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 Safeguards Act

[Marc Dalton, Conservative, Pitt Meadows—Maple Ridge, BC]

Mr. Speaker, there are few debates in Parliament that are more consequential and more deeply impactful than when we are called to debate life-and-death legislation. Issues of this importance require us to look beyond being partisan, and this is not the first time the chamber has had to grapple with such profound moral weight. We just have to look at our history.

I am thinking of capital punishment. A private member's bill was introduced to abolish it in 1914. For decades, in the 1950s, 1960s, 1970s, 1980s and 1990s, parliamentarians in this chamber grappled with that issue. They debated whether deterrence prevented murders, the morality of a state taking a human life, whether life imprisonment was a sufficient punishment and the irreversible possibility of making a mistake. We fast-forward to today. Medical assistance in dying is, without question, one of the most consequential public policy decisions this Parliament has ever made. It is a matter of life and death, literally, and that is precisely why we cannot afford to get this wrong.

When Canada first introduced medical assistance in dying in 2016, Canadians were assured by the government that it would be a carefully controlled, exceptional measure built on very clear limitations and uncompromising safeguards. We were told it was strictly an end-of-life compassionate option for those facing a reasonably foreseeable natural death. That is what we were told, but look at where we are today.

The data tells us a staggering story. In 2024 alone, 16,499 Canadians received MAID. Since its introduction, more than 76,000 Canadians have died through this program. It is approaching 100,000 now, in 2026. In 2024, MAID accounted for approximately 5.1% of all deaths across Canada. This is an extraordinary number. To put this in perspective, let us look across the border at California. It is a jurisdiction with about the same population size as Canada. Medical assistance in dying was legalized in both Canada and California at exactly the same time, yet we can look at the comparison of numbers: in Canada, 76,475 deaths, versus just 5,423 in California. In 2024, as I mentioned, there were 16,499 in this country versus 1,032 in California.

I think about how dramatically our legislation has evolved. In 2021, through Bill C-7, the government expanded eligibility far beyond those whose natural deaths were reasonably foreseeable. We created two distinct tracks, including a track for individuals who are not approaching the end of life. In so doing, Canada became one of the most permissive jurisdictions in the entire world when it came to assisted dying. By removing the requirement of natural death to be reasonably foreseeable, the government extended MAID to people with disabilities and chronic illnesses who were not otherwise dying. This approach is far outside the traditional, globally recognized end-of-life care model.

Mental illness was initially excluded from this expansion, but only temporarily. Ever since, Parliament has repeatedly had to step in to extend that exclusion as a matter of crisis management. Bill C-39 kicked the deadline down the road. Bill C-62 extended it again, to March 17, 2027, a date that we are now quickly approaching.

We must ask ourselves why MAID for mental illness was delayed in the first place. It was delayed because committees heard testimony after testimony from the front lines stating that this was an incredibly dangerous direction to go in. There was substantial, overwhelming agreement among mental health advocates, disability advocates, psychiatric professionals and academic experts. The special joint committee's recommendation was clear, to permanently exclude mental illness as a sole underlying condition for MAID, and Conservatives agree entirely with this.

We believe that someone suffering from depression, PTSD or another severe mental illness should be met with access to treatment, support and hope, not a path to assisted death. Mental illness can be utterly devastating. It distorts how a person sees themselves, how they view their current circumstances and how they perceive the future. However, we know that circumstances can change. Treatment can work. People can recover. People who once saw absolutely no hope can go on to live incredibly meaningful, beautiful lives.

I have shared this before, but it bears repeating. In my early twenties, I went through a clinical depression. It was a very dark period of time in my life. I had suicidal thoughts. Thankfully, I never made any attempts, but in that darkness I received vital support from health care professionals and those closest to me. I came out of it. Today, that dark period is a very distant memory. I feel no pain from it, but at the time I felt utterly incapacitated. With time and support, I recovered. I went on to go to university, become a teacher, an MLA in British Columbia, a member of Parliament, a father and a grandfather. I have lived a full and rich life and I am thankful. If MAID for mental illness had been legal and readily marketed for people like me at that time, how many would have gone that route?

The government itself has recognized these serious concerns, which is why it repeatedly extended the exclusion. However, with the current exclusion set to expire on March 17, 2027, there is an urgent need to act, and Conservatives have acted. The member for Cloverdale—Langley City introduced a private member's bill, Bill C-218, which would have permanently and cleanly excluded mental illness as a sole underlying condition for MAID. What happened? The Liberals voted against it. On October 7, this House had a clear opportunity to advance that protective legislation and the government voted it down. Now, just weeks later, the government has introduced its own legislation, Bill C-41, which we are debating right now as we approach midnight. What has it done? It has taken the exact permanent exclusion for mental illness and attached it to a completely separate, massive and entirely undebated element, the advance request for MAID. Let us call it what it is. The Liberals do not want to subject their new expansion of MAID to the raw public scrutiny that the mental illness expansion faced. The more the expert witnesses, physicians, psychiatrists and professional organizations spoke out about mental illness, the more the general public became concerned. They do not want to go in that direction. By chaining these two issues together in Bill C-41, it is trying to sneak a massive new policy under the radar. I say, shame.

The political dynamic in this House has shifted. Following the by-elections and floor crossings earlier this year, the Liberal government now holds a majority. It no longer needs collaboration with the opposition. It no longer needs to seek multipartisan consensus on matters of life and death. Because of this, it has the raw numbers to pass legislation independently, and it is using that power to ram this through. It is rushing this bill through the House, cutting off the thorough, isolated scrutiny that each one of these profound issues desperately deserves.

