Conservatives agree that conversion therapy is wrong and should be banned. No Canadian should be forced to change who they are, whether it be their sexual orientation or their gender identity. We know that too many Canadians have been harmed by this practice and, as parliamentarians, we have a responsibility to protect the most vulnerable in our society. That includes members of the LGBTQ community, who have been the target of degrading and dehumanizing practices in an effort to change their sexual orientation against their will. Everyone deserves to be treated with dignity and respect.

The bill states:

This [legislation] amends the Criminal Code to, among other things, create the following offences:

(a) causing a person to undergo conversion therapy against the person’s will;

(b) causing a child to undergo conversion therapy;

(c) doing anything for the purpose of removing a child from Canada with the intention that the child undergo conversion therapy outside Canada;

(d) advertising an offer to provide conversion therapy; and

(e) receiving a financial or other material benefit from the provision of conversion therapy.

I want to talk briefly about the details of the legislation and something that I have been able to speak about with many colleagues on different sides of the House, and even my constituents back home in Stormont—Dundas—South Glengarry, as they have questions and comments about the legislation. I will use a specific quote. The bill says, “repress or reduce non-heterosexual attraction or sexual behaviour” as part of the definition of conversion therapy.

I want to talk about the difficulty sometimes, in my opinion and my own life experiences, of trying to come up with a definition of conversion therapy that acknowledges how conversion therapy has changed in what it is over the years. Many people think of it as electroshock therapy, a terrible, horrible practice that I hope and believe is mostly eradicated in our country. I am not saying it is completely gone, but there has been an evolution over the years of what conversion therapy is, from that visual of electroshock therapy to what is more of a repression. It is some sort of therapy session to suppress feelings: It is okay to be gay but just do not act on it, or it is okay to have a different gender identity but just do not act on it. The suppression of that thought is equally as damaging as anything else.

When we talk about that, I want to acknowledge that the latest unfortunate trends and those who promote or offer conversation therapy are not so much the vision of something we saw decades ago, but something that is treated more as a therapy, when in fact it is anything but that.

As we move forward in the debate on this legislation and when the bill hopefully gets to second reading and into committee where the bill can be studied and discussed further, my Conservative team has noted that we will be proposing a reasonable amendment that will bring even more support to this legislation. I believe it to be fair, reasonable and bipartisan. I believe it should have the support of the government. That is because I believe we can simply add the words of its own news release earlier this year to confirm what the minister has said before.

As I am not a legal expert, the words the minister acknowledged in his comments could be put into the legislation for greater certainty, saying that private conversations are not subject to criminal prosecution. I will read the quote because I believe it. It is the intent of the legislation and I believe the legislation would be better off if the minister's words in the news release were put into the legislation. He stated:

These new offences would not criminalise private conversations in which personal views on sexual orientation, sexual feelings or gender identity are expressed such as where teachers, school counsellors, pastoral counsellors, faith leaders, doctors, mental health professionals, friends or family members provide affirming support to persons struggling with their sexual orientation, sexual feelings, or gender identity.

I believe that to be the intent of this legislation, in my own personal view. It would be reasonable and appropriate if we could work, as the minister said, in good faith, which he has from myself and members of my party, to bring that forward and get it included.

I am happy to see that Parliament is tackling the issue of banning conversion therapy. The sooner that we put a stop to it, the more lives we will save and the better quality of life and promising future we can give young members of the LGBTQ community.

I mentioned earlier that I talk a bit more often about my sexual orientation and being a proud gay man, but something I have talked less about is my faith. I know for many Canadians in every part of this country their faith guides them in the decisions they make and values they have.

As I reflect on my own personal faith, I will say this. My faith and the values my church taught me have not guided me away from this legislation, but the opposite. They have taught me to support it, to stand up for vulnerable neighbours and friends, to show empathy and compassion, to be there and stand up for those who cannot do it on their own. That is what my faith has taught me and where it has guided me. It is guiding me to be behind this legislation and seeing it enacted as we work together through committee, third reading and eventually on to the Senate.

I will end my comments today not with debate on the specific legislation, but with a message to young gay or trans children. It is okay to be gay. It is okay to be trans. It is right for them to live their lives as who they are and be who they are. Canadians know that subjecting anyone to conversion therapy is wrong and we must protect those who are vulnerable.

I am grateful for the time today to offer my support for ending conversion therapy, for working together here in second reading, in committee and in the Senate to make this happen and get the job done together. We need to do this for the young children I mentioned and for those who are tragically not with us anymore. We must act on their stories and struggles to do better. Let us continue this work and get it done for them.

Act to Amend the Criminal Code Regarding Medical Assistance in Dying

[David Lametti, Liberal, Minister of Justice]

Mr. Speaker, pursuant to Standing Order 32(2), I have the honour to table, in both official languages, the charter statement on Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying, and a legislative summary of Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying.

Business of the House

[Pablo Rodriguez, Liberal, Leader of the Government in the House of Commons]

Mr. Speaker, I thank my colleague for his question and for the clarification. Indeed, we will be in our ridings, not on vacation.

This afternoon, we shall continue debate on Bill C-3, an act to amend the Judges Act and the Criminal Code.

Tomorrow, we will begin second reading of Bill C-7, an act to amend the Criminal Code with regard to medical assistance in dying.

When we return after our constituency week, we will resume debate on Bill C-7. We hope we can begin the debate on Bill C-5, an act to amend the Bills of Exchange Act, the Interpretation Act and the Canada Labour Code regarding a national day for truth and reconciliation. This bill has to do with Orange Shirt Day.

Lastly, I wish to inform the House that Tuesday, October 20 and Thursday, October 22 will be allotted days.

I wish all members a pleasant week in their ridings. I hope members will take care of themselves and their loved ones and come back in good health.

Physician-Assisted Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, the second petition is with respect to Bill C-7.

The petitioners are concerned that the government is removing vital safeguards that only a few short years ago the government said were very much essential.

The petitioners are calling on the Government of Canada to reconsider its decision to remove the mandatory 10-day reflection period, and to also reconsider its proposal in Bill C-7 to remove the requirements for independent witnesses.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, it is a pleasure for me to be presenting five petitions in the House today.

The first petition is with respect to Bill C-7. It is timely, as it is the same bill number that the justice minister just tabled, although maybe we see some differences in the text.

This petition refers to some changes that were in the last version of the bill, which removed vital safeguards associated with the euthanasia regime. The petitioners are concerned that the bill sought to eliminate the 10-day reflection period and eliminate requirements regarding witnesses. They believe those safeguards should remain in place.

Justice

[David Lametti, Liberal, Minister of Justice]

Mr. Speaker, in the coming days, our government will reintroduce what was formally Bill C-7 on medical assistance in dying. We consulted extensively on this legislation and believe that it ensures personal autonomy and choice, while protecting the most vulnerable. It affirms the inherent and equal value of every life.

As we move forward, we will work to ensure the parliamentary process is inclusive and accessible. I want to assure my hon. colleague and all Canadians that even in a pandemic, all voices will be heard on this deeply personal and important issue.

[Iqra Khalid, Liberal, Mississauga—Erin Mills, ON]

Mr. Speaker, in February, our government tabled Bill C-7 to comply with a Quebec Superior Court ruling, which ordered changes to Canada's medical assistance in dying law. However, due to the pandemic, our government was granted an extension until December 2020 to comply with this order.

Could the Minister of Justice please update the House on our government's plan to comply with the Truchon decision and to respect the court-imposed deadline?

Alleged Premature Disclosure of Contents of Bill C-7—Speaker's Ruling

[The Speaker, Anthony Rota]

I am ready to rule on the question of privilege raised on September 25 by the member for Louis-Saint-Laurent requesting that a question of privilege found to be prima facie in the previous session be considered once again in the current session. At the time, the matter involved the premature disclosure of the content of Bill C-7, an act to amend the Criminal Code with regard to medical assistance in dying, while it was on notice awaiting introduction and first reading.

In this intervention, the member reminded the House that the question was raised earlier this year, on February 25, and was referred to the Standing Committee on Procedure and House Affairs on March 10, when the Speaker gave leave to move the appropriate motion. I want to thank the member for the clarity of his remarks and for the precedents he cited to bolster his case. Both helped me to understand the issues in play. The parliamentary secretary to the government House leader also intervened, focusing his remarks on the timelines for raising the questions of privilege.

As members are well aware, when questions of privilege are raised, the role of the Chair is to determine if the claim relates to the breach of privilege or a contempt that deserves priority of consideration over all other business before the House. It is not the responsibility of the Chair to decide whether there is an actual offence or its seriousness. Such a matter is determined by the House itself. This is one of the two criteria that the Speaker has to consider in assessing an alleged breach of privilege. The second criterion is whether the matter was raised at the earliest opportunity. In considering the revival of a question of privilege in this new session, the Chair is bound by the same criteria and has to take into account current circumstances.

In reviewing the precedents raised by the member, the character of the complaint in each case is important in determining if and to what extent it is relevant to the case at hand. For example, in his ruling of February 6, 2004, Speaker Milliken was considering the extent of privilege afforded to a member when called before the courts as a witness, more specifically the immunity from testifying in court during a parliamentary session. The other case related to the evident gap in the law and the practices of the House relating to members found to be in contravention of the Canada Elections Act. Both cases had far reaching implications that were not bound by the limits of the session.

The circumstances involved in the issue before the House are now substantially different. Bill C-7 is no longer before the House, nor is the infraction of its premature disclosure. Eight months have elapsed and as a result of prorogation, all proceedings including any outstanding legislation as well as any order of reference have been terminated.

With regard to the notice requirement, the Chair has observed that the issue was not raised at the earliest opportunity. While we might understand why there would be reluctance to raise a question of privilege on the opening day of a new Parliament or session, notices should be submitted early. This seems particularly pertinent in a case that seeks to revive a question of privilege from the previous session.

Given these circumstances, the Chair does not find that the matter should take precedence over all other business of the House. Grounds are not sufficiently compelling in this case. I therefore rule that the question of privilege has not been made out.

Alleged Premature Disclosure of Contents of Bill C-7

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons]

Mr. Speaker, I am rising to respond to a question of privilege raised on Friday, September 25, respecting the premature disclosure of Bill C-7, on medical assistance in dying, from the previous session. As members well know, the bill in question died with prorogation, as did the reference of the question of privilege to the Standing Committee on Procedure and House Affairs.

House of Commons Procedure and Practice, 2017, states at page 145:

The matter of privilege to be raised in the House must have recently occurred and must call for the immediate action of the House. Therefore, the Member must satisfy the Speaker that he or she is bringing the matter to the attention of the House as soon as practicable after becoming aware of the situation. When a Member has not fulfilled this important requirement, the Speaker has ruled that the matter is not a prima facie question of privilege.

I would also refer members to the footnote that is attached to the text that I just quoted. Footnote 369 states:

Any matter found to be prima facie and referred to committee in one session but not reported on would not survive a prorogation. However, if a Member wished to raise the question of privilege again in the following session, the Speaker could reconsider the matter provided that the rules of timeliness were respected.

The facts are clear. The former Bill C-7 died on the Order Paper with prorogation. The procedure and House affairs committee did not report to the House on the question of privilege. The member who raised the question of privilege on September 25 did not do so at the earliest opportunity.

I would draw to the attention of the House that the earliest opportunity to raise a question of privilege stemming from the previous session was Thursday, September 24. I would note that on Thursday, September 24, the member for Leeds—Grenville—Thousand Islands and Rideau Lakes raised two questions of privilege. That is a clear demonstration that this matter should have been raised on Thursday given that the House had adopted a motion on Wednesday, September 23, to allow all members to participate in the proceedings of the House whether in person or virtually. There is no excuse for not having raised this matter on Thursday.

I would conclude that since the matter was not raised at the first opportunity, the former Bill C-7 was discharged from the Order Paper with prorogation and there was no report from the Standing Committee on Procedure and House Affairs on this matter. This does not meet the well-established rule for raising a question of privilege.

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

Mr. Speaker, I rise today on a question of privilege concerning the disclosure of Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying, which was introduced in the previous session.

In the interest of time, my hon. colleague, the member for Fundy Royal, raised this question of privilege on February 25. I would direct you to the arguments presented at pages 1518 and 1519 of the Debates.

Mr. Speaker, on March 10, you concluded that there was a prima facie breach of privilege, and the House adopted the member's motion to refer the matter to the Standing Committee on Procedure and House Affairs.

On March 12, the committee agreed to suggest dates for inviting the Clerk and the law clerk to appear so that it could begin studying the matter. The next day, the House adjourned because of the pandemic. This meant that the committee never had a chance to get back to its order of reference because of the various Liberal motions prohibiting virtual meetings on this subject. The Prime Minister then decided to shut down Parliament, ending the study before it had even started.

I am asking you to find another prima facie breach of privilege so that the House can once again examine the issue and, if it so desires, send it to the Standing Committee on Procedure and House Affairs. There are previous rulings in which a prima facie breach of privilege was found when prorogation put an end to an order of reference on a question of privilege before a committee was able to report to the House on it. More specifically, I would refer you to the ruling made by Mr. Speaker Milliken on February 6, 2004, at page 243 of the Debates of the House of Commons, when he said that, for the same reasons that he gave in a ruling he made in the previous session, the question remained a prima facie breach of privilege. He then gave the member leave to move his motion.

Another of your predecessors, the hon. member for Regina—Qu'Appelle, who we know well, also made a similar ruling on October 17, 2013, at page 66 of the Debates of the House of Commons. The same circumstances exist as in previous cases and it is appropriate to raise a prima facie question of privilege.

If you agree, Mr. Speaker, I am prepared to move the appropriate motion.

Physician-Assisted Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, the second petition speaks to the government's priorities with respect to health care in January and February when it could have been focusing on improving seniors care and preparing for a response to the pandemic. The government's focus was instead on removing vital safeguards associated with the government's euthanasia regime. The petitioners raise concern about the government's plans previously in Bill C-7 to eliminate a 10-day reflection period and also reduce the number of witnesses required. The petitioners believe that these were important safeguards that need to be in place and question the government's priorities with respect to removing safeguards when there are so many other vital health care issues that we should be focused on.

Business of the House

[Pablo Rodriguez, Liberal, Leader of the Government in the House of Commons]

Mr. Speaker, I thank my colleague for the question.

This afternoon we will continue debate on the NDP motion.

Tomorrow, we will resume debate on Bill C-4 on the free trade agreement with Mexico and the United States. We hope to conclude the debate that afternoon.

When hon. colleagues return from the constituency week, we will follow up with Bill C-7 on medical assistance in dying, Bill C-8 on conversion therapy and Bill C-3 on CBSA oversight.

Finally, I would like to inform the House that Monday, March 23, and Thursday, March 26, shall be allotted days.

Reference to Standing Committee on Procedure and House Affairs

[Rob Moore, Conservative, Fundy Royal, NB]

moved:

That the matter of the premature disclosure of the contents of Bill C-7, An Act to amend the Criminal Code (medical assistance in dying) be referred to the Standing Committee on Procedure and House Affairs.

Mr. Speaker, thank you for your finding that a breach of our privileges did exist in this case in the leaking of the contents of Bill C-7 to the media before members of the House could see the bill.

There is a reason we have rules in this place to protect the rights and the privileges of members of Parliament in this place on all sides of the House, so that we are able to do the job that we were elected to do, which is to represent our constituents, to pass legislation and to debate. Those are the things that we have been given the ability to do by our constituents. When we have government departments, government members that do not abide by the rules of the House, it undermines not just those members in the opposition; it undermines all of us.

It is well-established practice in the House that when a bill is on notice for introduction, the House has the first right to the contents of the bill. Everyone in the House knows this. We know that the House is paramount when it comes to the introduction of the legislation, but if there is any one department in the whole of government that we would expect would know the rules around the laws and procedures in the House, that department would be the justice department, the department tasked with making laws that impact the lives of all Canadians. That department knows better. That is a department filled with hundreds if not thousands of lawyers and legal minds that know better.

Let us say they did not know better. Just like with any one of our children, sometimes if they make a mistake, we correct them. Maybe if they make a second mistake, we will correct them again. By the third time around, we expect that they know the rules.

This is the fourth time there has been found a breach of our privileges in the House that was made by the Department of Justice. In fact, the last ruling on this matter was also on the previous legislation around medical assistance in dying. It was even the same legislation.

The article that was put forward within The Canadian Press had very detailed and specific information contained in the bill. That is why this breach of privilege has been found.

The reporters and those who were leaking know that contempt has occurred by revealing later in the article that, "The sources spoke on condition of anonymity because they were not authorized to reveal details of the bill prior to its tabling in the House of Commons this afternoon."

There is no doubt in anyone's mind that those who were leaking this information from the Department of Justice or some other arm of government knew exactly what they were doing when they did it. What they thought about this place is not much, because we have rules, and they thumbed their nose at the rules that we have.

After the sources indicated to the reporter that they were aware of their guilty actions, they boldly and defiantly continued their affront to Parliament by providing even more detail of the bill. Quoting again from that article, “Sources say today's bill will not deal with broader issues that were excluded in the new law and that must be considered as part of a parliamentary review of the law that is to begin this summer.” Again, bang on with what was in the bill.

We saw the news articles and we thought we knew what had happened, another leak from the Department of Justice, another affront to this Parliament, another breach of all of our collective privileges, but again we had to read the bill to find out whether in fact that was the case.

We carefully reviewed the contents of Bill C-7 following its introduction in the House. When I and other members of Parliament got to see the bill for the first time, others in the media had seen the bill in its entirety for hours before.

The details reported by The Canadian Press hours earlier were indeed contained in Bill C-7. Ironically, over and over, the first precedent that I had quoted earlier was from the last Parliament, brought to the Speaker's attention on April 14, 2016, and in regard to Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts (medical assistance in dying).

The department in question is being absolutely recidivist. It is not taking seriously the consequences and the rulings of Speakers. The Speaker in 2016 found that there was, in fact, a prima facie case of privilege regarding Bill C-14 and said:

As honourable members know, one of my most important responsibilities as Speaker is to safeguard the rights and privileges of members, individually and collectively. Central to the matter before us today is the fact that, due to its pre-eminent role in the legislative process, the House cannot allow precise legislative information to be distributed to others before it has been made accessible to all members. Previous Speakers have regularly upheld not only this fundamental right, but also expectation, of the House.

The Speaker's concluding remarks in 2016 were as follows:

In this instance, the chair must conclude that the House's right of first access to legislative information was not respected. The chair appreciates the chief government whip's assertion that no one in the government was authorized to publicly release the specific details of the bill before its introduction. Still, it did happen, and these kinds of incidents cause grave concern among hon. members. I believe it is a good reason why extra care should be taken to ensure that matters that ought properly to be brought to the House first do not in any way get out in the public domain prematurely.

On October 4, 2010, on page 4711 of the House of Commons Debates, Speaker Milliken noted:

It is indisputable that it is a well-established practice and accepted convention that this House has the right of first access to the text of bills that it will consider.

This all goes back to my point about the Department of Justice not taking seriously the rules of this House. The one department that ought to know best about the rules of this House is now a four-time offender, with breaches of privileges found by successive Speakers over the last several years, sometimes over the same bill subject matters. The House, and the rules of the House, are being completely ignored.

The Speaker found another case of contempt on October 15, 2001, after, and members are not going to believe this, the Department of Justice briefed the media on the contents of a bill prior to the legislation being introduced in the House.

Maybe, in this minority House, members can finally take this department and this Minister of Justice's office to account and to task for their continuous disrespect of the privileges and the rights of this place, and the rights of all Canadians who send us as members of Parliament to do good work on their behalf.

Alleged Premature Disclosure of Two Bills—Speaker's Ruling

[The Speaker, Anthony Rota]

I am ready to rule on the questions of privilege raised on February 25 by the member for Fundy Royal and on February 27 by the Parliamentary Secretary to the Leader of the Government in the House of Commons concerning the premature disclosure of two bills.

Allow me first to recapitulate the arguments presented by the two members.

On February 25, 2020, the member for Fundy Royal raised a question of privilege regarding a Canadian Press article published online on February 24 that detailed specific information contained in Bill C-7, an act to amend the Criminal Code with regard to medical assistance in dying, even before it was introduced in the House by the Minister of Justice. The member quoted from the article in question, which mentioned that anonymous sources allegedly discussed the contents of the bill with the journalist while knowing full well that doing so contravened the practices of the House. The member for Fundy Royal feels that this premature disclosure of the bill constitutes a breach of his privileges and contempt of the House.

On February 27, the Parliamentary Secretary to the Leader of the Government in the House of Commons raised a question of privilege also concerning the premature disclosure of a bill.

During this intervention, the parliamentary secretary said that a bill entitled “an act to amend the Criminal Code (unlawfully imported firearms)”, put on notice on February 21 by the member for Markham—Unionville, was also the subject of an article published on February 24 in iPolitics before it was introduced in the House. On February 25, the member put another bill on notice, one with a slightly different title, “an act to amend the Criminal Code (possession of unlawfully imported firearms)”. The bill became Bill C-238 after it was introduced on February 27.

The parliamentary secretary feels that the provisions of Bill C-238 correspond to what was described in the iPolitics article, and he presumed, therefore, that the two bills are in large measure the same. The parliamentary secretary suggested that this disclosure contravenes the principle that members are the first to know the contents of a bill. Since a breach of privilege was apparently committed, he suggested referring the matter to the Standing Committee on Procedure and House Affairs.

On February 28, the member for Markham—Unionville apologized and admitted that he had indeed discussed the contents of the first bill with fellow members and journalists. He said that he had acted in ignorance of the rule prohibiting discussion of bills on notice before they are introduced in the House. He also explained the reasons for the change in title between the two bills.

The same day, the parliamentary secretary to the leader of the government in the House presented his most sincere apologies for the premature disclosure of Bill C-7, saying in passing that no one within the government had been authorized to discuss the bill before its introduction in the House.

I believe that the whole matter can be summarized as follows.

First, based on a reading of the Canadian Press article on Bill C-7 on medical assistance in dying, and in the absence of any explanation to the contrary, I must conclude that the anonymous sources mentioned were well aware of our customs and practices and chose to ignore them. It seems clear to me that the content of the bill was disclosed prematurely while it was on notice and before it was introduced in the House.

Second, in his apology, the member for Markham—Unionville made it clear that his two bills on firearms were substantially the same, apart from the slightly different titles. It seems clear to the Chair, therefore, that the member also discussed a bill before its introduction. It matters little that the bill in question was subsequently withdrawn and never introduced in the House.

The rule on the confidentiality of bills on notice exists to ensure that members, in their role as legislators, are the first to know their content when they are introduced. Although it is completely legitimate to carry out consultations when developing a bill or to announce one’s intention to introduce a bill by referring to its public title available on the Notice Paper and Order Paper, it is forbidden to reveal specific measures contained in a bill at the time it is put on notice.

In this case, it is clear that the content of the bills, both the private member's bill and the government bill, were revealed to the media before their introduction and first reading. The question now is to determine whether the disclosure of these bills was a breach of the House’s privilege and whether mitigating circumstances should be considered.

In this instance, I am prepared to give the benefit of the doubt to the member for Markham—Unionville when he says that he was unaware of the rules regarding the confidentiality of bills on notice. I believe that his remarks were sincere and that he believed he was advancing his cause in a legitimate fashion.

My analysis is different for the question of privilege raised by the member for Fundy Royal concerning government Bill C-7. Permit me to quote a part of the article at the heart of this matter:

The sources spoke on condition of anonymity because they were not authorized to reveal details of the bill prior to its tabling in the House of Commons this afternoon.

Everything indicates that the act was deliberate. It is difficult to posit a misunderstanding or ignorance of the rules in this case.

On April 19, 2016, my predecessor, faced with a similar situation regarding the premature disclosure of Bill C-14 on medical assistance in dying, found a prima facie case of privilege in a decision that can be located on pages 2442 and 2443 of the Debates.

In light of the information provided by the member for Fundy Royal, the precedents and the current practice in this matter, the Chair notes the existence of sufficient grounds to conclude that there was a prima facie breach of the privilege of the House and the members and their right to be the first to know the contents of Bill C-7.

Consequently, I now invite the member for Fundy Royal to move the appropriate motion.

Alleged Premature Disclosure of Private Member's Bill

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons]

Madam Speaker, in light of an apology from the member for Markham—Unionville with respect to the premature disclosure of his bill, I too, would like to apologize unreservedly for the premature disclosure of the contents of Bill C-7, medical assistance in dying.

I would like to state categorically that no one from the government was authorized to speak publicly on this bill prior to its introduction.

Palliative Care

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Madam Speaker, there is one thing I have learned since being elected, and that is that what the left says never means what people might think it means.

When Liberals talk about unity, what they really mean is “My way or the highway.” When they talk about diversity, they never mean diversity of opinion. When they talk about truth and reconciliation, they have no intention of respecting elected band councils unless it is convenient. When they talk about consultation, what they really mean is, “Let me tell you what I think.” When they say “dying with dignity”, they only mean euthanasia.

Canadians look to this House for compassion, truth and leadership. In light of this week's debate on Bill C-7, let us ensure that when we say we are committed to quality palliative care, we truly mean what we say we mean.

Opposition Motion—Additional Allotted Days

[John Nater, Conservative, Perth—Wellington, ON]

Madam Speaker, “Parliament is more than procedure – it is the custodian of the nation’s freedom.” Those words were spoken by the great defender of parliamentary democracy, the Right Hon. John George Diefenbaker.

