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

Sponsor

David Lametti  Liberal

Status

This bill has received Royal Assent and is, or will soon become, law.

Summary

This is from the published bill.

This enactment amends An Act to amend the Criminal Code (medical assistance in dying) to delay, until March 17, 2024, the repeal of the exclusion from eligibility for receiving medical assistance in dying in circumstances where the sole underlying medical condition identified in support of the request for medical assistance in dying is a mental illness.

Elsewhere

All sorts of information on this bill is available at LEGISinfo, an excellent resource from the Library of Parliament. You can also read the full text of the bill.

Bill numbers are reused for different bills each new session. Perhaps you were looking for one of these other C-39s:

C-39 (2017) An Act to amend the Criminal Code (unconstitutional provisions) and to make consequential amendments to other Acts
C-39 (2014) Law Appropriation Act No.3 , 2014-15
C-39 (2012) Law Restoring Rail Service Act
C-39 (2010) Ending Early Release for Criminals and Increasing Offender Accountability Act
C-39 (2009) Law An Act to amend the Judges Act
C-39 (2007) An Act to amend the Canada Grain Act, chapter 22 of the Statutes of Canada, 1998 and chapter 25 of the Statutes of Canada, 2004

Criminal CodeGovernment Orders

February 13th, 2023 / 8:20 p.m.

Conservative

Gerald Soroka Conservative Yellowhead, AB

Mr. Speaker, very much so, that is what needs to be done. We have a different culture, completely, in Canada, that needs to be dealt with differently, and I will give her an example of that.

When I was mayor, I was also the chair of our seniors foundation, and one of our board members from the MD of Greenview had said he wanted to build an indigenous lodge right in Grand Cache. That is actually in the works right now. It is going to be 12 rooms. It is only going to be breaking ground this spring, so we are getting ahead of ourselves, but I know when he brought that forward, he said it was going to be a round building with a lot of cultural amenities, so I am very much in favour of making sure we take care of the needs of our indigenous peoples.

Criminal CodeGovernment Orders

February 13th, 2023 / 8:20 p.m.

Conservative

Jeremy Patzer Conservative Cypress Hills—Grasslands, SK

Mr. Speaker, there is one aspect, when we talk about health care or access to mental health care, that quite often gets forgotten about or just more or less put onto the back burner. It is people living in rural Canada and the access people have to the different types of care and services they need.

I am wondering if the member wants to talk about the importance of having services for rural Canadians. That needs to also be part of the conversation when we talk about supports for mental health.

Criminal CodeGovernment Orders

February 13th, 2023 / 8:20 p.m.

Conservative

Gerald Soroka Conservative Yellowhead, AB

Mr. Speaker, that is a very good point. Like I said, when I was mayor, that was one of the things we also talked about. Our county started about half an hour west of Spruce Grove. That was our closest location to get assistance for mental health, and unfortunately in rural Alberta, and I should say rural Canada for that matter, we do not have nearly the level of assistance compared to our urban partners. We need to really balance out and make sure we have equal access right across the country to deal with the mental issues in Canada.

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February 13th, 2023 / 8:20 p.m.

NDP

Lisa Marie Barron NDP Nanaimo—Ladysmith, BC

Mr. Speaker, on a point of order, I would like to provide an opportunity, if I could, for the member. I realize that it was probably made in error, but just for the record, I do want to correct the statement he made of “our indigenous people.” Perhaps that was a mistake.

We know that indigenous people are not our property, and I just want to offer an opportunity for the member to correct the language he used to ensure that it is on the record what he intended to say.

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February 13th, 2023 / 8:20 p.m.

The Deputy Speaker Chris d'Entremont

While not a point of order, it is a great suggestion, which we have heard a number of times in this chamber. I did not hear it said, but if someone wanted to retract something, I would be more than happy to allow that to happen.

The hon. member for Yellowhead.

Criminal CodeGovernment Orders

February 13th, 2023 / 8:20 p.m.

Conservative

Gerald Soroka Conservative Yellowhead, AB

Mr. Speaker, I did not mean “our” as in possession, absolutely. I just meant “people as well”. I thank the member for bringing that forward, and I do apologize for that.

Criminal CodeGovernment Orders

February 13th, 2023 / 8:20 p.m.

Conservative

Jeremy Patzer Conservative Cypress Hills—Grasslands, SK

Mr. Speaker, right before Parliament resumed following the Christmas break, countless Canadians participated in Bell Let's Talk Day. They took the opportunity to talk about mental health, raise awareness, share stories and remind each other that it is good to offer or ask for help whenever it is needed. There are many members of Parliament from all parties who have joined this effort, and it is only fair to assume that they have done so because they sincerely wish to help people.