Conservatives are deeply concerned with the safeguards in this bill, particularly with the sudden expansion to advance directives. The cold, hard fact is that there is already widespread abuse and inappropriate promotion with our current MAID regime. Time and again, I talk with residents in my community who tell me horror stories about family members having MAID actively promoted and suggested to their loved ones. One of my own staff members was offered MAID three separate times because of the migraines he suffered from a fall a decade ago. Another man told me how his father was offered MAID because of a hip injury. The son had to step in and tell providers that his father needed exercises and stretching, not MAID. He helped his father get the proper rehabilitation and guess what. He is out of the hospital. He is not dead.

[Jenny Kwan, NDP, Vancouver East, BC]

Mr. Speaker, I rise to speak to Bill C-41, the medical assistance in dying safeguards act. This is one of the most profound questions Parliament can consider. It touches on life, death, dignity, autonomy, compassion, equality and our responsibilities to one another. It is deeply personal, affecting individuals confronting serious illness, their families, caregivers and medical professionals. There are deeply held differences of opinion on this issue shaped by personal experience, ethical traditions, religious beliefs and understandings of human dignity. For that reason, this is a matter of conscience and a free vote for the New Democratic caucus.

At the heart of this debate is a fundamental human rights question: How do we respect individual dignity, autonomy and rights while protecting those who may be vulnerable? Every person deserves to live and die with dignity. That means respecting the right to make deeply personal decisions about one's body, health and end-of-life care. It also means ensuring that people are not abandoned by the systems and institutions meant to support them.

Canada's debate about assisted dying has been shaped by decades of advocacy, legal challenges and difficult ethical questions. We all remember the case of Sue Rodriguez in 1993. Former NDP MP Svend Robinson stood by her. It was a difficult moral issue then, and it remains difficult today. Living with ALS, Rodriguez challenged Canada's prohibition on assisted dying. She argued that she should have the right to seek assistance in ending her life before her illness took away her ability to do so. The Supreme Court rejected her challenge in a narrow 5-4 decision, but her struggle brought questions about autonomy, equality, security of the person and dignity into the national conversation.

More than two decades later, the Supreme Court revisited those questions in Carter v. Canada. In February 2015, the court unanimously found that the Criminal Code prohibitions on physician-assisted dying violated the charter rights of certain competent adults experiencing grievous and irremediable medical conditions causing enduring and intolerable suffering. That decision was a landmark moment in Canadian human rights law.

Parliament responded with Bill C-14 in 2016, establishing Canada's first federal framework for medical assistance in dying. In 2021, Bill C-7 expanded eligibility for certain individuals whose natural death was not reasonably foreseeable, while introducing different safeguards. Subsequent legislation, including Bill C-39 and Bill C-62, delayed the proposed expansion to people whose sole underlying medical condition is a mental illness. Now Bill C-41 is before us to respond to the courts, and Parliament is addressing two critical questions: one, the issue of advance requests and, two, those whose sole underlying medical condition is mental illness.

On the first question, what Bill C-41 would do is establish a framework for advance requests for MAID, and it would only be permitted in provinces and territories that have the required legislative regime in force. Because Bill C-41 stipulates that an advance request is permitted only in provinces or territories that have the required legislative regime in force, it raises serious concerns about unequal access. Canadians should not have different rights depending on where they live, yet this is where we are at with Bill C-41. I will have more to say about that.

On the second point, the bill would maintain the exclusion of people whose sole underlying medical condition is a mental illness. There are different human rights perspectives on that question. Excluding people solely because of a mental illness raises serious charter equality concerns. There is an argument that people should not be denied access to a legal medical procedure simply because of their diagnosis and that eligibility should be considered through appropriate individualized assessments and safeguards.

At the same time, mental health experts and disability rights organizations have raised concerns about the ability to determine when a mental illness is irremediable, the availability of appropriate treatment, and profound disparities in access to care. There is no question that these concerns deserve serious consideration. For example, end-of-life advocacy groups view the exclusion of mental illness as discriminatory and unconstitutional, emphasizing bodily autonomy and equity under the law.

Dying With Dignity Canada expressed deep disappointment over legislative barriers, stating that preventing a group of people from having access to a legal medical procedure simply because of their diagnosis violates charter rights. The organization maintains that individuals should have equal rights to apply based on rigorous individualized assessments.

On the flip side, Inclusion Canada, a leading disability rights group, argued that expanded eligibility perpetuates dangerous ableist assumptions that life with a disability is not worth living. Meanwhile, the Centre for Addiction and Mental Health notes that there is a lack of established criteria and consensus among psychiatrists for if and when a mental illness should be considered irremediable, alongside stark disparities in access to care.

To that end, there is another dimension to this debate that we cannot ignore. The right to make a choice is meaningful only when people have real choices available to them. Experts, disability advocates and health care organizations have raised concerns about whether people experiencing profound suffering always have access to the care and support they need. Some warn that assisted dying risks becoming an answer to suffering that could be alleviated through better access to health care, affordable housing, disability supports and community services. The government's own report has identified inadequate funding for mental health services.

A person living with a disability should not have to fight for basic services, appropriate housing or the resources required to live independently. A person experiencing mental health challenges should not face inaccessible treatment, long wait-lists or a shortage of community-based supports. Someone approaching the end of life should not be denied quality palliative care because of where they live or their financial circumstances. Telling someone that a service exists is not the same as ensuring they can access it.