Today, we find ourselves called upon to once again stand in support of this great institution, to once again stand for the right of opposition parliamentarians to hold the government to account.

Many Canadians may not be closely following the business of supply. They may not closely follow the allotted days, or the opposition days, that are often called in Parliament. However, these days, in which the agenda of the House falls to the opposition parties, are absolutely essential to our great parliamentary democracy. We as the opposition, both the official opposition and the other opposition parties, have the right to bring forward matters that we feel are important to our constituents and to all Canadians.

Beauchesne's Parliamentary Rules and Forms, sixth edition, states “The Opposition prerogative is very broad in the use of the allotted day and ought not to be interfered with except on the clearest and most certain procedural grounds.”

We have brought forward this opposition day motion on this day for very important reasons. The Liberal government decided to punish the official opposition by giving us a short parliamentary day, a short day when only two full speaking slots would be allocated to the opposition parties.

The Liberal government seems to have forgotten that it is among the weakest governing mandate in Canadian history. The Liberals forget that they actually lost the popular vote in the last election and Canadians saw fit to return them with a minority of seats in this place.

Bosc and Gagnon states the following, on page 855:

The setting aside of a specified number of sitting days on which the opposition chooses the subject of debate derives from the tradition which holds that Parliament does not grant supply until the opposition has had an opportunity to demonstrate why it should be refused.

In other words, before we as the opposition can consent to the continued funding of the government, we must, and we will, have the opportunity to raise our concerns in this place. We will not be silenced. We will not accept that the government, and only the government, has a legitimate voice in this place.

I would remind members of the Liberal Party that they are first and foremost members of the legislative branch of government. Those who do not sit in cabinet are not members of the executive branch. They are parliamentarians and parliamentarians first and foremost. They too should be concerned that the members of the executive branch of government are the ones who are trying to control the debate of this very place.

I ought not to need to remind the government of its legislative record and its mismanagement of House time in the previous Parliament. At the time of dissolution, it had left at least 17 government bills lying on the Order Paper. This is in spite of the fact that it used time allocation on dozens of occasions. On top of that, there were 13 motions for closure and 40 motions to proceed to orders of the day, thereby bypassing the opportunity for opposition MPs to move concurrence motions or to table petitions on behalf of the constituents in each of our 338 ridings across the country.

Today's debate is about returning the House to the people, to give the official opposition, the Bloc Québécois and the New Democratic Party each one additional opposition day during the supply period, to give each of these parties the opportunity to raise the issues before granting supply to the Liberal government.

I do not need to remind the House either about the disregard we have seen in the past by the Liberal Party to this institution.

In the previous Parliament, on one of its very first bills, Bill C-14, the medical assistance in dying act, the Liberal government was found to have contravened the rights and privileges of the House by leaking the contents to the media before it was tabled for all parliamentarians to see. Old habits die hard, because it appears it did that once again this time with Bill C-7, the amendments to medical assistance in dying.

The Conservatives do not need to remind the Liberals either about the impacts they bring upon themselves when they attempt to use draconian measures to shut down debate in the House. We all remember Motion No. 6, when they tried to unilaterally take control of every mechanism for debate in the House. We do not need to remind the Liberals of the standing order standoff, when they tried to diminish the opportunity for the opposition to hold the government to account by unilaterally changing the rules of the House. It fell to the Conservatives, as the official opposition, and the third party, the New Democrats, to ensure we were that line of defence, that we were that thin line of the wedge to prevent the Liberal government from doing that.

In fact, in the previous Parliament, during a debate in this very House on a question of privilege, one of the most significant matters with which the House can be seized, a Liberal member of Parliament, the member for Brossard—Saint-Lambert, stood in the House, used a procedural measure to move to orders of the day and killed that debate. However, our Parliament is stronger than any one Liberal member of Parliament. At that time, the Speaker saw fit to return that question of privilege to the House so members of Parliament could have their voices heard.

We see this time and again with the Liberal government. At every opportunity it has to do the right thing, it goes the opposite direction.

That brings me to the events we have seen just in the last couple of weeks on the new NAFTA. It is not a great deal and it is not the worst deal; it is somewhere in between. We are the party of free trade and we support the implementation of the new NAFTA despite its imperfections. However, to hear the Deputy Prime Minister state publicly and in this place that the Conservative Party was somehow trying to delay the new NAFTA is an insult to the opposition and to the House of Commons.

Just yesterday, my colleague, the opposition House leader, gave the Liberals the opportunity to right their wrong by bringing forward NAFTA today. We could be debating NAFTA today and I could be raising the concerns of the people of Perth—Wellington, the farmers, the manufacturers, individuals who have concerns with the bill. However, the Liberals did not budge. In fact, speaking for the government, the parliamentary secretary to the government House leader said no, that the government would not be willing to bring NAFTA forward. That is unacceptable.

We stand here today debating this opposition motion, a motion that gives the rights and responsibilities of the House back to all its members. I encourage all members to stand for their parliamentary privilege, to stand for democracy and vote in favour of this motion.

Criminal Code

[Philip Lawrence, Conservative, Northumberland—Peterborough South, ON]

Madam Speaker, all of the speeches in the House come from a great place. On my side of the House we value life, and that is meritorious. We have heard other perspectives that talk about ending suffering and that truly has merit, so I appreciate all of the speeches that have taken place on such an important topic.

I know members have gone over this, but just for clarity I want to go over the background for medically assisted suicide in Canada. The 2015 Carter case was a landmark decision for the Supreme Court of Canada. The previous prohibition for assisted suicide was challenged as contrary to the Charter of Rights and Freedoms. In a unanimous decision, the court abolished the provision in the Criminal Code, thereby giving mentally competent Canadians who were suffering intolerably the right to medical assistance in dying when they had provided clear consent.

In June 2016, the first legislation on medical assistance in dying was passed in Canada's Parliament. In the recent 2019 Truchon decision, the Superior Court of Québec considered the constitutionality and Quebec's requirements in accessing MAID. The plaintiffs in the Truchon case were suffering from grave and incurable medical conditions that were causing tremendous suffering and a total loss of autonomy. However, they had each been refused MAID under the legislation in Quebec and federally. Because they were not at the end of life for the Quebec legislation and federally, death was not reasonably foreseeable.

Madam Justice Baudouin held that “reasonably foreseeable natural death” in the federal provisions infringed the plaintiff's fundamental rights under sections 7 and 15 of the charter. The court declared the impugned provisions unconstitutional. In a surprising and, in my mind, incorrect decision, the government chose not to challenge this decision, thereby getting guidance from higher courts such as the Supreme Court. By not challenging this legislation, the Liberal government was admitting that the legislation the House passed was deeply flawed.

The court's decision in Truchon gave the government until March 2020, which is now in the process of being extended, to amend the legislation to remove the reasonable foreseeability of death criteria from the MAID legislation. Prior to the introduction of this bill, the government conducted a narrow consultation process, limiting its consultations to urban centres and online surveys.

The minister noted several times, in his address to the House, that the provisions of Bill C-7 were the result of this process. However, he will not share that consultation with Parliament. This lack of respect is disheartening, and counterproductive to open and meaningful dialogue. I wish the government would stop playing games with such important topics and share the information it has with this minority Parliament.

Given that there is a limited timeline, that we are in a minority Parliament, and that MAID legislation will be subject to a complete review this summer, I would have expected the government to take a limited approach. Rather, the government has chosen to take a very different approach. The legislation makes substantial changes to the MAID eligibility far and beyond what is required to the Truchon decision.

[Darren Fisher, Liberal, Parliamentary Secretary to the Minister of Health]

Madam Speaker, medical assistance in dying, or MAID, is complex. It is a deeply personal and difficult topic, yet this past January alone, more than 300,000 Canadians took part in the online public consultation to have their say. Many others, including experts and family members of loved ones who received MAID, took part in round-table discussions.

We also heard how the legislation is working from many of the conscientious health care providers involved in delivering this service. Canadians are engaged and aware of the importance of bringing the compassionate, sensible measures contained within Bill C-7, an act to amend the Criminal Code (medical assistance in dying).

This bill builds on the foundation laid by the current legislation on MAID, passed by Parliament in June 2016, and extends eligibility for MAID to persons who, while suffering intolerably, may not be at the end of life. This bill respects the Truchon decision and supports the autonomy of Canadians wanting to make an informed choice to end the suffering they face as a result of serious illness, regardless of whether their condition is life-threatening in the near term.

Respecting the autonomy of Canadians while protecting the safety of vulnerable people remains our central objective. That is why Bill C-7 proposes a two-track approach to safeguards, based on whether or not a person's death is reasonably foreseeable.

We have proposed to ease certain safeguards that had the unintended consequence of creating a barrier for someone accessing MAID whose death is deemed reasonably foreseeable, and we will introduce new and modified safeguards for eligible persons whose death is not reasonably foreseeable.

Bill C-7 would permit the waiving of final consent for persons at the end of life who have been already assessed and approved to receive MAID, but who are at risk of losing their decision-making capacity before it can be provided. There was very strong support for this type of amendment from Canadians, experts, health care providers and their professional regulating bodies.

Our government recognizes the importance of data and science-based evidence in the decision-making process. That is why this bill proposes that we expand data collection through the federal monitoring regime to provide a more complete picture of MAID in Canada.

I would like to note that following the Truchon decision there has been widespread speculation about the potential for persons solely with mental illness to be eligible for MAID. However, many stakeholders in the mental health community have expressed deep concern about this possibility. They feel this option directly conflicts with important treatment principles, which are that there is always hope for recovery and that people can live fulfilling lives with a mental illness.

From the perspective of many health care providers and many health care specialists, assessing eligibility for such individuals poses numerous challenges. Mental illnesses are not generally considered to be incurable, which is a requirement under the current law. In addition, the trajectory of such conditions can be more difficult to predict.

In light of the multiple challenges we heard and the lack of support from the practitioner community who would bear the responsibility for conducting eligibility assessments, this bill does not permit MAID for persons whose sole medical condition is a mental illness.

This decision was not taken lightly. It in no way implies that suffering associated with mental illness is any less severe or more tolerable than that associated with another medical condition, such as one arising from a physical condition. Rather, this decision reflects the many uncertainties underlying this question and a concern that allowing MAID in these circumstances could place Canadians at risk.

We recognize that there are proponents who support MAID eligibility for persons solely with a mental illness. However, in light of the Quebec court decision and the compressed time frame for legislative amendments, there is insufficient time to fully address this topic and determine whether a regime that allows access to MAID for persons whose sole underlying condition is a mental illness is viable.

For these reasons, we are adopting an incremental and cautious approach. It is our view that this issue should be explored as part of the parliamentary review process, which is expected to begin later this year.

It is easy as parliamentarians and as legislators to lose the human element of what we do and to focus on talking points and politics, but these compassionate and sensible measures have come from extensive consultation with Canadians, experts and folks who have lived with the unintended consequences of the original legislation.

These are folks like the late Audrey Parker, a Nova Scotian who wanted to spend just one last Christmas with her family but ended her life through MAID two months prior, while she could still give consent.

I want to take this time to read some of Audrey Parker's final posts into the record so they will be preserved in Hansard, because this legislation includes her amendment. As my colleagues in the House debate, discuss and study the bill, I want them to remember that there are many folks like Audrey across Canada who deserve this autonomy and this compassion.

She said:

“This is my last note to you. I can tell you I loved my life so much and I have no regrets. I feel like I’m leaving as my best self and I’m ready to see what happens when I die today. I’m hoping for something exciting to happen but I guess I won’t know until the time is here.

“The one thing I’m happiest about, is that I finally found ‘my people’ during my lifetime. I’ve even met new people that I already adore near the end of my journey so it’s never too late for anything in life.

“In the spirit of teaching and sharing, I’d like to leave you with some words that explain my position with MAID.

“When the MP’s debated MAID federally, someone decided to add late stage consent as a fail-safe to ensure no one dies at the hand of another.

“There are four categories of MAID candidates.... Of the four categories, the only one that is cut and dried is my category of Assessed and Approved. We are terminal, suffering outrageous pain and there is no time frame with using MAID. The kicker that makes it difficult is the late stage consent.

“As I near my death today, it is even more evident than ever before, that late stage consent has got to be amended and removed from MAID in Canada for my category of end users.”

“Dying is a messy business. I can’t predict when cancer will move into my brain matter or when something else big happens to make me more unwell. I and only I can make that decision for myself. It’s about living out every extra day that I can. No one including my doctor knows what the right day to die will be. Only I can know that as I wake each day. I’m not going to wait until I lose myself.... I wanted to make it to Christmas and New Year’s Eve... my favorite time of the year but I lost that opportunity because of a poorly thought out federal law.

“Had late stage consent been abolished, I simply would have taken my life one day at a time. If I noticed I was losing capacity, I would have taken control myself....and called my doctor to come assist me with my death. All I have to give is 24 hours notice so she can pick up the drugs from the drug store in my neighborhood. We were totally organized but the law tied our hands.

“This decision has to come from the patient. No one else. That’s why we the dying should be living day to day until we have to leave by invoking MAID.

“Be happy everyone and be kind to others.... Audrey.”

I ask that all members in the House support Bill C-7.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, I thank my colleague for her speech.

I would like to remind her that medical assistance in dying is an intervention allowed only in exceptional cases, under very strict conditions. Access to this intervention is strictly regulated by law.

Bill C-7 will not bring about an unreasonable increase in MAID cases. According to a report of Quebec's commission on end-of-life care, from December 10, 2015, to March 31, 2018, a total of 830 requests for MAID were denied for various reasons, including the death of the person before the procedure, the withdrawal of the request by the sick person or a death that was not reasonably expected.

In short, there is nothing in Bill C-7 that will cause a substantial increase in requests for medical assistance in dying.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Madam Speaker, I appreciate the opportunity to speak on Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying, which was introduced earlier this week and dramatically expands the existing euthanasia regime in Canada.

This bill was introduced in response to a ruling made September 11, 2019, where the Superior Court of Québec found, in Truchon versus the Attorney General of Canada, that it was unconstitutional to limit access to medical assistance in dying to people nearing the end of life.

I believe it is completely unacceptable that the government did not appeal the Truchon decision to the Supreme Court. Truchon struck down vital protections for vulnerable Canadians that the Liberal government put in place less than five years ago. Appealing this decision would have allowed us to get certainty on the framework within which Parliament can legislate.

The summary of the bill states that it amends the Criminal Code to:

among other things,

(a) repeal the provision that requires a person's natural death to be reasonably foreseeable in order for them to be eligible for medical assistance in dying...

It excludes mental health as an eligible reason to receive assisted suicide. It creates two sets of safeguards that must be respected before medical assistance in dying may be provided, which differ in application depending on whether death is reasonably foreseeable. It also creates an advance directive wherein a medical practitioner can proceed with assisted suicide without consent immediately before administering it, assuming all other criteria are met and the patient enters into an arrangement in writing with a medical practitioner or a nurse practitioner to cause death on a specified day.

While these changes are significant, it is the other things where I will focus most of my attention. In responding to Bill C-14 in the last Parliament and now to this bill, it has always been our priority, on this side of the House, to ensure that legislation permitting euthanasia and assisted suicide includes safeguards for the most vulnerable in our society, as well as for the conscience rights of physicians and allied health professionals.

Of all the proposed changes, I am most concerned about the removal of the 10-day waiting period. This was not a change mandated by Truchon. Rather, it is a deliberate choice by the Liberal government to strike down one of the most important safeguards for vulnerable people facing uncertain medical prognoses.

Nearly every one of us can think of someone in their lives, perhaps a friend, a grandparent or even a spouse, who has received a serious diagnosis. The emotional impact of hearing that news can be overwhelming for both the patients and their families. It can cause depression, anxiety and a great fear of the unknown.

I am sure many of us can also think of people we know who have received terminal diagnoses and went on to beat their illness and live for years afterwards. However, with the safeguard of a 10-day waiting period gone, such stories may be fewer and farther between.

Without having to take the time to come to terms with their situation, to speak to their families and to learn about treatment options from their doctors, many people will make emotional decisions based on fear.

Another amendment removes the need for two independent witnesses and allows health care workers to act as witnesses. People may not even hear another voice offering a different solution.

By making these changes, we diminish the extremely important role legislators play in contemplating all of the unintended outcomes and consequences and then protecting against them. We know very well that the current euthanasia regime has serious problems, that it has been abused and that it has been used as a tool of desperation after the failures of government.

Sean Tagert suffered from an advanced case of ALS that left him completely paralyzed, unable to speak and reliant on a ventilator. Despite these challenges, Tagert fought to stay alive so he could watch his son, whom he spoke of in lengthy Facebook posts, grow up.

Sean required 24-hour in-home medical assistance to stay alive. Initially the health care system provided him only 15 hours, leaving Sean to somehow pay hundreds of dollars each day. Eventually, even that was too much for the health authority. Health care authorities told Sean that he would no longer receive funding for home care, leaving as his only option institutional care at a facility hours away, separated from family and removed from the son he called his reason for living.

Sean appealed, but to no avail. He was going to lose his home care. Mr. Tagert fought long and hard for the rights of persons with disabilities and their families but in the end, he was driven by his desperate circumstances to believe that assisted suicide was his only option. He was “worn out”, in his own words. On August 6, 2019, he ended his life.

I am going to read from the statement his family posted at that time:

We would ask, on Sean's behalf, that the government recognize the serious problems in its treatment of ALS patients and their families, and find real solutions for those already suffering unimaginably.

“Real solutions” does not mean removing the safeguards for those who are the most vulnerable. It means providing true alternatives, be that palliative care, in-home care or the unique care needed.

It is not enough to simply put in legislation as we find here in proposed paragraph 241.2(3.1)(g), under Safeguards:

...[to] ensure that the person has been informed of the means available to relieve their suffering, including, where appropriate, counselling services, mental health and disability support services, community services and palliative care and has been offered consultations with relevant professionals who provide those services or...care.

If we have no intention of ensuring that those services are being funded or are even available, we have failed.

I note that the current federal government broke a key election commitment to invest $3 billion in long-term care, including palliative care. Access to palliative care is an essential part of end-of-life decision-making. That point has been made over and over during this debate.

People should never be put in a position where they believe death is the only solution available to them. We are, and we must be, better than that. We must protect every human life with a jealousy born of the knowledge that each person is unique, and has an innate dignity that nothing, not time, not illness nor disability, can ever take away.

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

Madam Speaker, it is an honour to speak today to Bill C-7 regarding medical assistance in dying. This is the second time, the first being in the last Parliament, that I have had the opportunity to take part in the debate on this absolutely essential legislation on such a difficult subject.

This bill represents a major improvement and reflects some of the amendments that I made but that failed in the House, in the 42nd Parliament. Some of those amendments, in fact, were picked up and approved by the Senate.

I want to stop and reflect on the trajectory of this issue in Canada.

As identified when I rose in my place, I am a member of Parliament for Saanich—Gulf Islands and I believe that Saanich—Gulf Islands may have more constituents concerned with and calling for medical assistance in dying than perhaps any other riding in Canada. There are two active death-with-dignity groups within my community, one on Salt Spring Island and one on the Saanich Peninsula, and I think it is for a very simple reason.

Feelings run high, and honestly, my constituents persuaded me in 2011 and 2012 that I had to stand up for ensuring that there was access to medical assistance in dying and stand up for removing the Criminal Code punishments for people who, motivated by compassion and basic human dignity, assisted someone who was dealing with unbearable suffering in their last days and weeks.

The reason that my community is so very implicated in this issue is that Sue Rodriguez was a resident of North Saanich. She was unable to take her own life due to the effects of ALS, but she was able to find a doctor, who remains anonymous to this day, who assisted her in ending her own life.

It is clear that many people in my riding support the measures in Bill C-7, as they did support Bill C-14 in the previous Parliament.

This is about helping to alleviate suffering through medical assistance in dying. This difficult and very serious situation is unfair to anyone.

Sue Rodriguez went to court, so it is also a trajectory of court cases. The Supreme Court of Canada ruled in 1993 against Sue Rodriguez. She was suffering from ALS. ALS runs as a thread through what I want to talk about today. Sue was losing ability and had lost ability to speak, to swallow and to walk. We know the trajectory of ALS. She asked the court to change the law and she was unsuccessful. That was in 1993. By the way, it was a very close decision. It was five to four, a very close decision. She died a year later, on February 12, 1994.

Then we take it to 22 years later. That is how slowly the laws evolve. It takes a while. The Supreme Court of Canada and the laws of Canada evolve to meet the changing circumstances. I think part of the reason is that we also realize now, unlike 20, 30, 40, 50 years ago, that we can prolong lives and sufferings through miracle advancements in medical science, but before we passed this law in the 42nd Parliament, we were denying people death with dignity and the ability to control their own decision-making about the timing of their own death.

Along came the Carter decision, finally, in 2015. Twenty-two years after the Supreme Court of Canada decision in Rodriguez, we had the decision in Carter. I felt very strongly when we debated the bill for medical assistance in dying in this place in the last Parliament, the 42nd Parliament, that our legislative efforts fell far short of what the Supreme Court of Canada ruled in Carter.

I felt quite sure, and said many times in this place, that the legislation we were passing, while an improvement, would not stand up to legal scrutiny and would be ruled unconstitutional by the courts. Now we have the decision that came out last September in the Truchon case, and again a court has given us a deadline to come up with an improvement. It is being called Audrey's amendment. Certainly a lot of people have identified with that situation, and their hearts have been broken by knowing that medical assistance in dying was out of the reach of people who were suffering gravely but feared they would not be able to form the required consent on the day of the procedure.

I think the bill before us is a substantial improvement, and it really reflects on how courts grapple with this issue and how society grapples with it.

I have to say that in the 42nd Parliament, I found the debate remarkably respectful. Across all parties, we recognized that these are serious matters of life and death, not to be trifled with and not to be turned into partisan debate. The reality is that in this legislation we do make amends for some mistakes in the previous bill.

I always find it rather odd that we have to find that a person's natural death is “reasonably foreseeable”. I do not think any of us in this place fancy ourselves immortal. All of our deaths are entirely foreseeable; we just do not know exactly the time and place in which they will occur.

Doctors of those who are suffering from a terminal illness are not even able to say the reasonably foreseeable date. What does it mean to be reasonably foreseeable? We put people in a stricture where even if they knew they had a terminal illness, such as ALS, they could not necessarily get aid from this legislation and they could not necessarily give advance consent to a doctor to indicate that they did not want to go through what they knew lay ahead of them.

One of my best friends emailed earlier today to ask me to stand up and fight this bill, because she is dying with ALS and she did not think the bill would cover her. I spoke to the Minister of Justice to confirm that I was reading the bill correctly and that, yes, they were thinking specifically of people with ALS.

Our friend who used to sit in that chair, Mauril Bélanger, was lost to us so quickly through ALS. My friend, who is losing the ability of speech, is in a chair and has tubes in her stomach that cause enormous pain. She knows that her lungs will give out, so she is emailing me while we are having this debate. I was really relieved to talk to the Minister of Justice and realize that I am reading the bill correctly, that my friend can get the help that is needed to be assessed and be able to say that she wants consent in advance.

However, I do think that there are some areas for amendments that should be made here, and I wish we had more time. I hope the court will give us the additional four months, but we do not know that.

Some of the bogeymen that have been raised here today I think are considered in the bill. We do have the requisite safeguards to keep vulnerable people safe. No one can give permission for medical assistance in dying other than the patients themselves. They still have to meet very tight criteria. They have to have a sworn witness. They have to have a doctor. The bill also provides that on the day of the procedure, if a person indicates that they have changed their mind, they are completely allowed and of course have the right to indicate that they have changed their mind through all sorts of gestures and words, but not through any involuntary gestures. I think the bill is drafted as well as it can be, but we will continue to consider it in the amendments at clause-by-clause consideration.

The bill does continue to ensure that the death is reasonably foreseeable, and there may be some complications there in the language. I note concerns from Dr. Jocelyn Downie at Dalhousie University, who is one of Canada's leading experts in this field, and I want to hear her evidence. I hope that she will be a witness, and I am sure she will be, as well as Dr. Stefanie Green, the president of the Canadian Association of MAID Assessors and Providers. We want to make sure we get the language right.

I will close by thanking the Minister of Justice and the government for following through and hearing the cries of Audrey, from Halifax, that her death be not in vain.

[Rachael Thomas, Conservative, Lethbridge, AB]

Madam Speaker, during this debate time, we have an opportunity as legislators to ensure that we carefully and thoughtfully examine Bill C-7 with the best interests of Canadians in mind.

On September 11, 2019, the Superior Court of Québec found that it was unconstitutional to limit access to medical assistance in dying to people nearing the end of life. Although the current bill before the House, Bill C-7, responds to the court's ruling, it goes far beyond the scope of Quebec's decision and it weakens the important safeguards that have been put in place under Bill C-14.

Since the Liberals put this legislation forward, I have heard from hundreds of my constituents in a matter of days. They have shared with me that they are very concerned about the bill.

I will use my time today to share a number of the concerns they have raised and to issue a thoughtful word of caution to this place.

First, there is a parliamentary review of the original legislation scheduled for June. The question has to be asked. Why are we rushing to expand the scope of the current legislation?

We are literally discussing life and death issues. Death, something so final, deserves just a little of our time, our attention and due diligence.

The government's original legislation went through a very lengthy consultation process. This time, however, the consultation only lasted a couple of weeks. That is not the sole concern I have. In addition to that, when I look at this survey, the questions that were asked were quite vague and the multiple choice answers that were provided were drafted in such a way that the party in power could interpret those answers to the secure findings it desired. It was unclear and therefore unhelpful, if we really are going to respect the voices of Canadians.