Every year, after the day comes and goes, it helps us realize that promoting mental health is actually a huge task and it is easier said than done. Over time, there has been some progress with how we approach mental health, but it can sometimes be discouraging to see that we still have to deal with some of the lingering problems or to know how much work there is left for us to do. It puts everything into perspective and shows that the results and decisions we make about an issue are more important than just talking about it.

In that light, Bill C-39, along with the larger issue surrounding it, is a real test for us. It forces us to consider what exactly we mean when we say that we want to promote mental health. Unfortunately, we are looking at a government bill that signals that we are going to take a wrong turn and fail vulnerable people who are suffering with their mental health. In a way, it is good to see Bill C-39 come forward, but it should also be clear that it is not good enough. At the very least, there will be a year before this new change takes effect, but that is nothing but a brief delay of the inevitable instead of reversing a terrible decision.

What is going to happen a year from now? Is the government going to bring another bill like this one forward to delay it another year? Will all the major problems raised by the provinces, professionals, advocacy groups and concerned citizens miraculously get resolved before the year is over? How is that even realistic? Does the government really expect Canadians to believe that?

The timeline is obviously ridiculous. It does not make sense practically and, more importantly, it will not take care of the issue at stake in the first place. There might be different views on assisted suicide for mental illness as the sole condition, but no one on either side of the debate can seriously say that it has been carefully considered in this country, if such a thing were possible. Instead, the whole process has been rushed and incomplete.

If the Liberals truly cared about making the right decision, the new legislation would be quite different. Even on their own terms, they will not be any more ready for the coming change next year than they would be if it was next month. It was only public pressure that made them slow down, but it is not going to stop them entirely. Clearly, they are planning to go ahead with the plan and hoping to get away with it again next spring.

It is highly irresponsible if we take a step back to consider the larger issue. First, I will look at this bill as it has been presented to us. We normally do not have to think too much about the official title of a bill as it comes through Parliament, but in the case of Bill C-39 it does matter, and it might even be fair to say that its name is somewhat misleading. It says that we are amending the Criminal Code related to the medical assistance in dying system, but that is only a technicality. In reality, this bill is not touching the substance of Bill C-7 as it was passed in the last Parliament. All it would do is delay the implementation of Bill C-7 or the aspect of the expansion for one year. That is definitely not a helpful or encouraging response to what Canadians and experts have been telling us since Bill C-7 became law, both inside and outside Parliament.

When Bill C-7 passed in 2021, 91% of Ontario psychiatrists opposed the expansion of euthanasia, but they were ignored. The government has not bothered to listen to critical advice and feedback. Make no mistake, there are ordinary citizens across the country who are horrified when they learn of what is happening here with expanding accessing to MAID for mental illness. I have heard from a lot of people in my own riding who are concerned. They came up to me at hockey rinks. They came up to me at my various town halls that I hosted over the winter break and told me how unimaginable it was for this is to happen in Canada.

There has been the same reaction around the world when people in other countries found out what has happened here in Canada. We stand out compared to other places that offer assisted suicide, and not in a good way. International media coverage shows how Canada's reputation has suffered as a result. It is long past time for the government to get outside of its bubble and hear what Canadians are thinking and feeling. Despite the Minister of Justice trying to claim that our system has strict safeguards, we need to look around and realize that something is not going right.

Canada reported 7,300 deaths in 2020 and 10,000 deaths in 2021. It is interesting that if we compare with another jurisdiction, it gets even more troubling. The state of California started to allow assisted suicide the same year that we did in 2016. The size of its total population is similar to that of Canada, yet it only reported 495 deaths in 2020 and 486 deaths in 2021. The difference in proportion is striking.

People see these numbers and they cannot believe that this government is considering expanding access even further to people with mental illness as a sole condition. They cannot help but wonder if these people are already slipping through the cracks and are caught up in the numbers we have here in Canada.

If we want to understand the background of how we found ourselves in the situation today with Bill C-39, we need to recall what happened with the previous bill. Back then, this Liberal government brought forward a piece of legislation that was a significant expansion from the way MAID was originally set up a few years before. It allowed assisted suicide for conditions where natural death was not reasonably foreseeable.

At the time, we heard overwhelmingly from many advocates, organizations and members from the disability community who were deeply concerned about the government's new direction. They pointed out the flaws and the risks involved for people with disabilities who could find themselves in a vulnerable position, and experience abuse rather than receiving the support and the resources they needed. They also worried about the stigma and the message it could send to the disabled as well as to wider society. It was clear that it would not be unacceptable for anyone, whether they live with a disability or not, to get the impression that these human lives are inferior or not worth living.

Here we are seemingly caught in a similar position once again. It was shocking when the Liberals accepted the last-minute amendment to include mental health as a condition for assisted suicide. Since then, they have had time and opportunity to reconsider, but they refuse to listen and protect the lives of vulnerable Canadians. If government members do not put a stop to the expansion of MAID for mental health, it will be impossible to take them seriously when they try to talk about a mental health crisis.