Palliative care, counselling, disability services and mental health treatment must be timely, affordable and appropriate. This is not an argument against individual autonomy. It is an argument that autonomy must be supported by the social and economic conditions that allow people to exercise it meaningfully. The federal government has a responsibility to work with the provinces and territories to address these gaps. Dignity cannot be separated from the material conditions in which people live.

In June, the Special Joint Committee on Medical Assistance in Dying recommended that the federal government indefinitely exclude people whose sole underlying medical condition is a mental illness. The committee also identified a pressing need for increased and more equitable access to adequate mental health services. People deserve timely access to treatment, counselling, psychiatrists, psychologists and community-based services. The committee's call for more equitable mental health services must not be lost in this debate. Maintaining an exclusion in the Criminal Code cannot substitute for the government's responsibility to invest in mental health care.

We must also consider how this legislation would affect people differently. People living in poverty, experiencing homelessness, living with disabilities or living in remote communities can face significant barriers to accessing health care. First nations, Inuit and Métis communities have experienced generations of inequities in health care, including inadequate access to culturally safe services and palliative care.

The government must engage indigenous governments and organizations meaningfully in implementation, respecting indigenous self-determination and the diversity of perspectives within indigenous communities. We must ask whether every person can make an informed and voluntary decision without pressure, discrimination or the absence of meaningful alternatives. This is a fundamental human rights question.

I began by noting that Canada's debate about assisted dying has been shaped by decades of advocacy, legal challenges and difficult ethical questions. I suspect that this is not the end to legal challenges on this question. There are people who believe that the right to die with dignity is inseparable from the right to make decisions about one's own body and the circumstances of their death. There are others who approach this question through concerns for the sanctity of life, the protection of the vulnerable, disability rights and the responsibilities of society. We must make room for these differences and chart a path forward.

Regardless of which party one belongs to in the House, we can all agree that every person deserves dignity, compassion and access to appropriate health care and support. No one should be made to feel that their life is less valuable because they live with a disability, an illness, poverty or circumstances that make life more difficult. The right to make decisions about one's own life and death cannot become an excuse for the government's own withdrawal from its responsibility to provide care.

There is the important work of the parliamentary committee. People with lived experiences, families, disability advocates, indigenous organizations, medical professionals and other experts must have the opportunity to contribute and be heard. We must not rush the bill through committee. We owe Canadians a process that is thoughtful, transparent and grounded in human rights, and we must respect the dignity of people at the end of life, protect those who may be vulnerable to coercion or who have inadequate support, and build a health care system that gives everyone the opportunity to live and die with dignity.

[Tako Van Popta, Conservative, Langley Township—Fraser Heights, BC]

Madam Speaker, at the outset, I would like to note that I will be sharing my time with my colleague, the member for Elgin—St. Thomas—London South.

Tonight, we are debating Bill C-41, the medical assistance in dying safeguard act. This bill would do two substantially different things. First, it would permanently cancel the expansion of MAID for those who are suffering from mental illness. Second, it would introduce a framework for advance medical directives allowing individuals to make decisions in advance about receiving MAID if they later lose the capacity to consent. I support the first measure. I cannot support the second.

The permanent exclusion of mental illness as the sole underlying condition for MAID is a necessary and long overdue correction. It reflects what many medical experts have been saying, including mental health professionals and disability advocates, which is that our health care system cannot reliably distinguish between a treatable mental illness and an irremediable one. The risks are simply too great. I am happy that the Liberals have finally come to that conclusion as well.

Advance medical directives, on the other hand, raise a very different and a far more complex set of ethical and legal questions. They touch on issues of consent, autonomy and the value of human life at the moment when a person may no longer be capable of expressing their wishes. These two issues should never have been bundled together in one single bill. One requires urgent legislative action before a deadline that is only six months away. The other demands careful study and thoughtful consideration.

To understand why the government is finally reversing course on the first issue, medical assistance in dying for those who are suffering from mental illness, it is useful to explore how we arrived at this point. It all started with the Sue Rodriguez case in 1993, where the Supreme Court of Canada upheld the Criminal Code provision that prohibited assisting somebody to die, to commit suicide. Twenty years later, the Carter case came along, and the Supreme Court of Canada changed its mind. It came to quite a different conclusion.

Faced with the circumstances of Ms. Kay Carter, who suffered from ALS, a progressive and incurable neurodegenerative disease, the court found that an absolute prohibition of physician-assisted dying was a breach of section 7 of the charter. The court stated that MAID could be available for people in Ms. Carter's condition as long as that adult was one who clearly consented to the termination of life and it was a grievous and irremediable condition causing enduring and intolerable suffering. It was those two things: clear consent and an irremediable condition. Importantly, the court also emphasized that it really was limited to those specific facts, which is exactly what courts usually do. It was making no pronouncement over any other situation where physician assistance might be sought, for example, for mental illness.

Parliament responded to that Carter decision with Bill C-14, establishing a MAID framework that included a further requirement, that natural death had to be reasonably foreseeable. We thought that was going to be our MAID regime going forward into the future. Unfortunately, that proved to not be the end of the story.

For the next chapter in how the Liberals have mismanaged this whole MAID file, we turn to the Truchon decision in Quebec, where two individuals successfully challenged the “reasonable foreseeability of natural death” provision. What happened next was remarkable. Rather than appealing a lower court decision that struck down an act of Parliament, the Liberal government, the attorney general, chose not to defend the legislation that had been adopted in the House after one of the most significant ethical debates in modern Canadian history. The result was Bill C-7. The legislation created two tracks, one for those whose death was reasonably foreseeable and the other for those who were not in a situation of dying. Significantly, Bill C-7 expressly stated that mental illness alone would not qualify a person for MAID.