However, the fact that this survey was so unhelpful goes to show that the current government was not interested in hearing from Canadians. The current government was interested in pushing through its agenda and therefore being able to twist and manipulate the survey data to its end, which is absolutely wrong.

It is wrong, because it goes against the very essence of this place, which is 338 common people representing common people. This place exists for us to deliberate the issues that matter most in our country and to speak up on behalf of Canadians. Unfortunately, what we have before us is a bill that represents the Liberal agenda rather than the voices of the Canadian people. This is wrong.

With legislation of this magnitude, I would urge the members of the House to slow the process down, to consult extensively and for us to come back to the table.

I cannot think of another responsibility we carry as legislators that is more crucial, more obligatory than our duty to protect the most vulnerable in Canadian society. Therefore, we have to take every effort to alleviate any possibility for abuse or misuse based on what is in this bill or based on what is left out of the legislation.

My Conservative colleagues have raised many concerns and have given multiple examples where extreme liberties have been taken with physician-assisted suicide where there are looser restrictions in place. I do not wish to rehash all those examples here today, but I certainly will draw the House's attention to a few.

Sadly, members across the floor have disregarded many of those examples provided by my Conservative colleagues. They have suggested that the differing jurisdictions and rules should deem these cases irrelevant in this place.

We have the opportunity and even the duty to learn from other countries and the way they have legislated, to learn from cases within our own country and to make changes that are necessary to properly protect Canadians.

It is undeniable that as one's medical condition progresses, the individual inevitably become more vulnerable. It is our responsibility to stand up for the vulnerable.

Individuals could lose their ability to speak, to move autonomously or they could lack the coherent and cognitive ability to be able to interact correctly. When an individual reaches this state, this is precisely when the safeguards around MAID, medical assistance in dying, should be strong enough to keep them safe rather than weak enough to make them vulnerable.

The proposed change in the bill would allow for advance directive, which takes away the need for the patient to consent immediately before having medical assistance in dying administered. This proposed change is alarming and dangerous as well to the Canadian public.

When we are faced with difficult physical ailments, they often fluctuate in intensity and as they do, our decision-making ability shifts. Think for example about people who are suffering from terminal cancer. They have been advised by medical professionals that their quality of life is likely to deteriorate to a certain degree by a specific date. Let us say that does not happen. Those cancer patients who want to avoid unnecessary pain have already given the date on which their lives will be terminated.

Changes take place. What if the diagnosis the doctor gave was not right? What if those patients have actually fared much better? Health care professionals could in fact euthanize these individuals at any point without needing to obtain consent immediately before death is administered.

This should concern all of us because of the vulnerability that is in place here. There should be a requirement for contemporaneous consent. We cannot allow one's former self to dictate the will of his or her present self. Minds change, circumstances change, so final consent is an absolute necessity.

This example has been raised in the House at least once before, but it is worth raising again because it is close to home.

Taylor Hyatt is a staffer on the Hill. I had the opportunity to interact with her personally. She has a linguistics degree from Carleton University. She lives on her own and she loves her life. Taylor has cerebral palsy and is restricted to a wheelchair. She lives an incredible life and contributes to Canadian society in a multitude of ways.

Two years ago Taylor went to the hospital because she was feeling quite ill. The doctors did some tests and they said that whatever it was it really was affecting her breathing, and if it came to it, should they administer oxygen.

Taylor was quite surprised at the question. Of course she would want oxygen, that seems like a very basic thing. It is not like it was life support or something that people often take, those decisions of that magnitude, quite seriously. It was the simple administration of oxygen. A few seconds later, the doctor asked "Are you sure?", and he said it in such a way that he was actually applying pressure on her to reconsider her decision, as if to say that her life lacked the value that she felt it had.

That is atrocious. If we are sending that message to the most vulnerable in our society, then what have we become?

I would like to also address one other thing, and that is the need for palliative care. If we are going to talk about administering death to Canadians, then why are we not having a conversation around long-term care? If we are going to talk about the dignity of a human life, then what about those who want to live a dignified life right up until their last breath?

Why is the government not moving forward with the plan it promised to put in place with regard to palliative care? Why is it not spending the money that needs to be spent on preserving the dignity of those who wish to choose this type of death? These are essential questions with which the House must wrestle.

I would caution those within this place to take a step back, because we want our country to be one that supports all people.

[Yasmin Ratansi, Liberal, Don Valley East, ON]

Mr. Speaker, I am pleased to rise today in support of Bill C-7, which proposes amendments to the Criminal Code's medical assistance in dying regime, in response to the Superior Court of Québec's Truchon decision. I will provide the context for the change.

As we know, in September 2019, the Superior Court of Québec struck down the federal and Quebec criteria that limit the access to MAID based on circumstances where death is reasonably foreseeable. The court, whose ruling only applies in Quebec, suspended its declaration of invalidity for six months, until March 11, 2020. On February 17, the Attorney General of Canada filed a motion to request a four-month extension to give Parliament the time needed to implement a response and ensure that the law across the country is consistent as it relates to the federal MAID regime.

I will provide a brief overview of the amendments to the Criminal Code that are being proposed under Bill C-7.

First, on the eligibility criteria, the bill would repeal the reasonably foreseeable natural death criteria and exclude persons whose sole underlying medical condition is a mental illness. Second, with regard to safeguards, the bill would create two sets of safeguards, depending on whether a person's death is reasonably foreseeable, while easing some existing safeguards and adding new ones for persons whose death is not reasonably foreseeable. Finally, the bill proposes to allow for a waiver of final consent on the day of the procedure in specific circumstances.

How did these changes materialize? The development of this legislation was informed by the Truchon decision; available Canadian and international reports, such as the December 2018 report of the Council of Canadian Academies; the experience of existing international regimes; and our government's recent consultation on MAID, held in January and early February.

The Minister of Justice, the Minister of Health and the Minister of Employment, Workforce Development and Disability Inclusion, along with their parliamentary secretaries, hosted several federal MAID round tables across the country. These events were attended by experts and stakeholders, including doctors, nurse practitioners, representatives from health regulatory bodies, legal experts, representatives of the disability community, indigenous representatives and other key stakeholders. They shared their experience and insight into MAID and its implementation in Canada over the last four years.

In parallel to these efforts, our government heard from over 300,000 Canadians who participated in the online public survey on MAID between January 23 and 27, 2020. There was an unprecedented number of respondents, reflecting the significance of this issue for Canadians. This kind of input is invaluable to government and, I am certain, was seriously considered by the ministers in the development of the bill.

I would like to provide a personal perspective on the issue of MAID in its previous iteration.

In 2015, when the Liberal government came to power, it was tasked by the Supreme Court to amend MAID. A special joint committee was established, involving both Houses and all parties. The special joint committee conducted an enormous amount of consultation and came up with a proposal. The then minister of justice and minister of health were presented with this proposal. Through intense discussions and consultations, the proposal was amended.

In my riding of Don Valley East, I did a consultation in the sanctuary of the Donway Covenant United Church. Various constituents, as well as other members from across Toronto, participated in the town hall. Members of CARP, the Canadian Association of Retired Persons, were also on the panel. It was an emotional meeting. I clearly remember one of my constituents, who was non-verbal and had to use her communication board, telling me that she wanted advance directives while she was lucid but could not predict whether she would be lucid in the foreseeable future.

In 2019, I had to do another presentation at a church in another riding. Here, overwhelmingly the audience was against the phrase “foreseeable future” and also wanted advance directives.

I am glad to see that some of the changes requested through consultations have now been incorporated. I look forward to the five-year review that is scheduled for June 2020 to see the discussions around advance directives.

I will now go to the bill itself and some of the changes it proposes to the eligibility criteria.

With regard to the proposed Criminal Code amendments in relation to eligibility, the bill proposes to make two changes to the current set of eligibility criteria for MAID. First, it would repeal the reasonable foreseeability of natural death criteria from the list of eligibility criteria in response to the Truchon ruling. That is good news for some of my constituents in Don Valley East. The legal effect of this amendment would be that those whose natural death is reasonably foreseeable and those whose natural death is not reasonably foreseeable would be eligible for MAID if they met all other eligible criteria.

Second, the bill proposes to exclude people whose sole underlying medical condition is mental illness. Many practitioners, stakeholders and experts have identified increased complexities regarding individuals seeking MAID whose sole underlying condition is mental illness. I suggest that this could be an item for Parliament to look at it in its upcoming mandatory five-year review of the MAID regime.

The Council of Canadian Academies' experts group issued a report in 2018 on the same issue and could not come to a consensus on this question. The Government of Quebec has also announced that access to MAID for cases where mental illness is the sole underlying condition would be suspended and that a broad consultation process would be conducted on this issue.

Regarding safeguards, the public needs to know some of the safeguards that will protect the vulnerable. With respect to the applicable safeguards proposed, the proposed Criminal Code amendment would create two different sets of safeguards depending on whether a person's natural death is expected in the near term or not. The first set of safeguards would continue to be tailored to persons who have a reasonably foreseeable death where risks are reduced. The second set of safeguards would be tailored to persons whose death is not reasonably foreseeable and would address the elevated risks associated with the diverse sources of suffering and vulnerability that could lead a person who is not nearing death to seek access to MAID, such as loneliness, isolation, lack of adequate supports and hopelessness.

Bill C-7 proposes to use the reasonable foreseeability of natural death standard to determine which set of safeguards applies to a particular case. This standard would also determine whether a person who is assessed and approved for MAID but who risks dying before the day of the procedure can give consent in advance. I will be discussing that proposal shortly.

How will these safeguards be applied? Specifically, it would require that a MAID request be witnessed by one independent witness instead of two, and it would allow individuals who are paid to provide either health or personal care to act as an independent witness.

On the advance consent or directives, the bill proposes amendments that would allow people who have a reasonably foreseeable natural death, and who have been assessed and approved for MAID, to retain their ability to receive MAID if they lose the capacity to consent.

The bill represents a significant paradigm shift in Canada's legal landscape with regard to medical assistance in dying. I call on members to support this important legislation and send it to committee for further review.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

Mr. Speaker, as parliamentarians it is incumbent upon us to draft responsible legislation that protects the sanctity of life, protects those contemplating suicide and protects vulnerable peoples. These are principles that were outlined in the preamble to Bill C-14, the landmark legislation that governs assisted dying in this country. These are principles that, although largely restated in Bill C-7, are being watered down and undermined by this legislation.

As recently as the early 1990s, in the landmark Rodriguez case, the court ruled that there was no constitutional right to assisted dying in this country. The Carter decision overruled that previous decision, and now Parliament has the difficult task of balancing the autonomy of Canadians with our responsibility to create safeguards for vulnerable Canadians. It is one of our most sacred responsibilities to protect the lives of our citizens. We need to get laws on assisted dying right.

The adoption of medical assistance in dying after the 2015 election is an event I am very familiar with. I had the honour of serving under the member for St. Albert—Edmonton as he took the lead as the Conservative vice-chair of the Special Joint Committee on Physician-Assisted Dying. During this time, I was involved in all aspects of the committee that was making recommendations on a new law. I heard from all the witnesses, and I listened to all deliberations regarding what direction our country should take.

That committee recommended a radical departure with very few safeguards. These recommendations did not reflect the testimony of experts, but instead the political agenda of special interests.

The Conservative minority report provided at the joint committee was entrenched firmly in the principles of the Supreme Court's decision in Carter, and included recommendations that were laid out by key witnesses, such as the former president of the Canadian Psychiatric Association, Dr. Karandeep Sonu Gaind. It outlined key principles for us on the issue of physician-assisted dying.

These included not accepting the provision that assistance in dying be provided to those under the age of 18, in line with the Carter decision, which stated that only competent adults should be allowed access to assisted dying. We also did not accept the extension of medical assistance in dying for those suffering exclusively from mental illnesses. We did not believe that any mental illness is irremediable, as the Canadian Psychiatric Association stated.

We also did not believe in the validity of advance directives to allow Canadians to consent to an assisted death far in advance of its administration. This change would stand opposed to the express will of the Supreme Court of Canada, which ruled that consent must be contemporaneous with the time of death.

We also recognized the lessons of the Quebec experience, as the first jurisdiction in this country to legalize euthanasia. In its regime, medical assistance in dying could only be rendered on adults with a severe, incurable physical illness, characterized by an advanced state of irreversible decline.

I believe many Canadians can sympathize with this limited exception for assistance in dying; however, even these safeguards have proved to be short-lived. Barely five years later, the courts and the government have decided that these safeguards are far too restrictive.

How did we get here today? Barely had the ink dried on Bill C-14 before proponents of expanded assisted dying launched their campaign to eliminate necessary safeguards.

As a Conservative who strongly believes in the sanctity of human life, Bill C-14 was a difficult pill to swallow. However, it was one that I believed upheld many of the values that I hold and the values that many of my constituents hold.

The previous legislation recognized that we must tread carefully with this new reality of assisted dying. It introduced safeguards that limited mature minors, those with exclusively mental illnesses and those whose deaths were not reasonably foreseeable.

I believe this is where the majority of Canadians are, and I believe the government largely got the balance right under Bill C-14. Unfortunately, there are a radical, vocal few who want to undermine even these protections and push this country headlong into a permissive regime for assisted dying, a regime that, as we know from international experience, has resulted in the deaths of vulnerable people.

If we continue to go down this road and liberalize all safeguards, we will continue to see mistakes and deliberate actions that end the lives of vulnerable people. This new legislation outlined in Bill C-7, although not taking these large, radical steps that I outlined, is opening the door to a wider radical departure from principles like the protection of the vulnerable and the sanctity of human life.

I am particularly concerned about the inclusion of the term and policy of advance consent.

The Supreme Court of Canada was very clear, crystal clear, that an assisted death should only be administered with the consent of a person at the time of death. We know that there are some cases where people fear losing their capacity to end their lives. However, we cannot allow the precedent of advance consent to gain legitimacy in our system. Advance consent in this legislation I believe is a Trojan horse designed to build the legal case to accept the adoption of advance directives.

Advance directives are a concept by which people can direct the actions of medical professionals after they have ceased to have the capacity to consent to an assisted death. Many Canadians are familiar with DNRs: do-not-resuscitate orders. DNRs are a completely ethical and morally acceptable practice, whereby a patient can designate that no action should be taken to attempt resuscitation. By respecting the will of the patient and not acting, medical professionals are allowing the patient to die a natural death. Medical professionals can also hasten the natural death of their patient through pain remediation. I believe this is also an acceptable practice.

I support do-not-resuscitate orders, and I think many Canadians are being deliberately misled into believing that an advance directive is the moral and ethical equivalent of a DNR. It is not. An advance directive does not ask medical professionals to withhold action allowing a natural death. It requires medical professionals to take direct action to immediately end the life of the patient.

This is a leap in practice that goes far beyond what I believe is ethical. It undermines one of the greatest medical principles: first, do no harm. I can imagine, in a not-so-distant future, someone with dementia or Alzheimer's who had previously written an advance directive, believing that life would be not worth living with this disease. Imagine in the future that we had the medical expertise and the breakthrough pharmaceuticals that could make life better for those suffering. How can someone consent to have life end without contemporaneous consent at the time of death, when they cannot know what their quality of life will be?

It introduces a high level of subjectivity to the question about what kind of life is a life worth living. This is a dangerous question that will lead us down a lethal road, a road that I do not think anyone wants to go down today. I believe it is unethical and dangerous to allow someone's life to be ended by an advance directive or consent, even with the meagre protections offered in Bill C-7, which includes a provision that no resistance be shown. There is still a threat of abuse. If people are unable to understand and consent to death, how are they supposed to know to resist when someone comes to administer their death?

Parliament is being rushed into liberalizing a practice that is not even half a decade old. Its members lack the experience, the data and the moral understanding to press forward with such a life-and-death issue. I am disappointed that the government abdicated its responsibility to stand up for vulnerable people when it chose not even to appeal the Quebec court's decision to the Supreme Court of Canada. What better court to clarify what safeguards are acceptable than the very court that originally dealt with these significant matters?

Instead, the government has given Parliament little time to contemplate such an important issue. Canadians are still catching up to the reality of assisted dying being legal in this country, and now we are foolishly pressing forward before we can fully understand the impacts of this legalization.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

Mr. Speaker, I rise today to address Bill C-7, an act to amend the Criminal Code, medical assistance in dying.

Assisted dying is the leading moral and ethical issue of our time. Previously respected traditions supporting the sanctity of all human life until natural death have been tossed aside, most recently with the Supreme Court's decision in the landmark Carter case.

As parliamentarians, it is incumbent upon us to draft responsible legislation that protects the sanctity of life, protects those contemplating suicide and protects vulnerable peoples. These are principles outlined in the preamble to Bill C-14, the landmark legislation that governs assisted dying in this country. These are principles, although restated largely in Bill C-7, that are being watered down and undermined by this legislation.

As recently as the early 1990s, the Supreme Court ruled in the Rodriguez case that there was no constitutional right to assisted dying in this country. The Carter decision overruled that previous decision, and now Parliament has been tasked to take on the difficult task of balancing the autonomy of Canadians with protecting vulnerable people.

The House resumed consideration of the motion that Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

Alleged Premature Disclosure of Private Member's Bill

[Rob Moore, Conservative, Fundy Royal, NB]

Mr. Speaker, the hon. member mentioned that he did not want to waste the time of the House, yet he went on, when we are debating medical assistance in dying, on a question of privilege about a private member's bill. I would point him back to earlier this week when the entire contents of Bill C-7, medical assistance in dying, was in a CP story the morning before the bill was introduced. This is just for his reference.

Criminal Code

[Majid Jowhari, Liberal, Richmond Hill, ON]

Mr. Speaker, it gives me great pleasure to once again rise in this House and speak to Bill C-7, an act to amend the Criminal Code (medical assistance in dying). This bill proposes amendments to the Criminal Code provisions on medical assistance in dying, or MAID, in response to the Superior Court of Québec Truchon decision, which struck down the eligibility criterion that natural death be reasonably foreseeable.

I would like to highlight five major components that stood out for me.

First, it repeals the condition that a person's natural death be reasonably foreseeable, with the exception of patients whose sole underlying condition is mental health issues.

Second, it introduces new safeguards in addition to existing ones for patients whose natural death is not reasonably foreseeable.

Third, it permits the waiver of the requirement for final consent, allowing patients to provide consent to health care practitioners in advance, in the event that their death is naturally foreseeable and they are at risk of losing capacity to consent.

Fourth, it permits the waiver of the requirement for final consent if a patient chooses MAID by self-administration, in case complications arise following self-administration, such as a loss of capacity.

Fifth, it modifies the MAID monitoring regime to require that health care providers and pharmacy technicians provide regulated information when assessing a patient's eligibility or when dispensing a substance for MAID.

Over the last two days, many of my colleagues from both sides of this House intervened on a fair number of details. It gives me great pleasure to see that there is broad agreement that this legislation, with these amendments, gets voted in and move to the committee for further study.

I rose in this House during the 42nd Parliament back in 2016, and shared my experience, which dealt with the tragic loss of my father as a result of stage 4 cancer back in 2014. Such assistance was not available to us and we saw the loss of dignity. We saw the loss of the person I called “my hero” losing the capacity to be able to function and lead our family, as well as the fact that his desire would have been met, had we had this type of assistance available.

Also, as the chair of the all-party mental health caucus, I have been advocating, and our caucus has been advocating, for the consideration of mental health and the exclusion of that. I am pleased to see that that remains.

As I was listening attentively to the interventions over the last two days, at times there were questions raised about why it took so long. Considering that, and considering that we are almost halfway through this debate, I decided to focus my intervention mainly on the journey that our government has gone through over the last four years. The key concepts within that journey are the challenges that we are faced with; the stakeholders that we engaged with; the consultations during the studies; and the implementation, successes and challenges we have had.

Having said that, since the introduction of the legislation for medical assistance in dying in 2016, we have witnessed a steady increase in the number of Canadians and health care providers who have adopted this new regime. We have seen a relatively smooth integration of MAID assessments and delivery in end-of-life care service available across the country.

The enactment of this historic legislation was just the beginning of our efforts. Our government has since been very active in supporting the implementation of MAID across Canada. The 2016 legislation included clear directives for action, including the need for government to initiate independent reviews on three complex issues not addressed in the bill back in 2016. Some of my colleagues before me touched on those complex issues.

Rather than proceed too hastily, Parliament felt that it required more study and a review of available evidence. The government tasked the Council of Canadian Academies with undertaking these studies and that is where the journey started.

The resulting report tabled in Parliament in 2018 reflected an extensive review of academic and policy research, stakeholder submissions and international expertise in all three areas. It documented a range of perspectives from health care professionals, academic disciplines, advocacy groups and indigenous leaders; hence, the stakeholders that we have engaged with. We expect dialogue on these issues to continue during the parliamentary review and, as I have indicated, I hope that everyone in the House votes for this so that we can move it to committee and continue this dialogue.

Taking into account our federal system and division of responsibility for health care and criminal law, the federal government developed the monitoring and reporting regime to collect valuable information about requests for and the provision of MAID. In all other jurisdictions permitting assisted dying, there is an oversight and monitoring mechanism in place. The roles and responsibilities of these monitoring regimes vary.

In the wake of this monumental shift toward legalized assisted dying, Canadians wanted to know what kind of uptake there would be. Some were keen to know how accessible MAID would be across this vast country. Others want to know how safeguards would be applied and if there were protections in place for the vulnerable. Our government worked quickly with the provinces and territories to establish an interim reporting system, collecting and reporting on the best data available.

I want to acknowledge our provincial and territorial partners that had the challenging task of arranging safe access to MAID services from scratch, in a short period of time and in collaboration with multiple partners, such as health care providers, professional associations and health care delivery institutions. This tremendous task involved setting standards of practice for physicians, nurse practitioners and pharmacists to support the consistent and safe delivery of MAID within a legally sound framework. It also helped minimize the disparity to access in rural and urban areas.

Our government produced four interim reports using data voluntarily transferred by providers and various jurisdictions from 2016 until the creation of the permanent regime in late 2018. These reports covered a six-month period and provided information on the number of MAID deaths, patient demographic information, underlying medical conditions and predicted MAID requests.

In reviewing these reports, we know that the awareness of MAID as a legal option is growing. There appears to be a growing comfort among health care providers. In the interim period, our government worked to establish a permanent national monitoring and reporting system as considered in Bill C-14.

Through stakeholder consultation and collaboration with provinces and territories, the government enacted federal monitoring regulations in late 2018. These regulations set out the reporting requirements for all physicians, nurse practitioners and pharmacists who participate in MAID. We were mindful of balancing the need for information while limiting the reporting burden on health care providers and avoiding duplication of effort. This system has been operating for just over a year. Late this spring, our government plans to release the first annual report using data from this new monitoring system.

Budget 2017 announced $11 billion over 10 years to support home and community care services, including palliative care, mental health and addiction services; $6 billion was specifically allocated to those services I talked about. In 2019, our government worked with all the provinces and territories to develop the framework for palliative care in Canada, which I consider a cornerstone of this bill.

Over the last three and half years that MAID has been available, our government has worked to support a smooth integration into the health care system based on the foundation I have just laid out. On the evidence that we have gathered, we have put together a bill that represents the Truchon decision and addresses other issues where there is clear consensus and a reasonable path forward. It is my hope that, after due consideration and debate, we move this bill to committee.

I will close by saying that I support this bill and I thank all members for intervening on this topic.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Mr. Speaker, I am here today to talk to Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying.

It is very interesting for me to be here in a new Parliament discussing something we spoke about in the last Parliament. I was a fairly new member when Bill C-14 was before the House. I had a lot of constituents calling my office, sending letters and emailing us on this very important issue. I spent a lot of hours responding to people, talking to them on the phone and hearing their stories. What I really respected was the thoughtfulness. There were concerns of course, which is legitimate, but there was a lot of hope for some people as well.

Here we are back at it again. It reminds me of a dear friend and loved one who used MAID in his journey. His name was Joey. When I think of the core issue and value we are discussing today, which for me is unnecessary suffering, I cannot help but think of Joey.

Joey had an illness that was slowly killing him. In fact, it was so painful for him that he made this decision. He rearranged his time of death so I could be there with him, which was a huge honour for me. I was so grateful for that.

I think about the process we went through together that day. It was a beautiful process, but it was also a hard process. Part of the reason why it was so hard was he could not take any of his pain medication that day. He had to be totally able to answer that question. After a lot of thoughtful discussion, he had to stay in pain all day. We spent the day with him, but it was hard to see him suffering.

When we look at the bill before us today, that is what I hope all Canadians and all parliamentarians remember. We are here ensure nobody goes through unnecessary suffering like that.

One of the things that really struck me about the day when Joey passed was his doctor came to be part of the process. His doctor had made a decision that he did not want to be in a role to administer MAID, but he came. There were a lot of tears and remembrance of the long-term relationship. We also have to talk about the length of time some of our doctors have known us. Some have known us for years in some cases, and in Joey's case that was the reality. Another doctor was there for the process, but Joey's doctor was with him. His loved ones were around him. It was a peaceful process when he left us.

Today we are here to do this important work. I hope this goes to committee. I have had discussions with doctors in my riding who administer this process and they have a lot of good things to say about the bill, as well as some concerns they would like addressed, and I hope that will happen.

As this process started, a lot of people started writing my office again. We did some outreach. We wanted to let people know that this would be coming up. We wanted them to know that there was a process for them to connect with us and give their feedback to the government on this issue. A lot of my constituents participated in the process online. Not only did they participate, they were very thoughtful to ensure that the information they submitted was also given to my office. In front of me, I have a small portion of the comments from the people who sent us information and shared their stories.

I want to be clear about something, and we have to remember this as we go through the legislation. I represent a rural and remote community. The doctors who provide this service sometimes spend the whole day travelling to the community to provide this very important service.

There are some specific barriers and we want to ensure that in all our legislation we do not let those people in rural and remote communities down.

There are three of these doctors in my region. The riding I represent is just under 60,000 square kilometres, it has several ferries and many small islands. The doctors in that area provide the total service for that area plus a portion of my neighbour's riding. They deliver the service to a huge number of people over a vast distance.

Message after message thanked those doctors. In fact, Dr. Daws, a doctor in my riding, was mentioned repeatedly for being compassionate and for helping people go through this process in a very respectful way. People wrote me before they were going to participate in MAID. They just wanted tell me that this doctor had been very helpful.

I want to recognize the amazing health care providers in our country who provide this service, who do it in a sensitive and beautiful way. They are with people at one of the most precious moments.

I want to talk about Margaret who told us about her nephew. Her nephew had participated in MAID and that this was his decision. The biggest issue for her was the lack of the advance consent clause. He was given a choice of either going through this process two months earlier or not at all. Due to the medication he would have to take for his illness, it would automatically disqualify him from having the capacity to provide the consent.

This is the biggest issue for me, because people were having to leave sooner than they wanted to because they were afraid they would lose the capacity to give their consent.

I think of Megan who wrote about the experience her family went through. They were present for a friend's death. She said:

I fully support the idea of giving prior consent for MAID in case one is unable to give that consent immediately prior to the procedure, or in case one is in considerable pain and discomfort and would go through the process more calmly with adequate pain control at the end.

This really resonated with my experience with Joey, watching him suffer physically, and waiting for the relief. It was really hard. This is so important as we go through this process.

I think about Dolores, who sent me a beautiful message about ensuring the process was clear for people, wanting to have the accessibility to this be very clear and easy, and in an information package. Her biggest concern was that her family physician did not believe in this process and would not give her the information she needed to make the decision. She said that it would be good to have an information package that was a little more effective, so when a doctor was struggling with that personal choice, it would not impact the patient.

As a parliamentarian, these are the moments when I really respect the role I have on a whole new level, when people are telling me about the precious experiences they have had in their lives.

Another family talked about its father-in-law who spent seven years with dementia and was very well cared for, but in his last year, he rapidly deteriorated. His dignity plummeted. A loving son said that he was convinced that if he could have projected how his final years of deterioration would happen, he would have chosen MAID as an option, if it was available to him.

Then there is Milt whose wife is in a care home. Because of her Alzheimer's, she will not be able to express herself. He is so concerned that she will suffer way too long and he does not want to see that.

Another family talked about a friend who had cancer of the brain. Then she had a stroke. After her stroke, she was concerned that if she had a second stroke, she would be unable to state her wishes. Because of that, she participated in MAID sooner than she would have wanted.

This is a precious decision people make. It is a decision they make with their loved ones and their health professionals. I will be supporting the bill because I do not believe in people suffering unnecessarily. There are some challenges in the bill that I hope are clarified, especially looking at the realities for rural and remote communities. However, when people tell these personal stories, we hear again and again that they do not want to see people suffer, that they do not want to see people lose their dignity and that they want to ensure their wishes are honoured.

I am happy to be here to talk to the bill. I want to thank all of my constituents who have reached out to me. I always appreciate these beautiful stories that people share and some of the hard ones.

[Kamal Khera, Liberal, Parliamentary Secretary to the Minister of International Development]

Mr. Speaker, it is an honour to rise in this House to speak today about Bill C-7. This bill would amend the medical assistance in dying regime in the Criminal Code to address the Superior Court of Québec's decision in the Truchon case. As members know, in September 2019, the Quebec Superior Court struck down the eligibility criterion of “reasonably foreseeable natural death” from the medical assistance in dying, or MAID, regime in the Criminal Code. Our government has made significant efforts to consult and engage with Canadians in order to inform the proposed approach to address this decision and amend the MAID regime in Canada.

An online consultation was launched, and over 300,000 responses were received from Canadians. In addition, the Minister of Justice and Attorney General of Canada, the Minister of Health and the Minister of Employment, Workforce Development and Disability Inclusion had the opportunity, along with their parliamentary secretaries, to meet with stakeholders and experts across the country during a series of round tables all over Canada. These consultations were an extremely important part of the development of Bill C-7.

Medical assistance in dying is a sensitive and challenging social issue that we are currently faced with, one that is deeply personal for very many people and for me personally. I worked as an oncology nurse at St. Joseph's hospital in Toronto and have seen end-of-life care first-hand. I have seen individuals making difficult end-of-life decisions for themselves or their loved ones, and I appreciate our government's decision to consult and listen carefully to Canadians on this issue.

In addition to being deeply personal, the issue of medical assistance in dying is also legally and ethically complex, which is why it was so important for our government to meet with experts, stakeholders and practitioners during the round tables. Our government listened. It listened to the health care experts, doctors, nurses, legal scholars and regulators, but most importantly, it listened to Canadians. The bill takes into account what was learned during these consultations and responds to the Truchon ruling by proposing amendments to the Criminal Code that would ensure consistency of the MAID law across the country by broadening eligibility, and adjusting the safeguards accordingly, for a MAID regime that is no longer limited to end-of-life circumstances.

Bill C-7 proposes to amend the Criminal Code in response to the Truchon ruling in three ways.

The first is by expanding eligibility to those whose natural death is not reasonably foreseeable but who are still experiencing intolerable suffering. This will give those who are suffering in a wider range of situations the choice of a medically assisted death.

At the same time, the amendments would exclude those suffering from only a mental illness. This is in response to very specific concerns voiced by experts and mental health professionals about eligibility on the basis of a mental illness. Many members will also recall that during the study of former Bill C-14, the government asked the Council of Canadian Academies to look into such cases. The experts in this field could not come to a consensus on this very complicated issue in their report on the subject, which was released and tabled in this chamber in December 2018.

Our government recognizes that the unique considerations for the availability of MAID for individuals experiencing suffering only from mental illness requires further discussion and public debate. I believe the parliamentary review that will begin in June 2020 is the appropriate forum for the further consultation and deliberation that are needed before considering any changes in this regard.

The second main feature of this bill is the creation of two sets of safeguards to be followed before medical assistance in dying is provided, depending on whether a person's natural death is reasonably foreseeable or not.

The bill would continue to use the expression “reasonably foreseeable natural death” as the element that determines which safeguards to use. This approach for a MAID request is consistent with the view that medical assistance in dying for people whose natural death is not reasonably foreseeable presents more complexity. Many experts believe that the assessment of a request should be tailored to these different types of cases.

New safeguards for those whose natural death is not reasonably foreseeable will focus on ensuring that assessments take adequate time and involve the relevant expertise to detect and address the sources of the person's suffering. They will also ensure that people receive information about the appropriate and available services and options to improve their quality of life. They will need to give serious consideration to those options before concluding that medical assistance in dying is the choice for them.

Finally, the bill would relax some of the existing safeguards, in particular for those whose natural death is reasonably foreseeable. Those whose deaths are reasonably foreseeable will not need to undergo the 10-day reflection period. These individuals have already given a lot of thought to their request before they made it, and requiring them to wait another 10 days after they have been approved for medical assistance in dying may prolong their suffering unnecessarily.

Just as importantly, the bill proposes to permit the requirement of final consent to be waived in the case of people whose natural death is reasonably foreseeable when certain conditions are met. These conditions are that the patient's death must be reasonably foreseeable; they must have been assessed and approved for medical assistance in dying in accordance with all safeguards; they are at risk of losing decision-making capacity before their preferred date to receive medical assistance in dying; and they have a written arrangement with their practitioner, in which they have given consent in advance to medical assistance in dying being administered if they lose capacity, and in which the practitioner agrees to provide medical assistance in dying on their preferred date, or earlier, if they can no longer provide the final consent.

These proposed amendments would also clarify that practitioners would not be allowed, in this situation, to provide medical assistance in dying if the patient demonstrates refusal or resistance by words, sounds or gestures.

For individuals whose natural death is not reasonably foreseeable, the remaining criteria defining the grievous and irremediable medical condition in the Criminal code would expand eligibility to medical assistance in dying to people with a wide range of conditions. A grievous and irremediable medical condition is defined in the code as a serious and incurable illness, disease or disability; an advanced state of irreversible decline in capacity; or intolerable suffering that cannot be alleviated under conditions that the person considers acceptable.

This means that a grievous and irremediable medical condition could include conditions producing chronic pain or other symptoms. Canada's medical assistance in dying regime would move away from being an end-of-life regime to becoming a regime in which MAID could be chosen to relieve unbearable suffering that occurs outside of the dying process.

To conclude, the bill before us today proposes the amendments required by the Truchon decision. It also reflects what we heard in 300,000 responses to the online consultation. This is what we heard from stakeholders when the ministers and parliamentary secretaries held consultations from coast to coast to coast. It takes into account the opinions and input of health care professionals, doctors, nurses, legal scholars, provincial regulators, civil society, non-governmental advocacy organizations and those with lived experiences. The bill strives to achieve a balance between respecting personal autonomy and protecting vulnerable individuals. Perhaps most importantly, it respects the equality rights of all Canadians.

For those reasons, I call on the members of the House to support this bill, send it to committee where it can be looked at even more thoroughly and make this a reality in Canada.

[Brad Redekopp, Conservative, Saskatoon West, SK]

Mr. Speaker, today I rise to speak on Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying.

My office has received about 135 phone calls, emails or letters so far on this issue, and I recognize that this is a very touchy, personal and non-partisan issue.

I will begin with a quick bit of history. The MAID legislation came into law in June 2016. Recently, one judge in Quebec ruled that the wording in the legislation on “foreseeable death” was too restrictive. The Liberal government was very quick to accept this ruling. It chose not to appeal, and instead moved to rewrite the legislation taking into account the decision of the court.

This caused me to compare this ruling to the recent Alberta court ruling in which four judges found the carbon tax to be unconstitutional. It made me wonder if the government is going to be as quick to accept the Alberta court ruling as well and not appeal it, but that is a digression.

As I said, MAID is a very touchy, personal and non-partisan issue. One can always find examples of people for whom MAID legislation is a difficult but welcome option. Unfortunately, those simple examples are usually in the minority. Far more often, it is much more complicated than that. The stories I have heard reflect these complications, such as the case where families are caught by surprise with a death and then forced to deal with the aftermath of that.

There are cases where a person is at a particularly low point in their health but, under this proposed legislation, would be able to request and receive MAID with no waiting period. There are cases where physicians or hospital officials apply pressure on individuals to consider MAID. For example, Roger Foley, an Ontario man who is suffering from an incurable neurological disease, said that the medical staff repeatedly offered him MAID, despite his repeated requests to live at home.

There is also the B.C. case of Ms. S. Dr. Wiebe lamented the profound suffering of Ms. S. but felt that Ms. S. was not eligible for an assisted death. Then, unfortunately, Ms. S. decided to starve herself. Dr. Wiebe and another doctor then determined that, due to the severe malnutrition and dehydration of Ms. S., her natural death was reasonably foreseeable, so Dr. Wiebe euthanized her on March 2017.

According to a Globe and Mail article, this case is the first to be made public in which a medical regulator has ruled on the contentious question of whether doctors should grant assisted death to patients who only satisfy all the criteria of the federal law after they have stopped eating and drinking.

It is not difficult to imagine a situation where a hospital will, for reasons of efficiency, encourage its staff to suggest MAID to patients with chronically difficult and complex cases. It is not a simple problem. It is a very complex problem.

What bothers me about this is that the government is pre-empting the parliamentary review process that was specified in the legislation. We know that the current justice minister voted against the party on the original legislation because he felt that it did not go far enough. Now, as justice minister, he is able to make the changes that he desired. This is troubling, because he is choosing to pre-empt the legislated review process and get his desired changes into legislation without consultation.

The existing law mandates the review of the legislation every five years, and the review will happen in just a few months.

Why is the government is such a rush to make substantive changes to this legislation and pre-empt the legislated review process?

To me, it makes far more sense to deal with the specific issue raised by the Quebec judge only, then do a proper consultation with Canadians this summer and propose changes based on that. Instead, the government had an extensive online survey that lasted two weeks. While it received a lot of responses, I think it just proves that there is great interest, and Canadians have a lot to say about this issue. So far, the results of these responses have not been shared, and I ask for these responses to be shared. I call on the government to do the right thing and leave any changes beyond what the Quebec judge has asked for until the completion of the review process later this year.

Since we are talking about changes to this legislation, I want to talk about palliative care. There are calls for a pan-Canadian strategy on palliative care. I think it is convenient to point to the provinces and say that this is their problem, but there cannot be a full end-of-life strategy without funds and laws around palliative care.

The government broke a key election promise to invest $3 billion in long-term care, including palliative care. Access to palliative care is an essential part of end-of-life decision-making.

I have a personal example from Saskatoon, which has 12 palliative care beds for an area with over 300,000 people.

My mother-in-law had a terminal disease. In her case, MAID was neither requested nor desired. She was fortunate in that her death was relatively quick, and by some miracle she was able to get one of those 12 beds in Saskatoon.

It should not take a miracle to get good end-of-life care. It should not be that MAID is the only reasonable solution at the end of life because palliative care is not available. Therefore, I call on the government to put as much effort into palliative care as it has into MAID.

Another significant area of concern is conscience protection. Physicians and health professionals must be given strong conscience rights. They must be free to not participate and be free of penalty or harassment for making that choice. They must also be free to not be required to refer to another health professional. They must have full conscience protection.

Further, it must be recognized that the conscience objection of institutions must be protected. Institutions are not bricks and mortar. They are collections of people with values. Therefore, institutions must also be given the right of conscience protection. Several Supreme Court cases are instructive here.

The Supreme Court in 2015, in the Loyola case, stated:

Religious freedom under the Charter must therefore account for the socially embedded nature of religious belief, and the deep linkages between this belief and its manifestation through communal institutions and traditions.

In another 2015 decision, the Supreme Court stated:

A neutral public space free from coercion, pressure and judgment on the part of public authorities in matters of spirituality is intended to protect every person’s freedom and dignity, and it helps preserve and promote the multicultural nature of Canadian society.

We must respect the multicultural nature of Canadian society. We must respect both medical professionals and institutions, and allow them to have full conscience protections free from harassment and consequences.

There are some specific changes proposed that I am concerned about. The current legislation includes a 10-day waiting period between when MAID is requested and when it can be administered. The current legislation already allows for this waiting period to be waived. It states that if two medical practitioners:

...are both of the opinion that the person's death, or the loss of their capacity to provide informed consent, is imminent—any shorter period that the first medical practitioner or nurse practitioner considers appropriate [can be used] in the circumstances.

There already is a provision to deal with this issue. There is no need to make changes. The situation has been contemplated and addressed in the current legislation.

Another area of concern is the lack of safeguards for the mentally ill. Mental illness is a very complex situation. Patients diagnosed with an underlying mental health challenge are not required to undergo a psychiatric assessment by a psychiatric professional to determine whether they have the capacity to consent.

There is no one-size-fits-all solution to the issues of mental health. However, it is not difficult to imagine a scenario in which a person is in a particularly dark period and considers MAID. It may well be that with proper professional help that person can work through the darkness and emerge a bit better. This may not always be the case, but that is why having a general waiting period is so important. It eliminates the ability of medical professionals or others to make a quick decision that they regret.

A poll in January found that Saskatchewan and Manitoba had the lowest support in the country for MAID. In 2018, in Saskatchewan, only 67 of 172 applicants for MAID actually received medically assisted death. Some were declined, some withdrew and some died before the request could be completed.

In summary, I would make the following observations. Most importantly, in the words of a constituent I spoke with this week, “We need to slow this down, not speed it up.” Yes, we need to deal with the Quebec court decision, but that only requires one change. There is a legislated review that will happen this summer.

Let us wait for a proper consultation and use that lens to view any proposed changes. Let us have a pan-Canadian strategy for palliative care. Let us put full conscience protection in place for physicians and health care professionals. Let us put conscience protection in place for institutions. Let us leave the 10-day waiting period and the ability to create exceptions the way it is. Let us deal with the Quebec court decision and leave the rest until after the legislated review this summer. Let us slow this down.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Mr. Speaker, I will be sharing my time today with my colleague, the member for Saskatoon West.

As a new member of the justice committee, I look forward to the issues that we will be dealing with in this new Parliament. While I am not a lawyer, nor do I have any desire to become one, I hope my contributions and insight on the issues of the day will help in rebuilding trust in our judicial system.

I am fully aware that many Canadians have serious concerns. Many are looking for solutions that will keep our communities safe, and they want us to begin the process of rebuilding the public's confidence in our justice system.

The legislation we are dealing with today is about one of those issues that almost every Canadian has heard of and will be, undoubtedly, following in the news. As a member of the Conservative caucus, I can debate this legislation and vote on it as I see fit. It is my intent to improve this legislation and to do the best I can in representing the good people of Brandon—Souris.

Like many Canadians, I find discussing the implications of medical assistance in dying challenging. There is no sugar-coating the fact that, for many people, it is extremely difficult to openly discuss the issue of death. As a result of the Carter decision, it was left up to Parliament in 2016 to determine the appropriate legislative response in order to be compliant with section 7 of the charter. It must also be said that the Carter decision was specifically limited to a competent adult who gave her consent in receiving medical assistance in dying.

When we were seized with dealing with the legislation, many members of Parliament felt the government's response did not go far enough. One of the Liberal MPs who voted against the legislation was none other than the Minister of Justice. Some members were quite concerned about the lack of clarity, such as in the term “reasonably foreseeable”, which was left undefined. Other members wanted Parliament to supersede the Carter decision.

Disagreement is not new in this place. It is to be expected in Parliament, with members from all political stripes and backgrounds. I would argue that our democracy is much better served having such divergent views as to guarantee that every position is fleshed out.

When we debated Bill C-14, our Conservative caucus studied the legislation with the rigour that Canadians demanded of us. We asked the tough questions, we put forward amendments and we did what we were sent here to do, which was to ensure the concerns of our constituents were put front and centre. It is my sincere hope that we once again invest the necessary time on this and be as inclusive as we can so that all Canadians have their say on Bill C-7.

It goes without saying that there are deep divisions on the overall issue of medical assistance in dying. I know every member of Parliament is hearing from constituents on this issue, and in the past couple of weeks numerous petitions have been sent to all members' offices. I would also note that in the election, I received inquiries on the future of the legislation and on whether Parliament would be reviewing it anytime soon.

One of the elements in the original legislation was to have an automatic review, which will be undertaken this summer. It is notable that the legislation now before us has pre-empted the automatic review on a few matters. This upcoming review will be far more comprehensive than the two-week online survey used for Bill C-7.

From what many were expecting, the legislation that was set to be introduced was to respond to the Superior Court of Québec's ruling. We now know that this is not the case. In fact, yesterday during debate, the parliamentary secretary of justice acknowledged that the Liberals did go above and beyond, because that is what he thinks Canadians want. While that may be his opinion, it is concerning that the larger changes found within Bill C-7 could have been dealt with in the larger review this summer.

What we are debating today has numerous changes that go much further than deleting and replacing the phrase “reasonably foreseeable” in order to be compliant with the recent court decision. For example, the government is easing safeguards, which I might add is the actual language found within the presentation with which departmental officials briefed MPs.

As it stands, patients must make a written request for MAID that is witnessed by two independent witnesses. In Bill C-7, this has been changed to one independent witness. I believe it is incumbent on the government to justify this change and to outline the rationale for why it needed to be amended. The government is also removing the mandatory 10-day period after the written request is signed. Once again, this is a significant change that goes above and beyond what was required for the law to be in compliance with the Quebec Superior Court decision.

It is my intent to invite as many experts, health care professionals and provincial governments to committee to ask them about the proposed changes and to determine if they are in fact needed. We must be cognizant that MAID still has the necessary safeguards in place to protect the vulnerable.

I want to put on the record that many of the issues we raised in the last Parliament, such as enshrining conscience legislation in law for medical practitioners, has fallen on deaf ears. This was an almost universal position among my Conservative colleagues, and the Liberal government of the day did not adopt those measures.

We were also quite adamant about improving access to palliative care. Even though the delivery of health care falls under the purview of provincial governments, we passed a private member's bill to implement an action plan. My colleague from Sarnia—Lambton, who worked hard to get this legislation passed, is very disappointed that the government's five-year action plan failed to commit enough resources or outline a clear set of measurable outcomes. In a rural riding like mine, there are not enough palliative care services available. My heart goes out to those families who must send loved ones to a different community in the final days of their lives.

As a champion of rural Canada, I know first-hand the unique challenges that millions of people face every day due to their isolation or remoteness. I want to give the benefit of the doubt to the government that it is committed to rural Canadians, but its record says something completely different. While these issues cannot be fixed in this legislation, we cannot treat them in isolation while discussing MAID.

In closing, I want the government to know I am committed to working with it constructively on this legislation. I will ensure that the concerns of my constituents are heard. We know there is nothing more precious than the gift of life: to live freely, to live safely and to live healthy and happily. It is our collective responsibility to do what we can to improve the quality of life of all Canadians.

I look forward to what my colleagues have to say on this legislation, and if it is sent to our justice committee, we will do our due diligence to listen to witnesses and improve it where possible.

[William Amos, Liberal, Parliamentary Secretary to Minister of Innovation]

Mr. Speaker, I will continue to speak to the report of the Council of Canadian Academies on the provision of medical assistance in dying to those struggling with mental illness.

The complexity of the issue is reflected in the fact that the members of the Council of Canadian Academies working group had vastly different opinions on the subject. On the one hand, the reports note that symptoms of mental disorder can impair cognitive abilities, making it more difficult to understand or appreciate the nature and consequences of treatment decisions.

The word “incurable” is not generally used by clinicians in the context of mental disorders, which makes it difficult to assess the condition of a person with “irremediable” health problems under the current legislation.

On the other hand, the report points out that the autonomy rights of an individual with a mental illness must be respected. The report cites the experiences of Belgium and the Netherlands, which permit assisted dying for psychiatric conditions, with additional safeguards. However, the report also acknowledges that assisted dying for persons with mental illnesses in these jurisdictions remains controversial, and the public debate is ongoing. Ultimately, the working group could not reach consensus on ways to address complexities and mitigate risks associated with mental illness and medical assistance in dying.

On the topic of advance requests, the Council of Canadian Academies report on advance requests also documents considerable evidence and provided many instructive findings on an issue of great interest and concern to many Canadians. Particularly in our riding, this was an issue I heard a lot about.

An advance request is a request for assisted dying made well in advance and in anticipation of the time when the person making the request may face suffering and other circumstances that may make them eligible for medical assistance in death. An advance request would set out conditions under which an individual requests MAID to be provided at a future date. Advance requests are premised on the likelihood that when people's health circumstances deteriorate to the point where they would want an assisted death, they would no longer have the capacity to affirm their decision immediately before receiving medical assistance in dying. In other words, that critical requirement of giving final consent would not be possible.

Many people express the desire to make an advance request so they have the comfort of knowing they will be able to avoid a lengthy period of grievous suffering for themselves and for their families. This is in the event they succumb to an illness that could leave them severely impaired and lacking cognitive capacity for a lengthy time period.

The CCA report helped unpack advance requests, in a way that really was helpful, by outlining several scenarios of increasing complexity. The first scenario involves an individual at the end of life who has been assessed as eligible for medical assistance in dying, but fears losing capacity while waiting to receive it. This is the situation experienced by Audrey Parker from Nova Scotia who chose to receive MAID earlier than she had wanted in fear of losing her eligibility status.

The second scenario involves an individual who has been diagnosed with a serious condition, but does not yet qualify for medical assistance in dying.

The third scenario involves an individual who wants to plan for various future outcomes, prior to any diagnosis.

The report indicated that when the request is farther in advance of the procedure, it becomes more challenging for health care providers to be certain that the request still reflects the wishes of the individual. The report found that the first scenario poses the least risk and is relatively straightforward. Canadians expressed a great deal of support for this scenario in the federal consultations and it is also widely supported by experts and practitioners.

Our proposed amendments in Bill C-7 would permit this type of advance request. This means that an individual who has a reasonably foreseeable natural death, and who is assessed and approved for medical assistance in dying, can wait for their chosen date without worrying about losing decision-making capacity. If the person does lose capacity prior to that date, they would still receive medical assistance in dying on the requested date or earlier, as expressed in their advance wish. It also means that individuals no longer need to reduce required pain medications and endure additional suffering in order to maintain their capacity to consent right before the procedure.

However, the other two scenarios, where significantly more time passes between preparing a request and medical assistance in dying provision, are far more complex and challenging.

I want to point out that we have definitely made movement on that first aspect. It is in those other two aspects where there is significantly more debate, and those need to be taken care of by Parliament in the coming months, which is exactly what this bill provides for.

The House resumed consideration of the motion that Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

Business of the House

[Pablo Rodriguez, Liberal, Leader of the Government in the House of Commons]

Mr. Speaker, this afternoon, we will continue debate at second reading of Bill C-7 on medical assistance in dying.