After Bill C-7 passed in the House of Commons, the Senate, shockingly in my opinion, proposed amending the bill. It proposed removing the mental illness exclusion after a sunset period of two years. Instead of rejecting the amendment, which the Liberals should have done, the Attorney General, who also should have done it as it is his job to defend the laws of Parliament, accepted it. They caved to the MAID activists. That decision launched Canada down a path that many experts have said is dangerous.

For example, in November 2023, the chairs and heads of numerous psychiatric departments across Canada said that there is “no...accepted definition of irremediability” in mental illness and “no reliable way to distinguish a MAID request from suicidal ideation.” That is what the experts were saying. I am happy that the Liberals finally listened to that and are convinced. They cautioned against expanding MAID in these circumstances, saying that it would risk facilitating preventable deaths and undermine suicide prevention efforts.

The Liberal government did the right thing, sort of. It postponed the implementation date, at first by one year and then later by three more years. Here we are, after six years of uncertainty. The government has finally arrived at where many experts and Canadians believed it should have been all along: MAID for mental illness alone is not sound public policy. The government made the right decision in the bill that is before us, and we agree with that part of it.

However, while retreating from one problematic expansion of MAID, the government would now advance another that is even more problematic. Advance medical directives would allow individuals to specify in advance the circumstances under which they would wish to receive MAID if they later lose the capacity to consent. Now, at first glance, many Canadians might think, well, that makes sense. We write wills. We write powers of attorney. We write health directives. Why should we not write advance medical directives for MAID?

MAID is substantially and fundamentally a different matter. Advance directives concerning MAID authorize an irreversible act that results in death, with someone else, a third party, being tasked with making the ultimate decision. The Liberals talk a lot about the importance of the autonomy of the person. Well, someone has lost autonomy when somebody else is making the decision. That is why many experts urge caution.

For example, Dr. Pageau of Université Laval told the Special Joint Committee on MAID that it is simply not ethical to permit MAID for persons with dementia through advance requests. He posed this question: As the disease progresses, are we honouring the wishes of the person who exists today, or the wishes of someone who existed years earlier? People change their mind. That question deserves much deeper examination before Parliament accedes. We should not be rushing through this very complex ethical question.

The strongest concern with advance medical directives is the issue of consent. The Supreme Court's decision in Carter began with the simple and essential principle that an individual “clearly consents to the termination of life”. Advance directives risk undermining that basic principle.

Dr. Alice Chung appeared before the special joint committee and posed an important question. She asked this: What right does the 60-year-old version of ourselves have to determine the quality of life experienced by the 80- or 90-year-old version of ourselves? She went on to note that medical evidence demonstrates that many individuals adapt to their severe illness, to their disability or to their cognitive decline in ways that they had not anticipated when they might have signed advance directives. What once to them seemed intolerable looking into the future, being uncertain of the future, may later become meaningful and a worthwhile life.

These are not abstract scenarios. They are real-world examples that we received from experts, which raised difficult questions about autonomy, dignity and the risk of ending the life of someone who may no longer share the wishes they had expressed years earlier.

In conclusion, we applaud the government for proposing to stop the expansion of MAID, but we say that it must not—

[Andrew Lawton, Conservative, Elgin—St. Thomas—London South, ON]

Madam Speaker, I am glad to see my colleague from Winnipeg North supporting, in principle, anyway, a halt to the forthcoming expansion of MAID for people with mental illness. However, the member has voted three times against stopping that expansion. He voted for adding mental illness to the MAID regime in Bill C-7. He voted against Bill C-314 in the previous Parliament, and a couple of weeks ago, he voted against Bill C-218.

To what do we attribute the change of heart?

Bill C-41—Proposal to Apply Standing Order 69.1

[Andrew Lawton, Conservative, Elgin—St. Thomas—London South, ON]

Mr. Speaker, I rise on a point of order to request the division of Bill C-41 for voting purposes, pursuant to Standing Order 69.1. Standing Order 69.1(1) says the following:

In the case where a government bill seeks to repeal, amend or enact more than one act, and where there is not a common element connecting the various provisions or where unrelated matters are linked, the Speaker shall have the power to divide the questions, for the purposes of voting, on the motion for second reading and reference to a committee and the motion for third reading and passage of the bill. The Speaker shall have the power to combine clauses of the bill thematically and to put the aforementioned questions on each of these groups of clauses separately, provided that there will be a single debate at each stage.

Bill C-41 seeks to do two fundamental things. That is to say, the bill stands for two separate principles. The bill seeks to stop the forthcoming expansion of medical assistance in dying to people whose sole underlying condition is a mental illness. It also seeks to allow medical assistance in dying for people who have no capacity to consent but who requested MAID before they lost capacity, otherwise known as advance requests. These are two fundamentally different questions that must, I submit, be voted on separately. The bill, as worded, would also fundamentally change the nature of the MAID regime by partially removing it from the realm of criminal law insofar as advance requests are concerned. This is another matter that speaks to both the complexity of the bill and its omnibus nature, which I believe warrants your prerogative to divide the question pursuant to Standing Order 69.1.

Based on my preliminary reading of the bill, there should be two separate questions: one on the mental health expansion in clauses 9, 10 and 14, which concern a statute passed in 2021, An Act to amend the Criminal Code (medical assistance in dying), as amended in 2023 and 2024, together with subclause 4(2) of Bill C-41 on the same subject matter; and the second question on MAID for people who cannot consent, otherwise known as advance requests, in the remaining provisions of Bill C-41, which propose amendments to a different act, the Criminal Code, plus consequential cross-references in three other statutes.