Tomorrow will be an allotted day for the Conservative Party.

The House will then adjourn for one week, during which we will be in our ridings doing incredibly important work with our constituents.

Upon our return, we will deal with Bill C-4, an act to implement the agreement between Canada, the United States and Mexico, and Bill C-7, an act to amend the Criminal Code on medical assistance in dying.

Criminal Code

[William Amos, Liberal, Parliamentary Secretary to Minister of Innovation]

Madam Speaker, I am pleased to rise on the topic of Bill C-7, as we embark on what I expect will be quite a lively and passionate discussion about issues that Canadians care deeply about and certainly my Pontiac constituents. I heard from them for several years on this topic, regular correspondence, regular discussions at the door, so I appreciate this opportunity to discuss certain aspects of our government's proposed changes to the federal MAID legislation.

It is timely to share some of the insights from three important studies on very complex and sensitive issues that were not included in the 2016 federal legislation. These are requests by people for whom mental illness is their sole underlying medical condition, advance requests and requests by mature minors. I hope we will get to all three of them, but may only get to the first two.

When Bill C-14 was debated in 2016, parliamentarians had difficulty finding common ground on how to address these types of requests within Canada's first assisted dying regime. Understandably, given the challenging nature of these issues and the limited time that was available, due to the Supreme Court's timeline, to deliver on acceptable approaches for Canada, parliamentarians collectively decided that more in-depth study and review of the evidence was needed.

The legislation in 2016 therefore included requirements for the government to undertake independent reviews. There were strict timelines set out in Bill C-14 and the studies that needed to be commissioned had to be done within six months of the coming into force of Canada's new legislation on assisted dying and the government was obliged to table the final reports on the studies within a further two years. Both of these timelines were met.

In December 2016, the government asked the Council of Canadian Academies, CCA, an independent organization that undertakes evidence-based expert study, to inform our public policy development and to take on these studies that were required by legislation. The resulting reports were tabled in December 2018, documenting extensive review of academic and policy research, stakeholder submissions and international experience in the three subject areas.

They also included a broad range of perspectives from relevant health care professions, diverse academic disciplines, advocacy groups, indigenous elders, essentially the whole of Canadian perspective was brought to bear. In accordance with the CCA practice, they did not in fact contain recommendations.

Two of the reports, one on request by individuals where mental illness is the sole underlying condition and the report on advance requests have been particularly informative during the development of our government's response to the Quebec's Superior Court decision in Truchon.

I will first talk about mental illness. Under the current law, very few persons with mental illness as the primary source of their suffering are likely to be eligible for MAID. This is because most mental illnesses do not cause a person's natural death to be reasonably foreseeable.

Removing the reasonably foreseeable natural death criterion introduces the possibility for persons with mental illness to be deemed eligible for MAID, if they meet the remaining criteria.

During the recent federal round-table consultations held on MAID, we heard many concerns from participants who felt that not enough is known to safely extend eligibility for MAID to people whose suffering is caused by a mental illness alone. They felt that the issue required further examination.

We also know that there is generally very little support for expanding eligibility among mental health care practitioners, such as psychiatrists and psychologists, and by organizations representing people with mental illness. The CCA report on this issue noted a number of challenges associated with the delivery of MAID to persons with a mental illness.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, it is with great humility that I rise in the House today to speak to Bill C-7, an act to amend the Criminal Code with regard to medical assistance in dying.

Many MPs have very personal stories about the end of life of one of their loved ones. As the Bloc Québécois critic for seniors, it goes without saying that I have heard my share. Therefore, in my speech, I will recall the work done by the Bloc on this issue, the sensitivity that exists in Quebec regarding medical assistance in dying and, finally, the position of certain groups of seniors and women who have come to meet with me.

First, let me go over the context again. In September 2019, the Quebec Superior Court ruled in favour of Nicole Gladu and Jean Truchon, both suffering from a serious degenerative disease, stating that one of the eligibility criteria for medical assistance in dying is too restrictive. This criterion, that of “reasonably foreseeable natural death”, is found in the federal government's Act to amend the Criminal Code and to make related amendments to other Acts with regard to medical assistance in dying, and the provincial government's Act respecting end-of-life care.

Justice Christine Baudouin said it well in her ruling when she wrote: “The Court has no hesitation in concluding that the reasonably foreseeable natural death requirement infringes Mr. Truchon and Ms. Gladu’s rights to liberty and security, protected by section 7 of the Charter.” Those two individuals had argued that they were being denied medical assistance in dying because their deaths were not imminent.

Let me now remind the House of the Bloc Québécois's position and highlight the outstanding work of the member for Montcalm, to whom I offer my deepest sympathies. I want to thank him for the work he has done on this file because, as he quite rightly pointed out, legislators did not do their job properly with Bill C-14. As a result, issues of a social and political nature are being brought before the courts. We need to make sure that people who have serious, irreversible illnesses are not forced to go to court to access MAID. That would be terrible, and yet that is what will happen if we cannot figure out a way to cover degenerative cognitive diseases.

However, we believe that it is important to be very cautious before making any decisions on questions related to mental health. That is why we are relieved that the bill does not address eligibility for MAID for individuals suffering solely from a mental illness. Indeed, this issue requires further reflection, study and consultation, which will be completed at the Standing Committee on Health as soon as the motion moved by my colleague from Montcalm is adopted.

For the second part of my speech, I would like to talk about Quebec's sentiments on this whole issue. Quebec was the first jurisdiction in Canada to pass legislation on medical assistance in dying. Wanda Morris, a representative of a B.C. group that advocates for the right to die with dignity, pointed out that the committee studying the issue had the unanimous support of all the parties in the National Assembly. This should be a model for the rest of Canada.

Ms. Morris said she felt confident after seeing how it would work in Quebec and seeing that people were pleased to have the option of dying with dignity. The Quebec legislation, which was spearheaded by Véronique Hivon, was the result of years of research and consultation with physicians, patients and the public. It has been reported that 79% of Quebeckers support medical assistance in dying, compared to 68% in the rest of Canada.

In 2015, when the political parties in the National Assembly unanimously applauded the Supreme Court ruling on MAID, Véronique Hivon stated:

Today is truly a great day for people who are ill, for people who are at the end of their lives, for Quebec and for all Quebeckers who participated in...this profoundly democratic debate that the National Assembly had the courage to initiate in 2009....I believe that, collectively, Quebec has really paved the way, and we have done so in the best possible way, in a non-partisan, totally democratic way.

For the third part of my speech, I would like to tell you about a meeting I had with the Association féminine d'éducation et d'action sociale, or AFEAS, in my role as critic for seniors and status of women. During the meeting, the AFEAS shared with me its concerns with MAID. I will quote the AFEAS 2018-19 issue guide:

Is medical assistance in dying a quality of life issue? For those individuals who can no longer endure life and who meet the many criteria for obtaining this assistance, the opportunity to express their last wishes is undoubtedly welcome. This glimmer of autonomy can be reassuring and make it possible to face death more calmly....As the process for obtaining medical assistance in dying is very restrictive, those who use it probably do so for a very simple reason: they have lost all hope....This process cannot be accessed by individuals who are not at the end of life....People with degenerative diseases, who are suffering physically and mentally, do not have access to medical assistance in dying.

Many people are not eligible for MAID because of the federal law governing the practice, which was imposed by a court ruling in February 2015. Four years after Carter, individuals whose quality of life is severely compromised by degenerative diseases are still being forced to ask the courts for permission to end their suffering.

In February 2015, the Supreme Court even struck down two sections of the Criminal Code prohibiting Canadian doctors from administering MAID. In Carter, the highest court in the land stated that a competent adult who clearly consents to the termination of life is eligible for MAID if that person “has a grievous and irremediable medical condition...that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”

According to the AFEAS, the Supreme Court's criteria were very broad. In drafting the MAID eligibility criteria, the Government of Canada included the concept of reasonably foreseeable natural death only for people at the end of life, which excludes a significant number of people who are experiencing intolerable physical and mental suffering.

The entire process is based on the intensity of the suffering as assessed by a doctor and a panel of experts. The sick person's own assessment is not always taken into account. There are no compassionate criteria among the requirements for obtaining MAID. A person may be at the end of their life and be unable to make the request themselves because they cannot communicate. The law applies only to people who are able to give their free and informed consent up until the very end, which could be terribly traumatic and even cruel to those who have been suffering for years.

With regard to advance consent, the AFEAS spoke about the case of Audrey Parker, a woman from Halifax who died with medical assistance on November 1, 2018. She made a video three days before her death. In that three-minute video, she said that she would like nothing more than to make it to Christmas, but that if she became incompetent along the way, she would lose out on her choice of a beautiful, peaceful and, best of all, pain-free death.

The Barreau du Québec believes that the law should be amended to comply with the criteria set out in Carter and thus prevent court challenges from being filed by people who should not have to carry such a burden.

A panel of experts has studied this issue and recommends, under certain conditions, ending the suffering of patients who have previously expressed their wish to receive medical assistance in dying, but who subsequently become incapable of expressing their consent, in particular people with various forms of dementia or cognitive loss such as Alzheimer's disease. This is why AFEAS is asking, with respect to human rights, that the process of medical assistance in dying be based more on the rights of individuals and on respect for their wishes.

With respect to reasonably foreseeable natural death, it requested that the reference to “reasonably foreseeable natural death” be removed from the eligibility criteria. With respect to advance consent, it asked that the person's informed consent be respected and that it be given in advance. Also on the subject of advance consent, it asked that the consent anticipated, stated and recorded by the person be recognized.

In conclusion, today's debate demonstrates the need to act so that people suffering from degenerative and incurable diseases are no longer forced to go before the courts to challenge the terms and conditions surrounding eligibility for medical assistance in dying, and so that we can ensure the best possible continuum of care.

Let's take action so that everyone can die with dignity.

[Nelly Shin, Conservative, Port Moody—Coquitlam, BC]

Madam Speaker, Bill C-7, an act to amend the Criminal Code in relation to medical assistance in dying, is one that I believe was written with the intention of providing compassion to those who are suffering through an unfathomable, unbearable degree of pain by allowing a lawful, expedited termination of their suffering and granting access to a dignified death. The intention is kind. I see an urgency from the government to extend this expression of compassion to those who are suffering beyond comprehension.

However, from the perspective of a visionary and a lawmaker who cares for the long-term wellness and prosperity of our country, I would like to invite all members of the House to pause and bring into our dialogue the long-term effect of this bill and the impact of this bill on the guiding principles of lawmaking going forward.

I do not stand to speak on this bill with the moral authority of one who has reached a point of suffering equal to those who may be applying for MAID. I do not think most members of the House here have the personal experience to speak on that level. However, I do stand here to speak on this issue because there has been a force in my life that carried me through some very dark nights of the soul when adversity, pain and repeated cycles of injustice were poignant enough to wear down my will to fight and to try, sometimes causing me to question the value of my existence.

I have seen this force raise addicts, cancer patients and those experiencing deep depression from deep pits of psychological paralysis and darkness. This force transcends the distinctions of race, gender, socio-economic background, etc. It is almost as vital as life itself. It is a force that is central to the existence of the human race, and that force is called “hope”. While hope is easier to access for some than others, for others it may be almost impossible, because their painful experience is choking the light from their vision.

As caring individuals, as communities and as a nation that prides itself on compassion, it is our duty to turn over every stone to help others find hope when they can no longer access it themselves. Hope is a journey that demands an unrelenting search until it is found.

We saw it with Terry Fox. He is a national symbol of hope, because despite his painful struggle with cancer, he made the sacrifice he made with his cross-country campaign for cancer research because he was in search of hope and giving that hope to others. The story of his triumph over adversity, though his life was tragically truncated at such a young age, still continues to champion Canadians today, as Canadians respond by revering him as a national hero, because we value hope. We have seen the power of hope that compelled Terry to pass the finish line of his last breath.

We see hope whenever we see Team Canada send our Paralympians to the Olympics. Many of them have overcome deep physical, emotional and mental suffering. Their focus, discipline and excellence have helped them to overcome their challenges.

Our nation is built on a foundation that values the sustenance of life and the right to prosper. We invest millions of dollars every year in first responders, medical services, infrastructure and laws to protect the survival, sustenance and prosperity of the people.

However, expediting the administration of death is counterintuitive to the inner reach for hope in the human condition. Our very Constitution is founded on the principles of the value of human life, the prosperity of each human being and each one's access to the opportunity to flourish.

While deep with the intentions of compassion and the appropriation of dignity, intervening with easier access to MAID opens a door to a very complicated path of further suffering, even for those who live on.

I would like to bring to the attention of the House the story of a man named Alan Nichols, from my province of British Columbia. As reported by CTV this past September, his family has stressed that Alan struggled with depression and should not have qualified for assisted death.

Alan's brother Gary told CTV:

He didn't have a life-threatening disease. He was capable of getting around. He was capable of doing almost anything that you had to do to survive.

Like many Canadians, Alan's life was altered dramatically when his father passed away. Especially since his father had been so involved in his life, his father's death made him particularly vulnerable, and he stopped taking antidepressants and became more angry and isolated:

Not going out in public, not seeing anybody, not eating properly.

This is how Gary described it.

Alan's family knows that he rid his home of furniture, apart from a bed and chair, and that he would refuse medication and food because of his depression. Another disturbing aspect to Alan's story is that despite his family's attempts to be involved in his life and an advocate for his life, his family members report that the hospital staff would not share information with them and shut them out from hearing the key facts.

There is more to this story, but I will leave it at that. This is accessible information.

The point I would like to illustrate here is that this is a very complicated issue. It is one that touches something so deep and necessary to our existence and our country, and that is hope. All because of the irreversibility of death, there is little intervention that can be done afterward when hope is terminated because there is no breath to receive the assistance of hope.

Rather than be in a rush to legislate this bill, we should focus on tackling things like the epidemic of suicide among first nations communities and youth. We should also focus on giving Canadians better access to mental health care so Canadians have greater access to hope when faced with situations of suffering, as people who are suffering so much consider MAID. We must do this until there are enough measures to show the flourishing of hope and human prosperity to counter a potential culture of death from capturing our nation, if we are to be too swift and lenient in our decisions surrounding issues of death.

It pains me to watch others suffer, but it also pains me to think that as lawmakers, our focus is on expediting access to death rather than expediting access to hope.

My statement in the House today is to inspire all members of this House to not only consider the dignity of the people suffering seeking release through death, but the dignity of existence and human prosperity for the long term.

Removing the mandatory 10-day waiting period reduces protections for vulnerable members of society. The government's original legislation, Bill C-14, went through extensive consultation. It is scheduled for parliamentary review this summer. I would ask the Liberal government to respect the process and allow the review to proceed rather than rush this very sensitive and complex issue in legislation. Let us give this time because death is irreversible.

I have decided to look at this bill through a filter of hope and preserving a culture of hope, as being a force that guides the laws we make not only today but for decades and centuries to come. Therefore, I stand today in the name of hope and invite my colleagues across all aisles to examine this bill through the lenses of hope and preserving hope in our country.

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

Madam Speaker, I will be sharing my time with my colleague from Coquitlam—Port Coquitlam.

I am very happy to be taking part in this debate, which is a departure from our usual political and often partisan work as elected officials.

This is the third time in my parliamentary career that I have been asked to debate and vote on the issue of medical assistance in dying. I was a member of Quebec's National Assembly for seven years, and I have served here in the House of Commons since 2015 with the support of my constituents.

I was elected to the national assembly in 2008. As a member of that assembly, I participated in the first debate we had in Quebec on this issue, the first time in a Canadian legislature, in 2010.

I also was a participant in the debate we had four years ago in the House of Commons, when, for first time, we addressed the issue. Therefore, in my parliamentary life, this is the third time I will participate and vote on this very touchy, personal and non-partisan issue.

That is why I would like to remind the House of certain cardinal rules that should guide our actions as parliamentarians in this debate, which we believe should be totally non-partisan. Things may get tense at times, but debate must remain respectful.

Respecting the free vote should be one of the cardinal rules of this debate. In my view, there is no right or wrong position in this debate. There are only positions that we are comfortable with as human beings. Whether we are for or against, there is no partisan politics behind it. There is only the personal opinion that we hold, share and analyze.

Consequently, it is important to keep a completely open mind and respect the fact that certain colleagues from our own party may not share our point of view, while colleagues from other parties may. That is fine. There is nothing wrong with that, really. Some positions we adopt, and some positions we cannot be comfortable with. That is all.

We must respect the debate. We must respect personal opinions. We must respect the fact that there is no place for partisanship in this debate and that positions are neither right nor wrong. There are positions that we can agree with and others that we cannot. We must respect that.

There are also certain elements that we must bear in mind before we dive into this. In our opinion, the bill has some shortcomings.

First, we must respect the freedom of conscience of physicians who are called on to provide MAID. If a physician feels that they cannot in good conscience provide MAID, they should be able to say so and not have to proceed. I have spoken to many people in the context of this debate, in which I have been participating for a very long time. Everyone I have spoken to has told me that physicians can show a certain openness in some circumstances, but change their minds in others. Physicians should never be forced to act against their conscience.

Furthermore, we should always bear in mind that MAID, by its very nature, is the last level of health care that can be offered. We must never forget that the role of palliative care is to ensure that those who are ill can live with dignity even in tragic circumstances. Therefore, we must respect physicians' conscience and focus on palliative care.

Taking our time is another cardinal rule that must be respected in this type of debate.

Let me remind members that the first time this issue was addressed in Quebec, it took six full years, three different governments and three different premiers. There was a huge debate about it, a strong and wise debate. Each and every position had been clearly established by those people who participated in the debate. There is no rush. We must take our time.

For some people, we are talking about assisted suicide. It is a very touchy issue. The worst-case scenario is to rush it. Quebec spent six full years, and we should follow this example. It obviously will not take six years this time, but the first step took six full years.

Let's agree that this debate cannot be rushed.

Why are we debating Bill C-7 today?

When the House of Commons adopted Bill C-14 in 2016, I was a member of the committee that studied it. We knew then that Canadians would challenge parts of it and that there would be court rulings. That is exactly what happened on September 11, 2019, when the Quebec Superior Court struck down the notion of “reasonably foreseeable natural death” in the bill that became An Act to amend the Criminal Code and to make related amendments to other Acts regarding medical assistance in dying.

I did not know this before I looked it up, but it is interesting to note that the current Minister of Justice, a man for whom I have tremendous respect and esteem owing to his experience as a lawyer and a McGill University professor, voted against Bill C-14. Now, as Minister of Justice, he is sponsoring this bill as the federal government's response to the Quebec Superior Court's ruling. The bill addresses some of the issues but sets others aside.

The first fundamental element of Bill C-7 is that it eliminates the 10-day waiting period that the current law requires as a buffer between the person's decision and the operation itself, to ensure that the second opinion provided for under the act is in fact obtained. The court deemed this provision invalid, and the minister decided to accept that opinion.

Let's also not forget that the current law, which was passed four years ago, requires the provisions to be reviewed in just a few months, starting in June 2020.

The government decided to take note of the Superior Court of Québec ruling and act accordingly. That is its right. However, regardless of our views on the issue, we feel that this subject involves some truly fundamental questions and raises highly complex legal concerns. We think this ruling should have been appealed to the highest court in the land, so that the nine justices of the Supreme Court could study every possible ramification.

This bill sidesteps the issue of mental illness entirely. That is a very good thing, because in our view, it is extremely difficult to pinpoint the instant when a mental illness becomes irreversible, which can raise doubts about whether consent was given fully and freely.

As I said earlier, the worst thing we could do in this matter is move too fast. There is no rush. This concern may eventually be debated, but for now, let's take it one step at a time.

Since my time is almost up, I would just like to say that in this debate on such a delicate, sensitive issue, the worst thing we could do is plough full steam ahead and attack people's convictions instead of respecting their choices. Let's take the time to do things right on this extremely delicate and extremely important issue.

[Irek Kusmierczyk, Liberal, Windsor—Tecumseh, ON]

Mr. Speaker, that is an excellent question. If we read the preamble to Bill C-7, we will see the legislation's explicit desire to balance several interests and values: the autonomy of the person seeking a dignified death, the protection of vulnerable persons and the important public health issue that suicide represents.

I believe Bill C-7 achieves that balance by relaxing safeguards for Canadians who are at the end of life, but also strengthening safeguards and, just as important, strengthening supports for Canadians who have a grievous and irremediable medical condition and are in an advanced state of irreversible decline, but not necessarily at the end of life.

[Irek Kusmierczyk, Liberal, Parliamentary Secretary to the Minister of Employment]

Mr. Speaker, I will be sharing my time with the member for Beaches—East York.

It is an honour to stand up in the House of Commons and participate in the second reading debate for Bill C-7, an act to amend the Criminal Code to Canada's medical assistance in dying legislation.

In developing these amendments, Canadians were widely consulted in January 2020. During these consultations, approximately 300,000 Canadians completed an online questionnaire. In addition, the Minister of Justice and Attorney General, the Minister of Health and the Minister of Employment, Workforce Development and Disability Inclusion met with stakeholders in Halifax, Montreal, Toronto, Vancouver, Calgary, Winnipeg, Ottawa and Quebec City to discuss proposed revisions to Canada's medical assistance in dying framework.

These experts and stakeholders included doctors, nurses, legal experts, national indigenous organizations and representatives of the disability community. The high level of participation in both the questionnaire and the in-person sessions is a reflection of the importance of this issue to Canadians. Moreover, the results of the consultations were critically important in shaping the government's approach to medically assisted dying as it evolves to reflect the needs of Canadians.

This bill would amend the Criminal Code to allow medical assistance in dying for people who wish to relieve their suffering through a medically assisted death, whether their natural death is reasonably foreseeable or not.

This bill would remove the reasonable foreseeability of natural death from the list of eligibility criteria. It would also expressly exclude people seeking medical assistance in dying solely because of mental illness.

The bill proposes a two-track approach based on whether a person's natural death is reasonably foreseeable. Existing safeguards remain and are eased for those whose death is reasonably foreseeable. In addition, new and modified safeguards would be applied to eligible persons whose death is not reasonably foreseeable.

In the spirit of “nothing without us”, I would like to mention the government remains focused on addressing the concerns of the disability community around vulnerability and choice. The proposed changes to the legislation support greater autonomy and freedom of choice for eligible persons who wish to relieve their suffering by pursuing a medically assisted death.

At the same time, full consideration has been given to the protection of vulnerable persons and to respecting the equality rights and dignity of persons with disabilities. In short, this bill would maintain and strengthen safeguards to support fully informed decision-making, while also respecting individual autonomy.

In terms of advance consent, many participants were comfortable with implementing advance requests for those who have been assessed and approved for medically assisted dying, but are concerned about losing capacity before it is provided. This bill would allow people who risk losing decision-making capacity to make arrangements with their practitioner to receive medically assisted dying on their chosen date, even if they lose decision-making capacity before that date.

The bill would also make advance consent invalid if the person demonstrates refusal or resistance to the administration of medically assisted dying. The bill goes on to clarify that reflexes and other types of involuntary movements, such as response to touch or the insertion of a needle, would not constitute refusal or resistance.

In addition, the bill would allow eligible persons who choose to self-administer to provide advance consent for a physician to administer a substance to cause their death if self-administration fails and causes them to lose capacity. This type of advance consent would be available for all eligible persons, regardless of their prognosis.

I would like to take a moment to speak to the progress the government has made with respect to the rights of persons with disabilities in Canada. In fact, last year, the government enacted the Accessible Canada Act, which aims to create a barrier-free Canada through the proactive identification, removal and prevention of barriers to accessibility wherever Canadians interact with areas under federal jurisdiction.

The act is one of the most significant advances in disability rights since the charter in 1982 and is designed to inspire a cultural transformation for disability inclusion and accessibility in Canada. The act created Accessibility Standards Canada, a new organization that will create and revise accessibility standards, and support and promote innovative accessibility research. The CEO and board of directors were appointed and operations began last summer.

That act also established National AccessAbility Week, a week dedicated to accessibility in late May and early June each year. National AccessAbility Week is an opportunity to promote inclusion and accessibility in communities and workplaces, and to celebrate the contributions of Canadians with disabilities.

It is also a time to recognize the efforts of individuals, communities and workplaces that are actively removing barriers to give Canadians of all abilities a better chance to succeed. The act applies to federally regulated organizations for now, but we know the culture shift will have a trickle-down effect, and that awareness and action on disability inclusion will increase across the country.

Our government is taking real action to address the rights of persons with disabilities. The careful writing of Bill C-7 is a testament to that. Representatives of disability organizations and leading disability scholars participated in consultations across the country. Their input informed the reforms proposed in the bill.

We recognize that disability inclusion requires more than legislation. That is why we are continuing to work with the disability community and other stakeholders to address stigma and bias. It is important to bring about a culture change to ensure that the important contributions made to Canada by persons with disabilities are recognized and valued on the same basis as those of other Canadians. Going forward, we will continue to focus on improving the social and economic inclusion of persons with disabilities.

We will continue to work hard to ensure that all people are treated with the dignity and respect they deserve, especially when it comes to deep and personal issues like ending life. It is imperative that the voices of all Canadians, including Canadians with disabilities, continue to be heard on the issue of medical assistance in dying.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

Mr. Speaker, I am pleased to join the debate on Bill C-7, an act to amend the Criminal Code, specifically section 241 of the Criminal Code. That is the provision of the Criminal Code that makes it illegal to counsel a person to commit suicide or to aid someone to do so.

In the absence of more recent amendments, in the previous Parliament there was Bill C-14 in response to the Carter decision by the Supreme Court of Canada. In that case the court found that the plaintiffs' charter rights had been infringed upon by a strict interpretation of section 241.

Interestingly, Bill C-14 from the previous Parliament stated, as one of its objectives in paragraph six of the preamble:

...permitting access to medical assistance in dying for competent adults whose deaths are reasonably foreseeable strikes the most appropriate balance between the autonomy of persons who seek medical assistance in dying, on one hand, and the interests of vulnerable persons...on the other;

The relevant provisions in the Criminal Code included that language. It states that qualifications for MAID, including with respect to the person:

their natural death has become reasonably foreseeable, taking into account all of their medical circumstances....

All of this is about to change because of the Truchon decision.

I am speaking to Bill C-7, a bill that would eliminate the reasonable death foreseeability safeguard and expand MAID, medical assistance in dying, to a larger number of people. I have been encouraged to speak to the bill because of the many letters and the correspondence I have received from people in my constituency.

I have received some letters in support of expanding MAID, but the vast majority of the letters I have received encourage me to speak against expanding the availability of medical assistance in dying.

Correspondence that I am receiving from constituents repeat two basic themes. First is that the reasonable foreseeability of death safeguard should be maintained as an effective defence of societal interests and Canadian values. Second is that more should be done to expand palliative care services.

To quote one person, let Canada be a society that is known for its modern and advanced palliative care services and not as a country that has ever expanding use of medical assistance in dying. We should alleviate the suffering, not eliminate the sufferer.

I am going to read quotes from two people who each made the effort to write me a letter.

The first is Dr. den Hollander, who states:

If Canada must allow MAiD in some form (and I wish it didn't), it is incumbent upon us to ensure that it is rare. Eligibility requirements should be tightened, not loosened. More safeguards are necessary, not fewer. Enforcement must be scrupulous, not relaxed. Without these protections, vulnerable people will be pressured by family members, friends and medical practitioners to MAiD.

The second is a woman named Ramona. She works in health care, including palliative care. She quotes a person to whose care she attended, and who died in the Langley Hospice facility, as saying, “I want to live well while I'm dying.” Ramona goes on to comment, “Surely this is what health care was created for, to support people while they are alive, not to speed up their death.”

This is the tenor of the input I am receiving from my constituents.

Behind Bill C-7 is the Superior Court decision in Truchon. The plaintiffs in that case argued that their constitutional rights had been infringed upon by the now amended section 241 of the Criminal Code. They argued that the Carter decision, on which Bill C-14 was based, did not require that a person's end of life be reasonably foreseeable, and that is a true statement. That is not what the Carter decision required.

Secondly, they argued that the legislated end of life requirement violated the right to equality, under section 15 of the charter, and the right to life, liberty and security of the person, under section 7 of the charter. The federal government, acting through the Attorney General's office, did the right thing at that time. It defended its law. That is what the Attorney General should do. Bill C-14 was the well-considered opinion of the previous Parliament. It was the law. The Attorney General must defend the law.

Remarkably, the Quebec Superior Court refused to accept the arguments advanced by the Attorney General. The Quebec Superior Court said that the court cannot accept the first two objectives advanced by the Attorney General regarding the affirmation of the inherent and equal value of every person's life and the importance of preventing suicide.

In the opinion of the justice writing that decision, those two principles were not the underlying philosophy of Bill C-14. It was all about protecting vulnerable persons from being induced, in moments of weakness, to end their lives.

Remarkably, the Attorney General of Canada did not appeal that decision. That is what should have been done. Any self-respecting Attorney General would appeal a decision that attacked the laws of Parliament. This Attorney General elected not to do that. Now we are in this position where we are under pressure to amend the law, when we should instead be following the directive of Bill C-14, and that is to have a comprehensive review of the whole legislation.

That is what we should be doing. What is the rush? The rush is caused by the Attorney General's failure to appeal this decision. It should have been tested through the court system, up to the Supreme Court of Canada.

With the reasonable foreseeability of death safeguard down, this is what we have left. An applicant for MAID qualifies if he or she has a serious and incurable illness, disease or disability; is in an advanced state of decline; or their physical or psychological suffering is intolerable to them, which is a completely subjective test. The reasonable foreseeability of death criteria is now gone.

Let us just test this against a couple of hypothetical situations. We can imagine that a person has Parkinson's or MS, or was in a terrible accident and is a paraplegic. Under this new regime, if it becomes the law, people who are not dying but who meet all the other criteria, however subjective they may be, will qualify for state-sanctioned suicide. One of my constituents has said that we should let Canada be a society that is known for its modern and advanced palliative care services, and not as a country that has ever-expanding use of medical assistance in dying.

[Patty Hajdu, Liberal, Minister of Health]

Mr. Speaker, I am very pleased to rise in the House today to address Bill C-7 and to speak to our proposed changes to Canada's medical assistance in dying legislation.

The proposed measures respond to the Superior Court of Québec's Truchon decision, in which it ruled that it is unconstitutional to deny access to medical assistance in dying to individuals who meet all the other eligibility criteria but are not near the end of life.

In responding to this ruling, the Government of Canada has had the opportunity to consider some additional measures for which there is strong support. That is why we are proposing changes that will help clarify and add precision to Canada's medical assistance in dying legislation.

Over the past few months, I have had the honour of listening to many Canadians, and it was important for me as the Minister of Health to hear first-hand what they had to say. My colleagues and I hosted a series of round tables and heard from more than 125 experts, academics, ethicists, doctors, nurse practitioners, members of the disability community, indigenous groups and key stakeholders. I also engaged my provincial and territorial colleagues, and my officials worked closely with their counterparts across the country.

In January, I was in Calgary and spoke to Cynthia Clark, who saw her husband through the process of medically assisted death last summer. Her perspective, as well as those of so many others with first-hand experience were invaluable.

I also listened to practitioners who have been providing medical assistance in death in a very thoughtful, compassionate way over the last four years. They had a lot to say about what was working well but also about what was not working well.

We heard many personal stories like Cynthia's, and they helped shape the changes that we are proposing today. In addition, the feedback received from our online consultation was astounding. In two weeks we had more than 300,000 responses.

It is clear that certain aspects could be improved in order to facilitate access, protect the vulnerable and respect personal choice.

With this bill, I think we have achieved a balanced approach that reflects the best interests of all Canadians.

Protecting the safety of vulnerable people while respecting the autonomy of Canadians remains our central objective. That is why the bill proposes a two-track approach to safeguards, based on whether or not a person's death is reasonably foreseeable.

Reasonable foreseeability of natural death would no longer be a requirement for determining whether a person can access medical assistance in dying. It would, however, be used to guide practitioners in determining which safeguards to apply. This is consistent with what we heard at the round table meetings.

Providers involved in assessing the eligibility of applicants for a medically assisted death told us they have a good understanding of the concept and are comfortable applying it. Under the amended law, they would use reasonable foreseeability of natural death to determine not eligibility, but rather which safeguards would apply.

For those whose death is reasonably foreseeable, we would ease some of the pre-existing safeguards. Under the current system, there is a requirement for a 10-day reflection period. We are proposing to eliminate this reflection period. For those who are at the end of their life, the decision to request medical assistance in dying is well considered, and this additional period only serves to prolong suffering unnecessarily.

The current system also requires that two independent witnesses confirm that the person who has signed a request for medical assistance in dying is who they claim to be and that no fraud has occurred, such as the forging of someone's signature. During our consultations, we heard that this requirement was a significant barrier for many people at the end of their life.

We propose requiring only one witness and allowing this witness to be a paid personal or health care provider. These individuals naturally would be excluded from acting as a witness if they are a beneficiary of the person's will or if they would receive a financial or material benefit from the person's death. Anyone involved in assessing or providing medical assistance in dying would continue to be ineligible to serve as a witness.

For those whose death is not reasonably foreseeable, we would create a new, more robust set of safeguards. We think it is important, even while improving access, to ensure that people who are suffering but who are not dying are given full and careful consideration as they assess whether or not to pursue an assisted death.

Strengthened safeguards would also serve to protect vulnerable individuals. For example, the bill proposes a minimum period of 90 days for assessing a MAID request in the case of a non-imminent death. This period would allow for exploration, discussion and consideration of options to alleviate suffering by the person seeking medical assistance in dying and with the practitioner.

The bill would also require that the person requesting MAID be provided with information on available counselling, mental health supports, disability supports and palliative care as part of the informed consent process.

We know that the majority of practitioners are already ensuring that their patients are aware of all of the supports and options that are available to them. This provision underscores the importance of the doctor-patient relationship. It allows for a practitioner and a patient to decide whether medical assistance in dying is the right step and provides sufficient time for the patient to discuss and consider other treatment options, which is crucial for patients weighing this kind of decision. This provision supports fully informed decision-making and individual autonomy.

Under the current legislation, those who become incapacitated lose their eligibility for medical assistance in dying because the person must give their consent immediately before the procedure. This means that some individuals deemed eligible for medical assistance in dying have chosen to end their lives earlier than they wanted out of fear of losing the opportunity to receive this service.

That is why we are proposing to include a waiver of final consent for persons whose death is reasonably foreseeable and who have been assessed and approved to receive medical assistance in dying. Individuals at the end of their life who risk losing their decision-making capacity before their chosen date would have an avenue to receive MAID without worrying that loss of their decision-making capacity before their chosen date would disqualify them. Support for this amendment is strong among stakeholders, Canadians and health practitioners.

Canada has had four years to reflect on the current MAID legislation passed in June 2016, and there are many complex issues that require further study.

In December of 2016, the Government of Canada asked the Council of Canadian Academies to conduct independent reviews on three specific types of requests for medical assistance in dying that are currently outside of the scope of the law: requests by mature minors, advance requests and requests where a mental disorder is the sole underlying medical condition.

The Council of Canadian Academies convened a multidisciplinary panel of 43 experts to review an extensive body of evidence, including Canadian and international academic and policy research.

We tabled those reports in Parliament in December 2018. They provide us with a thorough, thoughtful examination of these very difficult subjects. I encourage all members to read those reports as we continue our deliberations on the proposed legislative amendments and the parliamentary review that will be conducted later this year.

There is agreement among experts that allowing advance requests for people with illnesses such as Alzheimer's disease well before they would otherwise be deemed eligible is very complex and will require careful consideration and consultation before it could be included in legislation.

During the round tables I heard directly from health care providers who expressed discomfort because they have seen patients who, as their position progressed, might not have the same desire for medical assistance in dying as when they were first diagnosed. The Council of Canadian Academies' expert panel report on advance requests came to the same conclusion.

At the same time, we know that many Canadians have expressed an interest in advance requests so that they could have the comfort of knowing that they could avoid extreme suffering at some future date.

For all these reasons, we believe this issue deserves deeper examination through parliamentary review. That will be our opportunity to tackle questions that are profound and difficult to answer, even for practitioners who have been providing this service over the past four years.

The proposed changes to the medical assistance in dying legislation would exclude persons if mental illness is the sole underlying medical condition.

This does not mean that people with mental illness are ineligible; it means that mental illness cannot be the sole underlying condition. This is another complex aspect that warrants a more thorough discussion.

Since the federal legislation came into force in 2016, Health Canada has released four federal interim reports that provide more information on how the legislation is being implemented across the country.

In November 2018, we implemented regulations that resulted in the creation of a permanent monitoring regime that sets out obligations for reporting on medical assistance in dying cases by doctors, nurse practitioners and pharmacists. The first monitoring report under these regulations is expected to be released in spring 2020.

Since MAID legislation was enacted in 2016, more than 13,000 Canadians have chosen this option of a medically assisted death. This is not unexpected. We have seen a gradual increase in the numbers over the last three years. The number of MAID deaths in Canada, slightly under 2% of all deaths, is in line with international regimes. The increasing use of MAID is largely a result of enhanced awareness of it as a legal option and greater acceptance by Canadians.

The federal government recognizes that public reporting is critical to ensuring transparency and also to ensuring public trust in the legislation. That is why we are proposing changes to expand data collection to help provide a more complete picture of medical assistance in dying in Canada.

Under the current legislation, only practitioners who receive a written request for MAID and pharmacists who dispense a MAID substance are required to provide information, but it has become clear that capturing information based solely on written requests for MAID received by physicians and nurse practitioners has resulted in an incomplete picture on who is requesting MAID across the country, and why.

The amended legislation would authorize new regulations to be developed in partnership with provinces and territories to allow for the collection of data on all assessments for MAID, and this would include those undertaken by other health professionals on the care team. It also clearly aligns with the original intent of the legislation to collect information on all requests for, and cases of, MAID in Canada.

I think we can agree that Canadians with life-limiting illnesses deserve the best quality of life possible as they approach the end of their lives. Palliative care and end-of-life care provide patients with relief from the pain and distress associated with a life-threatening illness. Supporting home care and palliative care is a key priority in our ongoing efforts to improve our health care system.

Through budget 2017, we made historic new investments in health care to improve access to mental health and addiction services, as well as home and community care, including palliative care.

To further support access to palliative care across the country, the government worked closely with provinces, territories, and stakeholders to develop the framework on palliative care in Canada, which we tabled in Parliament in 2018. We have released an action plan to support each of the priority areas identified in the framework.

I want to assure the House that the proposed bill responds to concerns identified by practitioners and experts through the round table discussions.

I will continue to work closely with the provinces, territories and key partners to support the implementation of the proposed legislative amendments, if they pass in Parliament.

This includes working with provinces, territories, health system partners and regulatory bodies to support best practices and information sharing on clinical guidance and other aspects of implementation, which includes training and retrospective reviews.

I have a great deal of respect for the practitioners who have been providing this service over the last four years with immense diligence and a huge amount of compassion. Their experiences have helped us craft legislation that much better meets the needs of Canadians. This law is constructed in a way that supports autonomy, but it includes the flexibility to allow a practitioner and a patient to work more closely together.

Medical assistance in dying is a complex and deeply personal issue. In tabling these changes, our government has considered carefully the need for personal autonomy and the protection of vulnerable people.

There is strong public support for change, and I believe we have found an approach that reflects the best interests of all Canadians. I urge all members of the House to support the proposed changes.

The House resumed from February 26, consideration of the motion that Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

[Kody Blois, Liberal, Kings—Hants, NS]

Mr. Speaker, as members know, on September 11, 2019, the Quebec Superior Court's decision in Truchon struck down the eligibility criterion of reasonably foreseeable natural death from the medical assistance in dying, MAID, regime in the Criminal Code. It is my sincere pleasure today to join the second reading debate on Bill C-7, which is the government's response to this ruling and which includes a revised safeguard framework.

Bill C-7 proposes amendments to the Criminal Code that would work to ensure consistent application of the MAID law across the country and would adjust the safeguards for a MAID regime that is no longer limited to end-of-life circumstances. Specifically, the bill would create two sets of safeguards to be followed before MAID is provided.

One set would be for individuals who are dying whose death is reasonably foreseeable; in which case, most of the existing safeguards would continue to apply, with a few being eased or removed. The second new set of safeguards would apply to individuals whose natural death is not reasonably foreseeable. That is why we are here today, to talk about this legislation given the fact of the decision from the Superior Court in Quebec.

This approach to differentiating between MAID requests is consistent with the view that providing MAID to people whose natural death is reasonably foreseeable presents less of a risk and is less complicated than providing MAID to those who are not on a clear trajectory toward death. It is sensible and appropriate that the assessment of a MAID request should be tailored to these different types of cases to account for the different types of risk that could arise.

For people who have requested MAID and whose natural death is reasonably foreseeable, amendments to the safeguards in this legislation include the removal of the mandatory 10-day reflection period, which, of course has been discussed quite widely in the speeches here today; a reduction in the number of independent witnesses; and a change regarding who can be independent witnesses.

Existing safeguards, such as the need for two independent practitioners who verify the person's eligibility and the need for the person to confirm consent immediately prior to the provision of MAID, will remain unchanged for those whose natural death is reasonably foreseeable. The exception is in specific circumstances where consent is given in advance. I am referring to Audrey's amendment, which is something that is very important to me, and was certainly highlighted given the fact that Audrey Parker was from Halifax in my home province.

During the government's recent MAID consultations, stakeholders noted that the existing 10-day waiting period could result in the prolonged and unnecessary suffering of the patient. We can all appreciate some of the challenges that would present. Bill C-7 proposes to remove this requirement for people whose death is reasonably foreseeable. A patient who is in that situation and requesting MAID has likely thought and reflected about this particular decision for a considerable amount of time. Requiring the patient to wait an additional 10 days when his or her suffering is already unbearable is just unnecessary.

For both streams of the MAID request, it is proposed that the requirement for two independent witnesses to a patient's written request for MAID be changed so that only one is needed. The role of an independent witness is to attest to the fact that persons requesting MAID have signed and dated their MAID request themselves in a voluntary manner. The witness would not play a role with respect to the eligibility assessment, which is the responsibility of two independent practitioners, nor do witnesses confirm whether the safeguards required by the Criminal Code have been followed.

The current rules also exclude people like health care providers and personal support workers from being independent witnesses. This can create access barriers for individuals living in nursing homes or other residential settings who may have very few family or social networks.

Speaking from my own experience in my riding, that certainly can be the case, where individuals who are living in nursing homes or in these situations might not have a large family or friend network to be able to draw upon, and I think that is an important piece. Individuals who are paid to provide personal care or health care are likely to be among the limited number of personal contacts an individual living in a care institution may have, as I alluded to. The amendments to the MAID regime would allow a paid personal or health care worker to be an independent witness, which would increase access to MAID for this population. That is key.

For patients who are eligible for MAID but whose natural death is not reasonably foreseeable, the key piece of the Truchon decision, Bill C-7 proposes a separate set of safeguards in addition to the existing safeguards, such as written requests that are signed before an independent witness and confirmation of consent.

In situations where natural death is not reasonably foreseeable, there would be new requirements that focus on the need for additional time, expertise and information in these circumstances. I believe that is balanced in the way we move forward.

First, there would be a minimum assessment period of 90 days, which could be shortened if loss of capacity was imminent and the assessments were complete. Second, one of the assessing physicians would need to have expertise on the condition that is causing the person's suffering.

There would also be two clarifications of the requirement for informed consent. First, the patient must be informed of the appropriate counselling, mental health supports, disability supports, community supports and palliative care options available to them, essentially outlining the availability of health care and supports that are there.

The second practitioner would need to agree with the patient that the reasonable means of alleviating their suffering have been discussed together and seriously considered, which is very important.

It is fair to say that the assessment of MAID requests by those whose death is not reasonably foreseeable can be more challenging, and can raise more concerns, than MAID requests by those who are dying or whose death is reasonably foreseeable. I think that certainly resonates with Her Majesty's loyal opposition and my colleagues on that side of the House.

For example, is their suffering caused by factors other than a medical condition, such as loneliness or lack of access to necessary supports? Are there ways of addressing the suffering, other than MAID? I think this really gets into the slippery slope in the sense that we are making sure that there are provisions in place to explore all options before an individual chooses to move forward with the process.

The new safeguards, the requirement of a minimum of 90 days and for one of the two assessors to have expertise in the source of a person's suffering, seek to ensure that enough time and the right kind of knowledge are devoted to exploring all relevant aspects of a person's situation, including whether there are treatments or services that could help reduce a person's suffering.

These are bolstered by the proposed requirement that practitioners discuss reasonable treatment options with the patient and be satisfied that the patient has weighed the risks and benefits of the available options. I think that is balanced and fair.

I think we can be confident that most of our practitioners, as part of their good medical practice, fully explore appropriate supports that are available and the available treatments in discussion with their patients. The proposed safeguards reinforce the importance of these good practices and will help to reduce risk to vulnerable persons, which I am sure we can all appreciate is a concern for members in the House.

I would like to conclude by stating that it is my belief that this bill strikes a delicate balance. We know that this is a challenging issue for many members, but it strikes a delicate balance between respecting personal autonomy and protecting vulnerable individuals.

MAID is a personal issue, and one that likely has or will touch many of us here today at some point in our lives. I, for one, am comforted by Bill C-7's proposed two-tier approach in terms of the safeguards. It is reasonable, and it is balanced.

Also, I want to go on record that I think Audrey's amendment makes sense. It was a gap under the former legislation. I have had many individuals reach out to my constituency office asking me to be a champion to make sure that Audrey's amendment was included in our revised legislation moving forward.

Other members have spoken to this, and I am certainly pleased to see that in there. If anyone knows Audrey Parker's situation, they would know of the challenge it presented to her and her family, and we do not want to have people in Canada who are forced to make that decision.

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

Mr. Speaker, I will be splitting my time with my colleague, the member for Kings—Hants.

I am pleased to rise today to speak to Bill C-7. I have some prepared remarks, and during the course of my comments, I will try to sprinkle in some responses to some of the various issues that have already been raised.

Clearly, we are here because there was a decision of the Quebec Superior Court in the Truchon case. This decision struck down a particular criterion under both the Quebec regime and the Canadian regime with respect to the end-of-life nature of medical assistance in dying, this being the reasonable foreseeability of natural death criterion, in particular at the national level.

The court's ruling only applies in Quebec. We heard the minister speaking about this. He suspended its declaration of invalidity for a period of six months, until March 11. It is important for this chamber to understand that on February 17 of this year, the Attorney General of Canada filed a motion to request an extension to give Parliament sufficient time to enact an appropriate response to ensure consistency in the criminal law. That motion was actually debated yesterday, and a decision from the court is forthcoming.

Before I go into some of the details in this bill, I want to start off with two important provisions related to conscience protection that were raised by members of the official opposition in the context of this debate. I want the record to be crystal clear that conscience protections are robust in this country and are entrenched in the law.

The first location is in the preamble to the old Bill C-14, which I will read. It states, “Whereas everyone has freedom of conscience and religion under section 2 of the Canadian Charter of Rights and Freedoms”.

I have had further questions from members of the official opposition about why it is only in the preamble and not in the statute. That assertion is wrong, because it is in the statute. Section 9 on page 8 of the old Bill C-14, which amended subsection 241.2(9) of the Criminal Code, says “For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.”

The third point I will read is from the Carter decision of the Supreme Court, which has been the subject of extensive discussion in this chamber thus far. I am reading from paragraph 132 of the majority reasons in Carter. The court states “In our view, nothing in the declaration of invalidity which we propose to issue would compel physicians to provide assistance in dying.”

Those are three instances. One is jurisprudential and the other two are statutory. The fourth one is of course the broad penumbra that is cast by section 2 of the charter, which protects freedom of conscience for all Canadians, including those who practise medicine. Therefore, the assertion that somehow conscience rights are not protected or are somehow being eroded is categorically false.

Another point in terms of what is being addressed in today's debate is the notion that a culture of overly facilitating medical assistance in dying is upon us, and that somehow this government bill is pushing us further toward predatory practices by health care practitioners or toward disavowing the right to life, liberty and security of persons who are vulnerable, including persons with disabilities. That is categorically false and is not commensurate with what is in evidence.

The evidence we have is readily available in the technical briefing that was already provided to all members of Parliament. It is that in total, 13,000 MAID-assisted deaths have happened in this country in the last four years. The average age of people who are accessing MAID is 75 years old. It is being accessed equally by men and women, 51% by men and 49% by women. The most common medical condition is cancer, followed by neurological conditions, in that 67% of all people who access it have cancer. Second come neurological conditions and third come cardiovascular conditions.

Very importantly, in the most recent year of analysis, a grand total of 5,444 people accessed MAID in this country. That represents 1.89% of all deaths in this country. I read that into the record because I think it is important for people to understand that there is not some sort of culture of medical assistance in dying that is being foisted upon unwitting individuals. I will elaborate on my reasons going forward.

I would like to talk about some aspects of the bill. The eligibility criteria have changed, as the Minister of Justice pointed out.

There are two series of safeguards. The first applies to cases in which the person's death is reasonably foreseeable, while the other applies when death is not reasonably foreseeable. The bill would add new safeguards to that second category.

Lastly, the bill allows a person to waive final consent on the day of the procedure in certain circumstances.

I will return to that in a few moments.

Much has been made about the consultation process, including some comments by the member for Mission—Matsqui—Fraser Canyon about it being a rushed procedure and that the government is not adequately listening to Canadians. I have great respect for all members in the House who are participating in this debate and raising a number of very personal, ethical, legal and moral issues. I understand that; the government understands that.

However, to assert that the consultation was not robust is again categorically false. We heard from 125 different individuals, who are experts in this field, whether they are delivering it or acting on behalf of disabled individuals, and from nurses, doctors, etc. We heard from 300,000 Canadians through their responses to a questionnaire that outlined the various scenarios.

The views of those individuals were quite concrete in the direction they were seeking. They wanted to be empowered in terms of their autonomy, dignity and their choices. They were seeking less obstacles to what had evolved to become an overly restrictive regime, as identified by the court in Truchon. That important feature must be canvassed here. What is important to understand is that the input received was critical to the development of the bill.

As part of the proposed amendments to the Criminal Code, the reasonably foreseeable death provision will be removed from the eligibility criteria. This is in response to the Truchon decision.

In terms of legal impact, this amendment would mean that people whose death is not reasonably foreseeable would be eligible for medical assistance in dying if they meet all of the other eligibility criteria.

This is very important.

The bill proposes to exclude persons whose sole underlying condition is mental illness. This has been touched upon by different people who have already intervened in the context of this debate. This is important, as was outlined by the minister. It recognizes the increased complexities and risks associated with such cases, which were highlighted by many practitioners, stakeholders and experts at the main round tables.