I recognize that these matters concern medical assistance in dying. However, the question under Standing Order 69.1 is not simply whether the provisions fall within the same broad policy area, but rather, whether they are sufficiently distinct so as to warrant separate votes. Speaker Regan addressed this contrast in a bill containing multiple principles while addressing a singular field of policy in his March 1, 2018, ruling at page 17551 of the Debates. He stated:

In presenting arguments relating to Bill C-63, the hon. member for Calgary Shepard raised an interesting concept from the practice in the Quebec National Assembly. Quoting from page 400 of Parliamentary Procedure in Québec, he stated:

“The principle or principles contained in a bill must not be confused with the field it concerns. To frame the concept of principle in that way would prevent the division of most bills, because they apply to a specific field.”

While their procedure for dividing bills is quite different from ours, the idea of distinguishing the principles of a bill from its field has stayed with me. While each bill is different and so too each case, I believe that Standing Order 69.1 can indeed be applied to a bill where all of the initiatives relate to a specific policy area, if those initiatives are sufficiently distinct to warrant a separate decision of the House.

To that end, Mr. Speaker, I submit that you should approach Bill C-41, legislation which quite literally concerns life and death, in a fundamentally different way from how you might consider a request to, say, separate a transportation bill with respect to its rail clauses and its aviation clauses. Stopping the expansion of MAID to people with mental illness was the subject of Bill C-218, which the Liberal government voted against earlier this session, citing an intention to bring forward the legislation it tabled yesterday, Bill C-41. In the absence of legislation, this expansion will go into effect March 17, 2027. You will recall, Mr. Speaker, that this deadline has been twice delayed by the Liberals, citing the need for further study and further readiness.

In this Parliament, the Special Joint Committee on Medical Assistance in Dying was re-established, with the narrow mandate of exploring the forthcoming mental illness expansion. The culmination of the study was a singular recommendation, supported by Liberal and Conservative members of the committee, that the expansion not proceed. This was an incredibly important act of bipartisan co-operation on what, I reiterate, is a life-and-death matter. This work underscores the importance of allowing parliamentarians to consider the mental health expansion of MAID on its own merit rather than marrying it to the separate and also consequential question about advance requests.

During the course of the committee's hearings, we heard from many experts, including MAID practitioners, who oppose MAID for people with mental illness but support MAID itself. There are those who support MAID for people with mental illness but not MAID for people without the capacity to consent, just as the inverse is undoubtedly true. On these questions of conscience, members should be free to vote individually on each of these two distinct questions.

In approaching the exercise of your authority under Standing Order 69.1, Mr. Speaker, I would encourage you to draw inspiration from the way in which the Chair uses its discretion on the selection of report stage amendments when a matter of conscience comes before the House. While on most bills, the criteria are applied in a clinical manner, the Chair will, on matters of conscience, approach the exercise in a more generous fashion.

Two such cases concern earlier iterations of medical assistance in dying legislation. On the original MAID bill, Bill C-14, Mr. Speaker Regan said, at page 3485 of the Debates on May 17, 2016:

The Chair appreciates the arguments put forward by hon. members as to why they consider these amendments to be of such significance as to warrant further consideration at report stage. I recognize that this is an important issue on which many members have strong and varied opinions. The Chair notes that the bill before us is unique, in its far-reaching social, moral and constitutional implications. The Chair also notes that, given the variety of opinions expressed by various members in all parties in relation to the provisions of this once-in-a-generation bill, the Chair is open to the argument of exceptional significance as contemplated in our Standing Orders. For these reasons, the Chair is prepared, on this occasion, to give members the benefit of the doubt....

Similar views were expressed concerning the later Bill C-7, by the Assistant Deputy Speaker, on November 27, 2020, at page 2603 of the Debates:

As with the original medical assistance in dying legislation four years ago, I recognize that this is an important issue with profound legal, moral and constitutional dimensions and that members have strongly held and varied points of view on these matters.

For these reasons, the Chair is prepared on this occasion to give members the benefit of the doubt....

To return to the threshold for dividing votes set out in the relevant standing order, I submit here that there is a sound basis for you to find that, despite the common element between the key questions involving MAID itself, the measures are fundamentally distinct from one another, with separate political, moral and legal implications, and for that matter, distinct levels of support and opposition among Canadians and, I suspect, Parliamentarians as well.

In closing, the disparate objectives of Bill C-41 warrant your prerogative as Chair to divide the question for the purposes of voting.

Medical Assistance in Dying

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Mr. Speaker, I rise today on behalf of the Conservative members of the Special Joint Committee on Medical Assistance in Dying to table, in both official languages, our supplementary opinion. Conservatives welcome the committee's recommendation that individuals whose sole underlying condition is a mental illness be indefinitely excluded from eligibility for medical assistance in dying. This will save thousands of lives.

This is the position that Conservatives have held from the beginning. Conservatives opposed the Senate amendment to Bill C-7, which set this proposed expansion in motion. We have consistently echoed the warnings of experts that the expansion cannot be implemented safely. We call on the government to accept the committee's recommendation and support Bill C-218, which is already before the House and which would accomplish the policy objective the committee recommends. Conservatives are prepared to work collaboratively with the government to that end.