What is very important is that the Canadian Mental Health Association supports the position we are taking with respect to excluding mental illness as a sole underlying condition to render someone eligible for MAID.

This complex issue must be examined carefully as part of the parliamentary review of the legislation on medical assistance in dying, which is to start in June of this year, as the minister himself mentioned.

Importantly, the Government of Quebec has also announced the exact same study for the exact same provision, that the issue of mental illness as a sole underlying condition is complex. Issues of consent and capacity and issues of properly being able to diagnose and have a prognosis are critical.

I will move to some of the comments that have been made. It is important for people understand that the safeguards are under two tracks. Those safeguards respond to persons whose deaths are reasonably foreseeable and those whose death is not.

With respect to some of the aspects raised in the context of today's debate, we have taken the 10-day period of reflection out of the legislation. This was put squarely into issue by the member for Fundy Royal when he asked about the basis for doing that. The basis for it was that the safeguard was not doing the work it was meant to do. As opposed to protecting vulnerability, it was actually increasing the vulnerability of individuals insofar as it was prolonging suffering in some instances.

We heard, and the minister commented on this, that some people were so concerned about the inability to provide their final consent after 10 days that they would stop taking their pain medication, which was creating further suffering, just to maintain the ability to provide that final consent.

On the question raised by the member for Sherwood Park—Fort Saskatchewan most recently with respect to how one assures informed consent is applied when it has not been solicited actively, I have two responses. This is with regard to the advanced consent regime.

The government is conscious of the Audrey Parker situation and we are seized with it. When people have been assessed and approved for this procedure and when they make a determination that they want to access it and provide consent in writing, that consent would be sufficient.

In direct response to the member for Sherwood Park—Fort Saskatchewan, could it be vitiated? Yes. First, if the person has not lost capacity, consent could be vitiated. Second, it could be done by a physical gesture that would be interpreted to fully and finally eliminate that consent for the purposes of the practitioners.

The bill strikes a balance and the balance is important. We are conscious that a compassionate response that protects vulnerable individuals and also respects their dignity and autonomy is critical and what is required by the Constitution.

That is what this bill represents and I am very hopeful, as the member from the Bloc Québécois pointed out, that we can achieve all-party consensus on that very fundamental point.

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

Mr. Speaker, the safeguards that need to be in place for medical assistance in dying are incredibly important. We want to make sure that at all stages patients, should they change their mind, have a way of opting out.

If the member has particular concerns with how Bill C-7 is currently written and is concerned that there is not enough addressing the concerns he just brought up, perhaps there will be an opportunity for some slight amendments at committee. I am sure that myself and the member for Esquimalt—Saanich—Sooke, who serves as our main justice critic, would be willing to look at his proposed amendments to see what he proposes to make that particular section of the bill stronger.

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

Madam Speaker, it is quite incredible to be revisiting this issue. I can remember when the debate on Bill C-14 went on, back in 2016. There were some amazing speeches uttered in Centre Block during that time. This truly was an issue that had a profound effect on so many members in the chamber but, we know, also on so many members of our society.

I was honoured in 2017 to serve as our party's justice critic. I am pleased to again be serving in the role as the deputy justice critic for the NDP. I have always felt that this particular critic role brings with it a very great weight of responsibility, especially when we are dealing with the Criminal Code. I do not think there is any other statute in Canada that has such a profound effect on people when they violate any of its provisions. It also gives a lot of guidance, as is the case in medical assistance in dying, over the parameters that are set up.

Regarding medical assistance in dying I, like many members in the chamber, received a lot of correspondence on the issue back in 2016, both from constituents who were against it and from constituents who wanted me to take up the cause.

I think that is the challenge that we as members of Parliament face on a regular basis. We have to look at our constituents' wishes, but they are not always very clear cut. We have to try to balance those with our own personal views on the subject and, at the end of the day, try to be accountable for the decisions we have made on behalf of our constituents in this place.

When it comes to an issue as complex as medical assistance in dying, I fundamentally believe that we must go beyond partisanship and work together with a compassionate lens. Ultimately, we must make sure that Canadians can die with dignity, compassion and fairness, and without excessive suffering.

I am pleased to see the introduction of Bill C-7 as part of the effort to help those who are looking to end their unnecessary suffering as they face the end of life. Bill C-7 is coming to us as a result of a decision in a Quebec court. For me personally, and for many members of the New Democratic caucus, it was quite evident in 2016 when we were debating Bill C-14 that this issue would come back to us. We knew it was only a matter of time.

I can remember referring, in the debates on Bill C-14, quite clearly to the Carter decision, which was handed down by the Supreme Court on February 6, 2015, in the final months of the 41st Parliament, when the Harper government was in power.

When the present Liberal government came to power in 2015, this was one of the major challenges it was faced with, because there was an impending deadline and there was a real rush to get in legislation that was going to respect the Carter decision.

I want to give a shout-out to two of my colleagues, Murray Rankin and Brigitte Sansoucy. As members of the New Democratic caucus, they sat on the special joint committee that looked at this issue as a result of the Carter decision, and presented the committee's recommendations to the House of Commons.

When we look at the Carter decision, which really started this whole process rolling just over five years ago now, we can see that they felt the prohibition on allowing people to take their own lives because of suffering violated their Charter rights. I will just quote from the ruling. It was stated that:

Here, the prohibition deprives some individuals of life, as it has the effect of forcing some individuals to take their own lives prematurely, for fear that they would be incapable of doing so when they reached the point where suffering was intolerable.

It went on to say:

An individual’s response to a grievous and irremediable medical condition is a matter critical to their dignity and autonomy. The prohibition denies people in this situation the right to make decisions concerning their bodily integrity and medical care and thus trenches on their liberty. And by leaving them to endure intolerable suffering, it impinges on their security of the person.

Thus, it violates section 7 of the Charter of Rights and Freedoms. Just to read it into the record, so that everyone is quite clear on what we are referring to, section 7 reads that:

Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.

What Carter was clearly explaining to people was that by not allowing people this option, by keeping them in a state of constant suffering, of basically confining them to their bodies, we were in fact violating their section 7 rights. That was the clear message that was delivered to Parliament.

There is always a careful dance between our courts and the legislature. The courts, of course, are very much responsible for interpreting the law, but also finding when such a law runs contrary to our Constitution. They also recognize that Parliament has its role to play as the lawmakers, as the one institution that can amend the law based on people's wishes. That was the task that was handed to us at the beginning of the 42nd Parliament.

When that special joint committee with the other place was formed, there were some clear recommendations that directly followed from the Carter decision. Recommendation number two, which I will read into the record, was as follows:

That medical assistance in dying be available to individuals with terminal and non-terminal grievous and irremediable medical conditions that cause enduring suffering that is intolerable to the individual in the circumstances of his or her condition.

The problem that led us to where we are today was the fact that Bill C-14, as a government bill, decided to insert a reference to “reasonably foreseeable death”. This meant that if one had a medical condition for which death was not reasonably foreseeable, one could not qualify for medical assistance in dying.

Also, as a part of that special joint committee's recommendations, it did touch on the subject of advanced directives which is also, I am glad to see, addressed in Bill C-7.

The Truchon decision of 2019, in the Superior Court of Québec, involved two plaintiffs who were each suffering from grave and incurable medical conditions that caused tremendous suffering and a total loss of autonomy.

They were 74-year-old Nicole Gladu, who used a wheelchair and had post-polio syndrome, which is a condition that weakened her muscles and reactivated her childhood scoliosis. She had difficulty breathing and was in constant pain. As well, there was 51-year-old Jean Truchon, who was born with cerebral palsy and no longer had the use of his four limbs. He lost the use of his only working limb back in 2012, due to severe spinal stenosis that left him almost completely paralyzed and caused painful spasms. He gave up most of his activities and went into assisted living since there was little he could do by himself.

Both of these individuals were refused medical assistance in dying under the Quebec legislation regarding end-of-life care as they were not at the end of their lives. Their deaths were not reasonably foreseeable.

With those grave medical conditions, they were prisoners in their own bodies but unable to find any relief. Really the heart of the matter here is how we, as an institution, respect individual autonomy. We can only imagine the pain and suffering they were going through on an hourly basis. When two individuals have arrived at this decision and obviously had the time to think about it, I think it is incumbent upon us to respect that, but more importantly to respect the fact that we have had a court look into this and determine that their charter rights were fundamentally violated.

That brings me through the long journey over the last five years to Bill C-7.

I am pleased to see the bill introduced. The Minister of Justice was one of four Liberals who voted against Bill C-14. I think he is now having a moment where it has come full circle. Now, as the Minister of Justice, I hope he feels some satisfaction in bringing in corrective measures to address the problems he saw as a Liberal member of Parliament back in 2016, when he voted against the government's legislation at the time.

As is required by the decision of the Quebec court, Bill C-7 will expand access to medical assistance in dying to those whose death is not reasonably foreseeable. I can assure the House that we are providing our support to the bill in principle at second reading. However, we will be doing our due diligence when it reaches the Standing Committee on Justice to ensure that access to medical assistance in dying has not been unreasonably restricted for those whose death is not reasonably foreseeable by the addition of the new conditions in the legislation.

We also want to ensure the standard of eligibility for receiving medical assistance in dying remains high. We remain disappointed that there has been no commitment by the minister to refer the question of the adequacy of the safeguards against pressure to seek medical assistance in dying to the formal legislative review, which will begin in June, again at the Standing Committee on Justice. Perhaps the government can hear those words, reflect upon them and address our concerns with respect to that aspect.

Going into some of the finer details of the bill, essentially there is a two-track process in Bill C-7. There is one for those whose death is reasonably foreseeable and one for those whose death is not reasonably foreseeable.

For the one where death is reasonably foreseeable, the 10-day waiting period is removed; the number of independent witnesses required for the written request is reduced from two to one; a paid professional or health care worker can be an independent witness; and the creation of a waiver of final consent.

For the second track, which is ultimately the part of the bill that is responding to the decision from the Quebec court, a few more restrictions are in place. The first big one, which will warrant some further study at committee, requires a minimum 90-day assessment period, which I think the legislation states can be shortened if loss of capacity is imminent and the assessments have been completed.

However, as I have said in previous questions and comments, we have already heard from some members of the medical community. They say that the 90-day assessment requirement may mean their patients have to endure another 90 days of suffering. For physicians, who take the Hippocratic oath to do no harm, if their patients are experiencing harm every day because of that suffering, that weighs very heavily on their conscience.

There are some other specifics in that other track process that I do not think warrant going into too much detail at this stage. The Standing Committee on Justice will do that.

I also want to touch on another aspect of Bill C-7, which is the advance directive. This is known as the Audrey Parker amendment. It refers to Audrey Parker, a Halifax woman who was diagnosed with stage four breast cancer, which metastasized to her bones and a tumour on her brain. She spent the last weeks of her life raising awareness about the challenges facing Canadians who had been assessed and approved for assisted dying. She opted to die earlier than she would have otherwise wanted to. The legal requirement in the existing legislation is that the suffering person has to be competent immediately before the life-ending treatment is administered.

That presents a number of problems. If someone has already been approved for medical assistance in dying within the tight confines of what is written in Bill C-7, he or she can give that advance directive so that those wishes will be fulfilled even if there is a loss of competency. It would remove a sense of pressure that could be brought to bear on individuals who may feel compelled to take their life earlier, while they still have competency and the ability to act on their own directive. Therefore, I think this is a particularly important section of this legislation that should be noted, and I certainly look forward to seeing what kind of testimony we hear at the justice committee.

I have received some correspondence with respect to the Audrey Parker amendment. I have an email here from a constituent. She sent me a copy of her letter to the justice minister. She states:

These steps ensure that the patient qualifies for medical assistance in dying under the law, making the late-stage consent requirement unnecessary — and puts an enormous physical and emotional strain on people who are at risk of suddenly losing capacity, or who need heavy medications to manage their pain.

Most importantly, this unfair requirement means that people in the Assessed and Approved category are faced with a cruel choice: access assisted dying now, or wait longer and risk losing out on their right to a peaceful death.

Right now, dying people are ending their lives far earlier than they would like, or are refusing adequate pain care out of fear that they will lose out on their right to a peaceful death. This is an unacceptable burden for anyone to bear, and it is a clear and grave violation of Canadians' Charter rights.

That is just an example of some of the correspondence I have received on that particular aspect. It is actually really nice and refreshing to hear someone lay it out quite clearly because I think if we were to visit any riding we would all have constituents who have faced those pressures.

This is weighty subject matter. I know that in this chamber and indeed across this great country there are going to be multiple views on whether we are in fact going down the right path.

In moments like this when we are called upon to make these momentous decisions, we are required to look inside ourselves and to switch more from sympathy to empathy. I see this difference between the two. Sympathy is feeling sorry for someone else, while empathy is trying to put oneself in that person's shoes in order to view the world as she or he sees it.

The truth is that the members of this chamber who are lucky enough to have their health and to lead privileged lives cannot adequately express or feel what it is like to live in a body that feels like a prison and to know that kind of suffering. My ultimate view of this bill, and what guides me in the direction we need to take, is that it is about trying to make sure we can give people the dignity in death that they had in life, to respect their autonomy, to respect their choice and to make sure that their charter rights are not violated.

I conclude by stating that the New Democrats will be supporting this bill at second reading, with the full realization that the committee work is before us, which will be a real opportunity to hear from members of the public and witnesses. Hopefully, when this bill returns to the House we will have a product that we all feel we have done our best on and that lives up to the important wishes of our constituents who are living with these incredible amounts of suffering.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, it is with some emotion that I rise in the House today to speak to Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying.

We are debating Bill C-7 today because the legislators who were here four years ago did not do their job properly when they debated Bill C-14. We do not live in a democracy run by judges. We are the ones that make the laws and who must make the voices of citizens heard, particularly the voices of those who are suffering. All judges do is interpret the grammar of justice. They look at the laws and people's rights and freedoms and determine whether the infringements are reasonable or not. However, before Bill C-14 was introduced, two courts told us that, according to the law, the Criminal Code infringes on the right to life and the right to liberty and security of those who are ill and suffering, are struggling with unbearable pain or have a terminal illness.

Today, I hope that we will seize the opportunity that is given to us. I hope that we will extend the debate until June because this is a serious subject. I hope that we will have a calm, rational debate.

I will start by saying that I am sure my colleagues in the House all have good intentions. They want to do good. They have kind hearts. I am sure that their behaviour throughout the debate will reflect the very values they are advocating, namely benevolence and caring. However, we cannot be benevolent and want what is best for a terminally ill person if we refuse to listen to what that person has to say before they die.

All I want is for us to understand what is at stake here, I am referring to the law, which my Conservative friends have always put on a pedestal. The value of autonomy is conferred by law through the principle of self-determination, especially with regard to medical care. I will come back to that.

I will take a moment in this debate on such a crucial and delicate issue to say that I hope all my colleagues get to cross the threshold of death peacefully, quietly and painlessly. That is my wish for everyone, because the best fate we can wish on another human being is to find peace, to let go and to receive what is known as good palliative care if they are terminally ill with an irreversible ailment. More on that later.

Today we are discussing the autonomy conferred by law through the principle of self-determination. In the biomedical context, there is a rule. A value gives rise to a principle, which in this case is self-determination. This principle gives rise to a specific rule, namely the rule of free, informed consent. The rule about free, informed consent to treatment has never been challenged in emergency situations.

Why would it be any different for human beings experiencing intolerable suffering due to an irreversible illness or condition?

Why would it be any different for competent individuals who are neither depressed nor suicidal and who have expressed a desire to live fully until they reach the limit of what they can tolerate?

I therefore invite my colleagues to join me in a debate on autonomy and self-determination. If someone shows up at an emergency room, they cannot be treated without their consent. Everyone has the right to refuse treatment, by the way.

In the Carter decision, which led to Bill C-7, the Supreme Court ruled that the provisions prohibiting medical assistance in dying violated the right to life, liberty and security of the person. People like Ms. Gladu, Mr. Truchon, Ms. Carter and Ms. Taylor have not reached the end-of-life stage. They might not even be in the terminal phase of their illness. That does not mean they have not reached, or are not in the process of reaching, the limit of what they can tolerate.

The court stated that those provisions were effectively shortening the lives of such individuals, that they violated their right to life by inciting them to commit the act before they were ready. That is the issue that we are called upon to address. There is no issue for people who are terminally ill. The issue we need to address as legislators has to do with people whose death is not reasonably foreseeable and imminent.

The bill proposes that a person who is not terminally ill must consent twice and be bound by a 90-day period. I really wanted to talk about advance consent. I imagine we will do so eventually. That is about all that is missing from the bill. Clearly the Bloc Québécois is in favour of passing this bill in principle.

What we want is respect for the moral autonomy of the dying. We often speak of dying with dignity. Dying with dignity does not mean having a sanitized death. That is not it. The dignity of a person is derived from their freedom to choose and respect for their free will. That is what it means to be a human being. When that is violated, we violate the dignity of the human being. Whether the death is unpleasant or not is not the issue. The crux of the matter is to allow the human being to make a decision about the end of their life.

Unfortunately, in the past, we won the right to die rather than undergo aggressive therapies. At the time, we called this passive euthanasia. The person was left to die without death being the intent. Palliative care was still in its infancy. There was a great fear of administering one last fatal dose of medication, which always ends up causing death, because palliative care provides care.

Human beings won the right to die rather than undergo aggressive therapies. People did not die of cancer; the therapies killed them. Experiments were conducted on human beings. Doctors led the way to ensure that they would have quality of life if they were to be struck by cancer. They did not want to receive treatments that would make them ill for a year when they only had two years to live.

The right to die won out over aggressive treatment plans. That idea evolved and became palliative care.

For a long time, palliative care was thought of as the only solution that would allow someone to die with dignity. However, in the past 30 years, were there people living with terminal illnesses, dying a slow, agonizing death, who did not receive all of the palliative care they needed until the end of their life, if that was what they wanted?

First, we need to look at whether palliative care is accessible. There is an increase in requests for medical assistance in dying. Bioethics talks about clinical ethics, in which the patient comes first. It is about listening. Sometimes, even the best palliative care in the world, with the best framework in the world, cannot alleviate someone's suffering.

That is true for Ms. Gladu and for Mr. Truchon, but those people are not suicidal. They want to live as long as possible. When they want to die, they may be given anti-depressants. They will be of sound mind when they make their decision. That decision will be reversible. I was listening to Ms. Gladu the other day. What does she want? She wants freedom of choice. In many cases, once people have that choice, they have so much respect for their dignity that they are no longer in such a hurry. That reduces suffering tremendously. That is the issue we are dealing with.

We must not sidestep this issue on the grounds that we want to move swiftly. I have a lot of questions about the bill because it does not address degenerative cognitive disease. I think a person with Alzheimer's should have the opportunity to make an advance request.

These are predictable diseases. Doctors can tell patients how they will progress. People with these diseases often remain of sound mind for years. Eventually, they become forgetful. In the end, they die not of the disease itself but of complications from being bedridden or immobilized or conditions other than that disease. This bill does not take those people into account.

What I would hate is to see a repeat of what happened with Bill C-14. The reasonably foreseeable natural death criterion was established, and it was supposed to protect vulnerable people.

Is there anyone more vulnerable than someone who is suffering from intolerable pain, who is living with an incurable illness and who is being told to go to court for the right to choose and to die with dignity?

Is there anything more important and more intimately personal for an individual? It is not as though the person's neighbour is going to die for them.

I have a hard time understanding our Conservative colleagues' argument that the state must decide for an individual, when they are so economically libertarian.

In 1957, Pope Pius XII was a pioneer. He said that we must stop claiming that only God can decide whether we should die a slow death. At a certain point, he made it possible for us to sanction palliative care.

Today, let us not pit palliative care and medical assistance in dying against each other, regardless of whether we are talking about a degenerative disease or an illness that causes extreme pain but is not terminal. Let us not pit those two realities against each other. Respect for human dignity includes proper support when one is dying, which requires doctors to have the humility to recognize that they cannot always help people manage their pain adequately.

Our society recognizes people's right to self-determination throughout their lifetime but takes it away from them at the most intimate moment of their lives. In so doing, we think that we know what is best for people or that we are doing the right thing, when we are actually undermining human dignity. There is no more important moment in a person's life than their death. Learning to live is learning to die. Learning to die is learning to live. I say that because the clock starts ticking the moment the doctor cuts the umbilical cord.

I appeal to my colleagues' humanity. I am a staunch democrat, humanist and, of course, sovereignist. I am all of those things, but one does not take precedence over the other when it comes to problems like this.

I am not saying that the federal government should have challenged that ruling because it came from a Quebec court. In any case, it is a court under federal jurisdiction that rendered that decision.

This ruling challenges us as legislators to do our job and stop off-loading the problems, the ethical, social and political questions to the courts. We have a job to do as legislators.

There is a sociology of law. In a society, the law evolves with people's consciences. I know I am straying from the technical details of the bill. However, I said from the outset that we agree in principle and on the grounds for discussion of this bill. I apologize for being overly philosophical today, but that is where the substance of the debate lies; it is ethical and it is political in the noblest sense of these words. Indeed, it is up to us to make the laws to ensure the well-being of all. It is a philosophical debate and, in a way, a theological debate that leads us to the law. However, regardless of how much time we spend on this, let us use substantive arguments.

When I hear arguments to the effect that this is a slippery slope, I think about the study of Bill C-14, during the last Parliament, when some people were practically saying that nursing homes and long-term care facilities would become euthanasia machines. I do not know of any evil people who work in health care, in any position. If such a person exists, then let them be fired, because they have no place there. I am not buying the slippery slope argument.

We must assume from the outset that all stakeholders in the health system are caring and compassionate. Yes, they sometimes experience difficulties. With just a slight increase in health transfers, they could provide better care and there might be more palliative care units in hospitals. Even though I do not believe that palliative care is the only solution, that is what people have been saying for 50 years. It makes no sense that there are not more palliative care units.

Not everyone asks for MAID. I talk a lot about those who do not pose a problem. In Quebec, where the Quebec law is in effect, the obligation to meet the criterion of a reasonably foreseeable natural death forces people to go to court or to go on hunger strikes. This criterion was unconscionable, and the courts handed down an appropriate ruling in that regard.

Therefore, I appeal to my colleagues' humanity.

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Madam Speaker, when this House opens most days, we take a moment to pray, reflect and ensure our words and our jobs of representing Canadians are done to our utmost ability. We are honoured to be in the people's House. My personal prayer today is that my words reflect the severity of Bill C-7, a very serious subject.

I have been closely following the Liberals' terrifying progress as they work to embed the practice of efficient death in our medical system. In January they held MAID legislative consultations online for a total of only two weeks; two weeks to hear from the public on legislation that is truly a matter of life or death.

There is a mandatory five-year review set for this June for our MAID law, but instead of working within that timeline, the Liberals have let one ruling from one Quebec judge dictate the legislative direction for the entirety of Canada. At minimum, this issue should have been referred to the Supreme Court of Canada.

I am fearful of the current justice minister who voted against MAID in the previous Parliament, not because he was against it, but because he felt it did not go far enough. That is the driving force behind some of these drastic changes.

As the Liberals have just tabled the bill this week, I have only had a short period of time to begin digesting it. I need to stress to the House today that these are my preliminary thoughts. In my opinion, this is a needlessly rushed process on a sensitive, significant issue that does touch every Canadian.

For the first four months of my term, I have heard from many concerned constituents, advocacy groups, differently abled individuals and organizations, and those in the medical profession.

What I need to emphasize at the outset of my time here tonight is the innate value of every human being, regardless of ability. I want to speak directly to those who are in physical pain, those in mental anguish and those who feel they are a burden. Everyone is loved, everyone is valuable and everyone is made in the image of God. There is a place in our society for patients in unbearable suffering with no possibility of recovery to be provided with end-of-life options. We owe this to Canadians. Autonomy and personal wishes do need to be respected.

There is a paradox, in that suffering is both hard and good. Everyone who suffers deserves our love, our care and access to appropriate palliative care. I will touch on palliative care in a moment, but presently I will address this bill, raise some of the concerns I have with it from my initial reading and voice the concerns of those it affects directly from whom I have heard, including our medical professionals and the vulnerable or disabled of our society.

Numerous organizations like Canadian Physicians for Life and Canadian Society for Palliative Care Physicians have raised numerous significant issues with Bill C-7. The organizations cite specific concerns with clauses of the bill and also relay an overarching general concern about how the proposed legislation erodes the trust that vulnerable people should be able to have in the medical profession.

We seek out medical aid when we are at the lowest, most vulnerable points in our lives. Vulnerable Canadians must be able to find protection within the medical community. In an ironic, tragic twist, the preamble of the bill recognizes the importance of protecting vulnerable persons from being encouraged to end their lives, but does nothing to support what should be foundational in our health care system.

The bill itself drops many of the already too few safeguards around MAID and places vulnerable people at an increased risk.

Point one is that the reasonably foreseeable natural death criteria has been removed, which would drastically reinvent MAID. It would no longer be an alternative to a painful death, but an alternative to a painful life.

Point two is that independent oversight has been reduced. Where two witness signatures were previously required on a patient's written request for MAID, the requirement would now be one. The bar would be lowered even further as that individual, that supposedly independent witness, can be the person paid to take care of someone, that is, medical staff.

Point three is that disturbingly, Bill C-7 also does away with the previous 10-day waiting period for those whose natural death is reasonably foreseeable.

Under Bill C-7, one could be diagnosed and killed all in one day, with no opportunity for reflection or discussion with friends or family members. That is what this bill would do.

Point four is that the bill would also legalize physician-assisted suicide by advance request through a waiver of final consent and drop the requirement for consent to be given twice before MAID is performed. The existing law requires consent at the time eligibility is granted and again before termination of life occurs. Under the new law, once consent would be given, there would be no need for medical staff to confirm it before administering a lethal injection.

Can someone consent in advance to being killed once they reach a state they fear but which they are not experiencing now and, in fact, have never experienced? Once a person has signed an advance request and has lost capacity to consent to medical treatment, at what point should euthanasia take place? At what point should a person be killed?

In a technical briefing yesterday, officials were pushed to explain how MAID would be administered and what safeguards would be in place for the day, the hour, the minute euthanasia would be carried out. Shockingly, the legislation would only require one medical practitioner to be present. Therefore, even if an individual attempted to withdraw consent, there would be no mechanism to ensure their wishes were respected. One medical professional should not be permitted to conduct euthanasia alone. This would not ensure accountability and, in my opinion, is completely unacceptable.

Additionally, there is no provision for individuals to be able to seek doctors who would not counsel MAID as a treatment option. In fact, there is no mechanism for physicians to opt out of providing MAID or any conscience protections for medical professionals who refuse to participate in MAID or do not wish to refer a patient.

We are seeing this in British Columbia, where the Delta Hospice Society has been denied funding for refusing to offer MAID services. With this in mind, how then are individuals able to trust that the doctor will really care for their well-being? The frightening thing is that pro-MAID health care providers are not waiting for people to raise the possibility of euthanasia. In fact, we are hearing first-hand accounts of individuals who have been encouraged to pursue this option unprompted.

What about section 241 of the Criminal Code, which counts it an offence to counsel a person to commit suicide? Those staring at the precipice of potential death should not have the entire medical establishment looming behind them to pursue a certain option.

This brings me back to palliative care and the dismal record on caring for Canadians at end of life. There is nothing in the bill and little tangible government action taken to approve access to palliative care. The Conservative dissenting opinion from the committee's review of previous MAID legislation states, ”A genuinely autonomous choice for a person to end their life is not possible if they are not offered palliative care as they will see their choice as only intolerable suffering or PAD [physician-assisted death].”

The Canadian Hospice and Palliative Care Association estimates that fewer than 30% of Canadians who need it have access to palliative services. The Conservative Party recognized this need in its 2019 platform and a Conservative government would implement the framework on palliative care in Canada.

As I referenced the Canadian Hospice and Palliative Care Association, I need to make one its points crystal clear, which is that MAID is not part of hospice palliative care. It is not an extension of palliative care, nor is it one of the tools in the palliative care basket. Health care articles, the general media and, sadly, politicians continue to conflate and thus misrepresent these two fundamentally different practices.

Hospice palliative care focuses on improving quality of life and symptom management through holistic, person-centred care for those living with life-threatening conditions.

In conclusion, at my first reading, I am disappointed to say that the Liberal government's proposed legislation to amend MAID sadly misses the mark on many levels. It had the opportunity to increase safeguards for the vulnerable, provide conscience right for medical practitioners, implement protections for those living with mental illness and address many more legislative inadequacies. I hope that in the spirit of this minority government the suggested amendments coming from all sides of the House will be welcomed graciously and thoughtfully.

To my constituents, I am opposed to these changes and will urgently seek their feedback. Many of them live with stories and experiences on both sides of this issue and I need to hear from all of them.

To reiterate, to those who are in physical pain, who are in mental anguish and who feel they are a burden, they are loved, they are valuable and they are made in the image of God.

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, it is a great pleasure today to rise as the shadow minister of justice for the official opposition to speak to the government's Bill C-7. As I rise to speak on this bill, I do so with concern over some of the contents within it and even over the way it was presented to the House this week when, unfortunately, many of us read about the contents of the bill in the media, rather than seeing it first in this House.

The bill was intended to be a response to the Quebec Superior Court decision that was made on September 11, 2019. The decision stated that the law as it stood was too restrictive around the requirement for death to be reasonably foreseeable. The official opposition called on the government at the time to appeal the decision to the Supreme Court of Canada in order for Parliament to receive clarity about the parameters in which we would legislate, but the bill was introduced without that clarity.

Not only was the bill introduced without that clarity, but it goes far beyond what was required to meet the Quebec Superior Court's decision. I believe that is an affront to this Parliament, because when the previous bill, Bill C-14, was passed in the 42nd Parliament, the wisdom of this Parliament required that there be a statutory review of our assisted dying regime in Canada. That statutory review was and is to take place in June of this year.

It is in that review period that parliamentarians would be able to go more into depth on how the government's legislation has worked over the past several years and on how best to proceed. Rather than wait for that review, as it should have done, the government has decided to start making amendments to the legislation now, avoiding the in-depth review that is to take place shortly.

The reality is that when we are talking about this legislation, we are literally talking about the matter of life and death. This is an incredibly sensitive issue. Members on all sides of the house have diverse opinions on it, and it is because of this diversity of opinions and because of the sensitivity of this issue that the Quebec Superior Court decision should have been appealed to the Supreme Court of Canada for further clarity. However, as the government has now opened this legislation up, it is upon us as legislators to now highlight other matters that should be addressed and included.

My office has heard plenty from concerned Canadians about the lack of protection for conscience rights for health care professionals. This is particularly important now that the government is broadening medical assistance in dying to include individuals whose death is not reasonably foreseeable. Expanding medical assistance in dying to more patients could in fact diminish the number of medical professionals willing to take part in the process. The fact is that this expanded access could result in a heavy emotional burden on those health care providers.

None of us here can fully appreciate the burden put on those health care providers currently working in the system and providing medical assistance in dying. The fact is that there is nothing about ensuring proper support to health care professionals who provide this service and there continue to be no penalties for pressuring a medical professional into providing medical assistance in dying, nor are there penalties for punishing or penalizing a medical professional who does not participate in medical assistance in dying. This means there continues to be no real protection for conscience rights for health care professionals.

The issue of advance directives, now rebranded as a “waiver of final consent” by this government, is a complex one that poses questions of ethics and safety and issues with oversight. The fact that the legislation legalizing this is half a page of a bill shows a lack of care given to this issue. This issue rightly should have been discussed as part of the parliamentary review to take place this summer.

The process for the creation and execution of this agreement remains ambiguous. Further, there is a lack of clarity on the process for proceeding with an advance directive agreement upon the date selected. The process will only be stopped if a patient expresses a form of resistance, but we do not know what that looks like. What if they are simply confused or groggy at the time? Under the legislation, unless they resist, the process will still proceed.

The bill also removes the 10-day waiting requirement when a person's death is reasonably foreseeable. When I read in media reports before the bill was tabled that this would be included, I, like many of my colleagues and parliamentarians, questioned as to what prompted its removal. I still remain incredibly concerned as to why this was included. This is particularly true because there was already the ability to remove the 10-day waiting period if a person's death or loss of capacity to consent was imminent, so why proceed with the removal of a safeguard that Parliament saw fit to include in the previous legislation?

It is also confusing that Bill C-7 requires a 90-day waiting period when a patient's death is not reasonably foreseeable. Why add an extended wait period for one, but remove the wait period entirely for the other?

On the issue of whether a death is reasonably foreseeable or not reasonably foreseeable, there is no clarification or guidance for health care professionals. As a result, it is not up to them to make the determination as to what category to put a patient under. That determination will decide whether a patient can access medical assistance in dying immediately or if they will require a 90-day waiting period. This is an extraordinary amount of pressure that the government is putting on health care professionals across this country.

The changing of witness requirements under this legislation has also been mentioned. The law requires only one independent witness, which is down from two.

All of these changes lead to an expansion of the law in Canada far beyond what was addressed in the Quebec court decision, an expansion that should have required deeper reflection through the study that is to take place this summer.

For a moment, let us speak to a point that seems to be lost in this conversation: palliative care services in this country.

The reality is if the choice is between a lack of quality palliative care and medically assisted dying, that really is no choice at all. Unfortunately, over the past number of years there have been instances of patients feeling they were forced to choose death because of a lack of palliative care.

The story of Archie Rolland comes to mind. Archie was a Montreal landscape architect who chose to end his life rather than continue suffering at a long-term care facility that was failing to provide him adequate care.

He had ALS and had his life upended when he was forced to move from a Montreal hospital that specialized in treating patients with severe respiratory ailments to a long-term care facility for geriatric patients. Mr. Rolland did not want to go, but he was transferred against his wishes. He called the system “inhuman”. He felt he was not getting adequate care, so he chose death.

I do not think that this is any real choice at all. We must have the discussion in this country about palliative care because people must not feel forced into a decision on medically assisted death. Mr. Rolland's story makes it clear that there was a failure of the system to provide him with adequate care. We risk medically assisted death being seen as some sort of bureaucratic solution for people who require an extra level of care. In a country like Canada, that is simply not acceptable. The government risks expanding a culture of not valuing life, and we should all agree in this place that we must place value on human life.

In closing, the bill disrespects Parliament and the parliamentary process. With Bill C-14, parliamentarians did a significant amount of work in the House and committee in an attempt to build consensus. The work was challenged by the Quebec Superior Court, but rather than defending the will of elected representatives in court, the Liberals immediately backed down.

Now the Liberals are responding not just to that decision but are also undoing the work of the joint committee on Bill C-14 by adding new measures.

Many of these issues should be dealt with in the summer when we have our scheduled parliamentary review. This is a complex matter that requires proper scrutiny and debate.

[David Lametti, Liberal, Minister of Justice]

moved that Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

Madam Speaker, I am pleased to rise today to speak to Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying.

The bill proposes a legislative response to the Superior Court of Québec's Truchon decision, as well as some other changes to the Criminal Code provisions that set out Canada's medical assistance in dying regime.

In June 2016, former Bill C-14 amended the Criminal Code to create Canada's first law on medical assistance in dying, or MAID. The legislation created exemptions to Criminal Code offences so that individuals suffering unbearably and nearing the end of their lives could die peacefully and with the help of a physician or nurse practitioner, rather than in agony or in circumstances that they considered undignified.

This significant change in our criminal law was indicative of the value that Canadians ascribed to having choices, including about the manner and timing of their deaths when suffering in the dying process was intolerable. The most recent data obtained by the federal MAID-monitoring regime indicates that over 13,000 Canadians have received MAID since it has become decriminalized.

We are now proposing another important change to our criminal law. In Truchon and Gladu, the Quebec Superior Court ruled that it was unconstitutional to limit access to medical assistance in dying to persons whose death is reasonably foreseeable.

We decided not to appeal the decision because we want to reduce the suffering of people waiting for medical assistance in dying.

When we announced our decision not to appeal the ruling, our government also committed to changing the eligibility criteria for medical assistance in dying throughout Canada to ensure that criminal law is consistent nationwide.

Application of the court's ruling, which is limited to Quebec, was suspended for six months. The deadline is March 12. Because these issues are so important and because we want to ensure that our laws are consistent all across Canada, we have asked the court for a four-month extension, which would give Parliament time to thoroughly consider and debate the amendments proposed in this bill. There was a hearing yesterday regarding this request.

Consulting Canadians about the next phase of medical assistance in dying in Canada was crucial to drafting this bill. That is why we launched a two-week public consultation on January 13. The level of participation was unprecedented. We received over 300,000 responses, an indication of how important this issue is to Canadians.

At the same time, together with the Minister of Health, the Minister of Employment, Workforce Development and Disability Inclusion and our parliamentary secretaries, we held 10 round-table discussions across the country between January 13 and February 3.

This included round tables in Halifax, Quebec City, Montreal, Ottawa, Toronto, Winnipeg, Calgary and Vancouver. We met over 125 individuals, including doctors, nurse practitioners, legal experts, members of the disability community, indigenous peoples, and representatives of health regulatory bodies and civil organizations.

We are grateful to all who participated in the round tables. Their shared expertise and experiences were of immense value in developing this bill. I have no doubt that many will continue to engage in the parliamentary process as witnesses before committees.

The results of this consultation process will be published shortly in a “what we heard” report. We heard views on many different topics, but I would like to mention just a few.

From the public online consultations we heard that, while the majority of respondents think the current safeguards are adequate to prevent abuse, in a MAID regime that is expanded to persons who are not dying in the near term, a majority of respondents also thought it would be important to require additional safeguards in such a broader regime. Many round-table participants suggested two separate sets of safeguards in an expanded regime. Others shared their experiences with existing safeguards as they apply to those who are near the end of their lives.

Specifically, many felt that the requirement for two witnesses when a person's written request was made was too onerous and afforded little protection, and that the 10-day reflection period unnecessarily prolonged suffering.

Informed by these in-depth consultations, and by the Canadian experience with medical assistance in dying to date, along with many other sources of information, Bill C-7 proposes to respond to the Truchon decision by adjusting both the eligibility requirements and the safeguards. It also proposes to enable patients in certain circumstances to waive the requirement for final consent so that they do not lose their access to MAID.

We know there are other issues about which many Canadians still feel strongly but which are not subject to the Superior Court of Québec's deadline, such as eligibility in cases where mental illness is the sole underlying condition, advanced requests and mature minors. These will be examined in the course of the upcoming parliamentary review.

Before describing the proposed amendments, I would like to address the concerns we heard from many in the disability community following the Truchon decision and during our consultations. Disability groups were very clear that, for them, removing the end-of-life limit on MAID would create a law that holds disability as a valid reason for ending a life and reinforces the false perception that disability is equivalent to a life of suffering.

Our government is sensitive to these concerns. We strongly support the equality of all Canadians, no matter their situation, and we categorically reject the idea that living with a disability is a fate worse than death. However, we are also mindful of the need to balance these concerns, along with others that have been expressed, with other important interests and societal values, in particular the importance of individual choice.

The bill's objectives are therefore to recognize the autonomy of individuals to choose MAID as a means of relieving intolerable suffering, regardless of their proximity to natural death, while at the same time protecting vulnerable persons, recognizing that suicide is an important public health issue and affirming the inherent and equal value of every person's life. More concretely, Bill C-7 proposes to expand eligibility for medical assistance in dying beyond the end-of-life context by repealing the eligibility criteria requiring that natural death be reasonably foreseeable.

Recognizing that intolerable suffering also arises outside of the end-of-life context and that Canadians want to have choices, medical assistance in dying would be become available to all those who are intolerably suffering; who have a serious and incurable illness, disease or disability; and who are in an advanced state of irreversible decline in capability, without regard to whether they are dying in the short term.

At this time, the bill proposes that persons whose sole underlying condition is a mental illness not be eligible for medical assistance in dying. First, we are subject to a court-imposed deadline and this matter requires more in-depth review and debate. We have learned that the trajectory of a mental illness is more difficult to predict than that of most physical illnesses. This means that there is a greater risk of providing medical assistance in dying to people whose condition could improve.

It is also more difficult to carry out competency assessments for individuals with a mental illness. In the case of some mental illnesses, the desire to die is itself a symptom of the illness, which makes it particularly difficult to determine whether the individual's request is truly voluntary.

Like the Government of Quebec, we are of the opinion that we need to continue consultations, discussions and policy development on the issue of MAID requests based solely on mental illness.

The parliamentary review that will be launched next June will be an appropriate forum for examining these issues, without the time constraints of the court-imposed deadline.

I would now like to turn my remarks to the question of safeguards. Many experts believe there are greater risks in assessing requests for MAID from individuals who are not nearing the end of their life. We agree. While these individuals would have a choice to seek MAID, the bill proposes that these requests be treated with greater sensitivity and care.

Accordingly, the bill proposes two streams, or two sets of safeguards. To distinguish these cases the bill proposes to use the concept of reasonably foreseeable natural death. Let me be clear on this point. Not having a reasonably foreseeable death would no longer be grounds for rejecting a MAID request; however, it would be used to determine which of the two sets of safeguards are required in a given case.

As enacted by Parliament in 2016, reasonable foreseeability of natural death refers to a death that is expected in the relative near term. It means that in light of all the person's medical circumstances, his or her death is expected in a relatively short period of time. Natural death is not reasonably foreseeable just because an individual is diagnosed with a condition that will eventually cause death many years or decades into the future.

In practice we know that practitioners are more comfortable prognosticating when death is expected in shorter time frames. The standard of reasonably foreseeable natural death provides flexibility in a way that maximum fixed prognosis would not. The standard also has the advantage of using language that practitioners have become familiar with over the last four years.

Those who are dying in the short or near term would benefit from the current set of safeguards in the Criminal Code, which the bill proposes to change in two ways.

First, the 10-day reflection period would be eliminated. We heard during the consultations that most persons have already given their MAID request a lot of thought by the time they sign their written request, resulting in the reflection period unnecessarily prolonging suffering.

Second, the requirement for two independent witnesses would be amended so that only one independent witness to the written MAID request is required. Further, we have added an exception so that health care and personal care workers who are not the person's provider or assessor would now be able to act as an independent witness.

Again, we heard that it is difficult for some who live in long-term care facilities or in remote areas to locate two independent witnesses. The purpose of the independent witness is simply to verify the identity of the person signing the request. The witness is not involved in the assessment process.

For persons whose death is not reasonably foreseeable, the existing safeguards would all apply with some additional ones. Specifically, the bill proposes a minimum 90-day assessment period, which will help ensure that practitioners spend sufficient time exploring the various dimensions of the person's MAID request, which, outside the end-of-life context, could be motivated by different sources of suffering requiring greater attention.

Also, at least one of the practitioners assessing eligibility would have to have expertise in the condition that is causing the person's intolerable suffering. The safeguard aims to prevent people from obtaining MAID when something could have been done to relieve their suffering or improve their condition.

The bill would also clarify the notion of informed consent for these kinds of cases.

First, a person who is not dying would have to be informed of the means available to relieve suffering, including counselling services, mental health and disability support services, community services, and palliative care, and be offered consultations with professionals that provide these services.

Second, the practitioners and the person would also have to agree that these means of relieving their suffering were discussed and seriously considered.

The bill also proposes to allow people whose death is reasonably foreseeable and who are eligible for medical assistance in dying to give prior consent if they risk losing capacity to consent before the date set for MAID. At present, the Criminal Code requires the practitioner to ensure, immediately before MAID is provided, that the person gives express consent to receiving MAID.

The bill would enable a patient who has already been assessed and approved to enter into an advance consent arrangement with their physician that sets out all the relevant details, including the date selected for the provision of MAID and the fact that the person consents to receiving MAID in case they lose the capacity to consent by the day in question.

Although this scenario was not covered in Truchon, experts told the government that it presents relatively little complexity and risk. Doctors also told us they would be comfortable with the idea of providing MAID under such circumstances.

To our government, compassion means ensuring that people waiting for MAID do not lose their opportunity to die in the manner or on the date of their choosing just because their medical condition robs them of the capacity to make decisions in their final days.

Another narrow form of advance consent would also be allowed in the unlikely event that complications arise after a person who has been assessed and approved self-administers a substance intended to cause their death and loses the capacity to consent to MAID, but does not die.

The patient and their physician could enter into an arrangement in advance, stipulating that the physician would be present at the time the patient self-administers the substance and would administer a substance to cause the patient's death in case the patient loses their capacity but does not die.

The data show that there have been very few cases of self-administration so far, perhaps due to fears of possible complications stemming from self-administration of a substance. Offering such an option could provide greater reassurance and allow more Canadians to choose this form of medical assistance in dying.

There are other changes in the bill that my colleagues will speak to, including changes to enhanced data collection and the monitoring regime that brings accountability and transparency to the practice of MAID in Canada.

A transitional provision would ensure that patients who have already signed their request when the bill comes into force would not be required to undergo any additional safeguards set out in the bill. At the same time, they would be able to benefit from the safeguards that would be eased, such as the elimination of the 10-day reflection period and the possibility of preparing an advance consent arrangement if it applies to that person's situation. We are committed to making the process as easy on patients as possible.

I would also like to briefly discuss the constitutionality of the bill. I have examined the bill as required by the Department of Justice Act. This involved consideration of the objectives and features of the bill. I am confident that the bill responds to the Truchon ruling in a way that respects the charter.

As is required by the Department of Justice Act, I will table a charter statement in the near future, which will lay out some of the key considerations that informed the review of the bill for inconsistency with the charter. This will serve to better inform parliamentary debate on this important piece of legislation.

I will conclude by thanking all those who participated in the consultations on medical assistance in dying and who contributed to the drafting of this bill. Bill C-7's proposed amendments to Canada's medical assistance in dying regime represent a fundamental policy shift, with the regime becoming less about end-of-life care and more about autonomy and alleviating intolerable suffering.

I look forward to working with all members of both chambers to ensure Bill C-7 is passed.

Alleged Premature Disclosure of Contents of Bill C-7

[Rob Moore, Conservative, Fundy Royal, NB]

Mr. Speaker, I rise on a question of privilege today concerning the premature disclosure of the contents of Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying, introduced yesterday.

As you know, it is a well-established practice in the House that, when a bill is on notice for introduction, the House has the first right to the contents of that legislation.

In a report circulated prior to question period, and hours before Bill C-7 was read a first time in the House, the Canadian Press published an article that detailed specific information contained in Bill C-7.

In the article it states:

The bill [would] scrap a provision in the law that allows only those already near death to receive medical assistance in dying—as ordered by a Quebec court last fall....

Sources say it will drop the requirement that a person must wait 10 days after being approved for an assisted death before receiving the procedure. And it will drop the requirement that a person must be able to give consent a second time immediately prior to receiving the procedure.

The reporter gives credence to the fact that contempt has occurred by revealing later in the article:

The sources spoke on condition of anonymity because they were not authorized to reveal details of the bill prior to its tabling in the House of Commons this afternoon.

After the sources indicated to the reporter that they were aware of their guilty actions, they boldly and defiantly continued their affront to Parliament by providing even more detail of the bill.

I quote again from the article, which states:

Sources say today's bill will not deal with broader issues that were excluded in the new law and that must be considered as part of a parliamentary review of the law that is to begin this summer.

Those issues include whether mature minors and those suffering only from mental [illness] should be eligible and whether people who fear losing mental capacity due to conditions like dementia should be able to make advance requests for medical assistance in dying.

It will, however, propose a measure intended to deal with a situation in which a person is given consent and who has been approved for an assisted death loses the mental capacity to give consent a second time immediately prior to receiving the procedure.

After carefully reviewing the contents of Bill C-7 following its introduction in the House, when I and other members of Parliament got to see the bill for the very first time, the details reported by the Canadian Press hours earlier were indeed contained in Bill C-7.

Ironically, my first precedent to present to you is from the last Parliament, brought to the Speaker's attention on April 14, 2016. It was with respect to Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts regarding medical assistance in dying.

It would appear that the Liberal justice team just has not learned any lessons as it was pointed out on April 14, 2016, as I am pointing out today on Bill C-7, that specific and detailed information contained in Bill C-14 was reported in a newspaper article and elsewhere in the media before the bill had been introduced in the House.

On April 19, 2016, the Speaker found that there was in fact a prima facie case of privilege regarding Bill C-14. He stated:

As honourable members know, one of my most important responsibilities as Speaker is to safeguard the rights and privileges of members, individually and collectively. Central to the matter before us today is the fact that, due to its pre-eminent role in the legislative process, the House cannot allow precise legislative information to be distributed to others before it has been made accessible to all members. Previous Speakers have regularly upheld not only this fundamental right, but also expectation, of the House.

The Speaker's concluding remark on April 19, 2016, was as follows:

In this instance, the chair must conclude that the House's right of first access to legislative information was not respected. The chair appreciates the chief government whip's assertion that no one in the government was authorized to publicly release the specific details of the bill before its introduction. Still, it did happen, and these kinds of incidents cause grave concern among hon. members. I believe it is a good reason why extra care should be taken to ensure that matters that ought properly to be brought to the House first do not in any way get out in the public domain prematurely.

On October 4, 2010, on page 4711 of the House of Commons Debates, Speaker Milliken noted:

It is indisputable that it is a well-established practice and accepted convention that this House has the right of first access to the text of bills that it will consider.

Getting back to my point about the Liberal justice team not learning any lessons, there was a similar case from March 19, 2001, regarding the Department of Justice briefing the media on a bill before members of Parliament. In that reading, Speaker Milliken said, at page 1840 of the House of Commons Debates:

In preparing legislation, the government may wish to hold extensive consultations and such consultations may be held entirely at the government's discretion. However, with respect to material to be placed before parliament, the House must take precedence. Once a bill has been placed on notice, whether it has been presented in a different form to a different session of parliament has no bearing and the bill is considered a new matter. The convention of the confidentiality of bills on notice is necessary, not only so that members themselves [will] be well informed, but also because of the pre-eminent [role] which the House plays and must play in the legislative affairs of the nation.

The Speaker found another case of contempt on October 15, 2001, after the Department of Justice again briefed the media on the contents of a bill prior to the legislation being introduced in the House.

Maybe, in this minority House, members can finally take these characters in the Minister of Justice's office to task for their continuous disrespect of this Parliament. Given the facts presented and the clear precedents on this matter, I believe, Mr. Speaker, you should have no trouble in finding a prima facie case of privilege. In that event, I am prepared to move the appropriate motion.

Criminal Code

[David Lametti, Liberal, Minister of Justice]

moved for leave to introduce Bill C-7, An Act to amend the Criminal Code (medical assistance in dying).

(Motions deemed adopted, bill read the first time and printed)