Our supplementary opinion also notes that over the course of the committee study, as we were examining system readiness for expansion, many witnesses questioned the effectiveness and enforceability of the current MAID safeguards. Conservatives encourage the government to undertake a review of the current safeguards to ensure that no vulnerable Canadians fall through the cracks of a system that is supposed to protect them.

Criminal Code

[Juanita Nathan, Liberal, Pickering—Brooklin, ON]

Mr. Speaker, I appreciate the opportunity to rise today to speak to Bill C-218, which proposes further amendments to Canada's federal legal framework for medical assistance in dying. Specifically, this bill aims to indefinitely exclude those patients whose only health condition is a mental disorder from being eligible for MAID.

This is an issue which is unquestionably complex and can be deeply personal. It continues to challenge parliamentarians, health care providers, experts and people in Canada alike. It is important for us to recognize that medical assistance in dying has been allowed in Canada for close to 10 years now. It is also important to remember that it is the provinces and territories that must put in place the tools and supports that clinicians need to deliver MAID safely and appropriately. Whenever we make changes to the federal legal framework for MAID, we must be cognizant of the impact that those changes have on our partners in the provinces and territories.

As the Supreme Court of Canada recognized in Carter, striking the right balance in this complex area of social policy, where competing social values are at play, is not an easy task. As legislators, we must balance respect for personal autonomy and dignity with our responsibility to those who may be vulnerable.

Today, I will speak to three key elements: first, the objectives of Bill C-218; second, the findings of major expert studies on MAID where mental illness is the sole underlying condition; and third, the federal government's support for provincial and territorial work to improve access to mental health services.

Bill C-218 seeks to make changes restricting eligibility for MAID indefinitely in cases where a mental disorder is the only medical condition involved. There have been concerns expressed by some stakeholders about whether there are sufficient safeguards in place, and whether health care providers have the tools and resources they need to provide MAID safely and appropriately when it comes to mental illness. These concerns are not new, nor are they trivial, and their desire for caution is laudable.

At the same time, we must also recognize that Parliament has debated this question repeatedly over several years. Our legislative framework has evolved in response to court decisions, expert analysis and extensive public engagement. A special joint parliamentary committee has carefully considered the issue at length and provided advice and recommendations on whether to proceed. That committee also reinforced the importance of provincial and territorial health system readiness.

Bill C-218 invites us to consider whether the appropriate balance has been struck with the upcoming lifting of the mental illness exclusion in 2027, or whether another legislative change is necessary at this time. To answer that, it is essential that we understand what the experts have already told us. Significant studies have been completed on the specific question of MAID eligibility where mental illness is the sole underlying condition, including by the Council of Canadian Academies and the expert panel on MAID and mental illness, among others. Taken together, they provide a rich body of evidence.

The Council of Canadian Academies, the CCA, examined Canada's legal and clinical landscape, along with international approaches. The CCA's work highlighted the core clinical challenge: Mental illnesses can be unpredictable in their course and determining irremediability is far more complex than in many physical illnesses. The CCA was not tasked with providing recommendations for or against eligibility, and the members of the working group that dealt with mental illness had a spectrum of views on the matter.

The expert panel on MAID and mental illness, which was mandated by the former Bill C-7, took this analysis further. Its mandate was not to recommend whether eligibility for MAID should be expanded to permit the provision of MAID based on mental illness alone, but rather to recommend protocols, guidance and safeguards for such cases. The panel concluded that the existing Criminal Code safeguards, when supported by the development of MAID practices standards and the implementation of other recommendations, are adequate to allow for safe provision of MAID to people whose sole underlying medical condition is a mental illness.

Both these expert reviews, along with the testimony received through parliamentary committee work, reinforce the same overarching message: MAID in cases involving mental illness requires exceptional caution, but it is not impossible to implement safely. At the same time, clinical readiness, clear standards and comprehensive training are essential.

Following these studies in 2023, a model MAID practice standard was published, and a Canadian-made curriculum was developed. In addition, the federal government is currently supporting the Canadian Psychiatric Association to develop clinical practice guidelines for assessing suicidality and irremediability. Through a federal, provincial and territorial assistant deputy minister-level committee, policy leaders are also considering a range of issues related to MAID, particularly with respect to complex cases, including mental illness.

We have heard from these expert reviews and from a broad range of stakeholders on the importance of provincial and territorial health systems' being ready for the lifting of the exclusion. This includes provincial and territorial efforts to improve access to mental health services and supports across Canada. No one should ever feel that MAID is the only option available to them.

The federal government remains committed to supporting provinces and territories to improve access to health care for Canadians, which includes strengthening mental health services. In 2023 the Government of Canada announced the working together to improve health care in Canada plan, a historic investment of close to $200 billion over 10 years to support provincial and territorial health systems to deliver health care to Canadians. This includes an investment of $25 billion through bilateral health agreements with the provinces and territories to support shared priority areas, including improving access to mental health and substance use services.

The federal government has also expanded support for youth mental health initiatives, recognizing that early access to therapy, counselling and culturally safe care can alter the trajectory of a person's entire life. We have also funded indigenous-led mental wellness programs, which acknowledge the need for approaches that are culturally relevant, trauma-informed and community-based, rather than one-size-fits-all solutions. Provinces and territories have taken significant steps to improve access to mental health services in Canada with federal supports over the past 10 years.

Questions related to MAID in the context of mental illness are among the most sensitive we confront as parliamentarians. Our decisions affect people in Canada at their most vulnerable moment, and our work must reflect both humility and resolve. Bill C-218 asks us to confront difficult but deeply important questions.

Deciding whether medical assistance in dying should be available when a mental illness is the sole underlying condition is not a choice that lends itself to simple answers. Reasonable people may come to different conclusions. The Supreme Court of Canada has recognized this complexity, affirming that Parliament is owed a broad margin of deference when navigating challenging social policy issues such as this.

We will have the opportunity to consider next steps further and to study the state of progress during the parliamentary review that will be held in 2026. I look forward to hearing from colleagues as well as from experts, stakeholders and regular people, including those with lived experience with mental illness, as we continue this important debate.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

moved that Bill C-218, An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

Mr. Speaker, I want members to imagine someone's son. He is in his forties and life has worn him down. He lives with a painful illness that leaves him sick, exhausted and often unable to leave the house. On top of that, he struggles with addictions, depression and anxiety, which have taken more from him than anyone can see from the outside. Some days, he can barely hold it together. He relies on his family for a place to live, food and help getting through the week. They are doing their best, and he is doing his best, but the weight of it is crushing.

One day, he finally meets a psychiatrist. He goes, hoping that this might finally be the start of real help. His addictions still have not been treated, and his mental health care has not truly begun. He is vulnerable, scared and hanging on by a thread.

At that appointment, instead of being offered a plan to get him stable, MAID is raised as an option. The assessment moves ahead, and before he ever receives proper support for his mental health or addictions, he is approved. His MAID provider is the one who drives him to the place where his life is ended. This is someone's son who needed help, not a final exit.

Believe it or not, this actually happened here in Canada, and this is where we are headed if we do not act. Unless this Parliament chooses a different path, Canada will allow MAID for people whose only condition is mental illness. That means men and women struggling with depression, trauma or overwhelming psychological pain could be steered toward death by a system that too often cannot offer timely treatment, consistent follow-up or even basic support. This is why I brought forward Bill C-218, the right to recover act. It is simple. It asks Parliament to stop, consider what we have learned and act responsibly before people are irretrievably harmed.

I often think of my grandparents, who immigrated here after World War II with very little. They chose Canada because it was a place where people had endless opportunities to better themselves, where neighbours watched out for each other and communities worked in unison to make a better life for all. They built a Canada where the vulnerable were cared for and the less privileged in society were valued and treated with equal care. Those fundamental values attracted millions of immigrants over the years.

Today, many Canadians fear we are losing those values. Canadians themselves remain some of the most compassionate people anyone will ever meet, but our system is overwhelmed, stretched thin and unable to meet the needs of people who are suffering.

When people fall through the cracks, the easy temptation is to accept that failure is inevitable. When that happens, people facing mental illness can end up alone, waiting months, or sometimes years, for specialized treatment, and when help does not come, they lose hope. That moment of hopelessness should never be treated as an opportunity for the state to end their lives through MAID.

When the House last debated MAID, mental illness was not a part of the core discussion. It was added in a last-minute Senate amendment to Bill C-7. The implications were not fully considered or understood by the House.

Since then, we have learned a lot more. Psychiatrists across Canada, including the chairs of psychiatry at all 17 medical schools, have told us plainly that there is no reliable way to predict when a mental illness is irremediable, which is a requirement in the MAID law. People get worse, but they also get better, and most do. There is no test, scan or clinical tool that can reliably tell us that someone will never recover. All people deserve the opportunity to get better. No one should be encouraged to give up on themselves.

As legislators, we need to listen to what so many medical professionals are telling us, which is how hard it is to distinguish between suicidal ideation and MAID. The feelings behind them, such as hopelessness, loneliness, fear and the belief that one is a burden, are the same. For decades, clinicians have understood that, when someone feels hopeless or sees themselves in a very negative way, it can look like they are thinking clearly, that they are rational, even when their judgment is clouded by despair.

In 2021, most of us did not have the evidence we now have about how MAID assessment functions in the real world or the specific dangers of expanding MAID to mental illness. We now know there is no reliable way to determine when a mental illness is truly irremediable. Suicide prevention experts, including the Canadian Association for Suicide Prevention, warn that how we talk about these issues shapes the choices people make. Suggesting that death is a solution to suffering undermines hope. It puts people at real risk.

The expansion of MAID to mental illness forces Canada into a huge contradiction. On one hand, we invest in suicide prevention. We train professionals to intervene, listen and pull back people from the edge. On the other hand, with the expansion of MAID, we would invite those same vulnerable people to consider state-facilitated death.

We must ask, who receives suicide prevention and who is guided toward MAID? If a person suffering from depression calls a crisis line tonight, do we encourage them to hold on or do we quietly redirect them to an assessor? What principle decides the answer? What medical test? What ethical standard? There is none. That is because the very feelings that drive someone to seek MAID, hopelessness, despair or the belief that they are a burden, are the same signals that every suicide prevention worker is trained to treat as a cry for help.

We would never tell a struggling teenager that their wish to die is rational. We would not tell a grieving spouse that their darkest moment is a reasonable exit point. We would reach out. We would support them. We would insist that their lives still matter. Why should that change simply because despair is given a different label? When someone feels worthless, our duty is not to agree with them. It is to stand with them until the light returns. Canada must decide: Are suicidal citizens people in need of protection or candidates for state-sanctioned death? We cannot pretend that they are both. Besides all this is the fact that we already know the current safeguards are failing.

Let us be absolutely clear about what an expansion of MAID to mental illness would mean. If Canada cannot protect vulnerable people under the current rules, then expanding eligibility to those whose very illness clouds judgment, hope and decision-making will lead directly to preventable deaths. We are already witnessing cases where safeguards fail, where capacity is misjudged and where people are assessed in moments of confusion, exhaustion or pressure. If the system cannot uphold basic protections now, it will not and cannot protect those suffering from severe psychological distress. An expansion would be reckless.

The evidence is already in front of us. A recent article about Ontario's MAID death review committee's findings lays out, in plain and troubling terms, cases that would worry every Canadian. They describe a man who had cancer. I will call him Bill. Earlier in his illness, he had briefly mentioned MAID, as frightened patients tend to do. By the time he was assessed, he was delirious, confused and heavily sedated. His own medical team made it clear that he no longer had the capacity to make major decisions, yet a MAID assessor shook him awake, took the faint motion of lips as consent, withheld sedation, obtained a rushed virtual second opinion and ended his life that same day. Bill was not stable. Bill was not capable. He did not understand what was happening.

In another case, a woman, whom we will call Margaret, wanted palliative care. She said so the day before her death, but she did not qualify for hospice. Her husband, worn down by caregiver exhaustion, arranged for an urgent MAID assessment instead. The day before she had told him she wanted to die with proper palliative support, but the next day two assessments were rushed through. Her final wishes were overshadowed by the strain of a caregiver who could no longer cope.

Another woman, whom we will call Alice, was living with advanced dementia and unable to communicate her wishes in any meaningful way. Her family brought MAID forward twice with minimal documentation, little clarity and no clear expression of consent, yet she was approved.

All of these examples were drawn from the auditor's report. These are stories about real people, who are family members, friends, neighbours and fellow citizens, the people to whom we owe a duty of care. They demonstrate that vulnerable Canadians are already at risk under the current MAID regime. People who are confused, pressured, exhausted or unable to communicate are slipping through the safeguards that were supposed to protect them. If safeguards fail for patients with physical illness, where assessing capacity is clear and verifiable, what will happen when the only condition is a mental illness which, by definition, clouds judgment and hope? To offer death at that moment will place some of the most vulnerable people in this country directly in harm's way.

Today, a person deemed unable to manage their finances must undergo rigorous capacity assessments, interviews, documentation, expert review, collateral information and verification because we recognize the risk of exploitation, yet for MAID, a situation of life or death, a brief conversation can suffice, with no thorough evaluation, and when the safeguards fail, there seem to be few consequences. We now live in a country where we protect bank accounts better than we protect a human life.

We also know of families across Canada that were deeply shaken by how MAID was carried out for a loved one. They describe decisions that felt rushed and were influenced by poverty, loneliness or a lack of access to proper treatment, not by a calm and informed choice. These experiences are warnings from the very people who lived through the consequences.

Canadians are uneasy. Polls show a clear majority do not support MAID for mental illness alone. Provinces are asking Ottawa to reconsider. They are calling for a stop. Quebec, one of the most permissive MAID jurisdictions in the world, has banned it by law.

International human rights experts have raised the alarm, including the UN Committee on the Rights of Persons with Disabilities, which has urged Canada to step back. It warns that our trajectory risks discriminating against people with disabilities and mental illness and recommends repealing this expansion entirely. This is what Bill C-218 would do.

We must remember a crucial truth, which is that recovery from mental illness is not rare, but common. Time and again, people who once felt utterly hopeless have rebuilt their lives once they received proper care and stable support. Every one of us knows someone, whether it was a neighbour, a colleague or a family member, who walked through a very dark season and is now grateful to be alive.

These stories matter because they show us what is at stake. Sadly, that is not true in every case, but there is no reliable way to know in advance who will recover and who will not. There is no test, no scan, no certainty. I respectfully suggest that, when someone's judgment is clouded by psychological distress, our duty is to offer treatment, protection and time, not an irreversible decision based on guesswork.

If MAID is expanded, we will be forced into an impossible paradox. A suicidal person calling a crisis line is urged to hold on, yet if they request MAID, that same despair may be treated as justification for death. This is why Bill C-218 is necessary. It would stop the 2027 expansion to mental illness because the evidence cannot support it and the safeguards cannot sustain it. Vulnerable Canadians are already at risk. Expanding eligibility now is reckless. A strong country does not turn its back on those who suffer, but believes in their future and gives them time and care to heal.

I urge every member in the House to support Bill C-218 so Canada would remain a nation that protects the vulnerable, offers treatment before despair and gives every person the chance to recover. Let us take this responsibility seriously. Let us listen to the warnings of those who are assessing the failures in the system. Let us listen to the families who have lived through the consequences of MAID and to those who survived mental illness and rebuilt their lives. Let us remember the kind of country we claim to be, one that protects the vulnerable and gives people the time, care and dignity they need to heal.

Medical Assistance in Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, the next petition deals with the issue of euthanasia and, in particular, highlights concerns that have been raised by those living with disabilities. The petitioners are very concerned that in the context of a lack of available services and treatments for people in various situations, euthanasia does not present itself as a real choice but is offered in the absence of alternative kinds of supports.

The petitioners argue that allowing medical assistance in dying for those with disabilities or chronic illness devalues their lives, tacitly endorsing the idea that life with disability is optional and by extension dispensable.

The petitioners are concerned about us having an ableist health care system where the lives of those with disabilities are seen as not worth living. They note that many disability advocates in Canada have expressed opposition to the expansions contained in the government's previous bill, Bill C-7.

The petitioners therefore call on the government to protect all Canadians whose natural death is not reasonably foreseeable by prohibiting medical assistance in dying for those whose prognosis for natural death is more than six months.

[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 is 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 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 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.

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 contempt 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.