I want to take a moment to talk about Michael Landsberg, who spoke very passionately about mental health a number of years ago, and I consider this man to be a pioneer and a trailblazer.

Michael Landsberg was the host of Off the Record on TSN. Mr. Landsberg has a foundation called “#SickNotWeak”. A big part of what he talked about 20 years ago, and what he talks about today once again, is the stigma that people with mental illness quite often face and that people with depression face. When we look at the disability community and what we talked about earlier with the stigma around them, we are seeing that happen again for people with mental illness. I think it is important that we look at the stories of people like Michael Landsberg who has spoken so clearly and passionately around making sure that we do not provide harmful stigma for mental illness. When we look at the statistics that I quoted earlier, there is a real and present danger here if we do not address this properly while we have the opportunity.

Across the country there is a lack of mental health support, especially in rural ridings like mine. It is absolutely shameful to offer death as a solution. While Bill C-39 brings a pause in this expansion, it is inappropriate to use it as a selling tactic with the hope that public opinion will shift to their direction in the meantime.

However, a delay is not enough. We need to exclude mental health as an eligible condition for assisted suicide. This government must stop and review what it has done with the system. If not, it only shows that it is untrustworthy. There has been no sign of meaningful reflection about its previous legislation. Because of this, it has failed to reassure Canadians about further changes. We talked about the safeguards earlier; people are wondering if they even exist.

How can we ignore the veterans who are offered MAID instead of mental health support? How can we proceed when we have seen people in poverty and distress offered it against their will? These types of reports are coming far too often, and we cannot say that we had no warning. The predictions of experts and from many of us here on the official opposition have been proven to be correct so far. If this expansion happens in March 2024, how can anyone possibly pretend that these problems cannot get much worse?

Because the Liberals will not do what is necessary, one of my Conservative colleagues has taken the initiative to introduce a bill that will remove eligibility for mental illness. It would give us another chance to prevent this catastrophe, and I hope my colleagues support it.

Criminal CodeGovernment Orders

February 13th, 2023 / 8:30 p.m.

Winnipeg North Manitoba

Liberal

Kevin Lamoureux LiberalParliamentary Secretary to the Leader of the Government in the House of Commons

Mr. Speaker, one of the things that I have witnessed over the years while we have been debating the issue of MAID, from 2016 and onward, is that there is no unanimous consent coming from the Conservative benches. There are many individuals even within the Conservative Party who have differing opinions in terms of what it is that the member himself is suggesting. If I am wrong on that I would be very much interested in the member telling me that I am wrong.

The reason I say that is because there was a special joint committee for MAID that has been out there doing a great deal of consulting, working with Canadians, looking to health experts and talking to individuals who are either direct or indirect stakeholders. There has been a great deal of discussion.

On the legislation itself, I suspect that the member is going to be voting in favour of it, but I am wondering if he could provide his thoughts in regards to the fact that even within his own political party there is no overwhelming sense that what he is suggesting is in fact the best way to be going.

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February 13th, 2023 / 8:30 p.m.

Conservative

Jeremy Patzer Conservative Cypress Hills—Grasslands, SK

Mr. Speaker, there was a great phrase coined by our interim leader that “unity does not mean uniformity.” The reason that is important is because MAID is a deeply personal issue. We are not here to talk about the merits of MAID in and of itself. What we are here to talk about today is the expansion of mental illness as a sole reason for people to be eligible for medical assistance in dying.

If we look at the results Canadians are seeing, it is quite alarming and astonishing to see the government is willing to proceed with that as a reason for people to access this. Where we are united as a party, and I think where most Canadians, generally speaking, across this entire country are united when it comes to this issue is they want to see people have access to the supports they need for mental health.

I referenced Mr. Landsberg and how for over 20 years he has been advocating for the conversation around mental health and to try to eliminate the stigma that for so many years was assigned to people with mental illness. When we proceed with allowing mental illness to be a sole reason, it sends the wrong message. That is where Canadians want to see us go, which is to make sure we are sending the right messages and giving people hope as they go forward when they are going through their darkest hour.

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February 13th, 2023 / 8:35 p.m.

NDP

Gord Johns NDP Courtenay—Alberni, BC

Mr. Speaker, my colleague talked about supports for people with mental health issues. One group we have not talked about is public safety personnel. This is definitely not partisan; it is about us both coming from rural communities. That includes border services, corrections services, firefighters, operational intelligence personnel, paramedics, police, public safety communications and search and rescue personnel. Half those individuals experience some sort of mental disorder in their career in their lifetime and one in 10 will actually consider death by suicide.

These professionals and their families have remained decades behind. We know about the military and veterans with regard to supports for their well-being, and we are just scratching the surface in addressing their considerable mental health needs. Their core funding comes from the Canadian Institute for Public Safety Research and Treatment and concludes on March 31, just six weeks from now. Without a renewed commitment on that funding, it will end.

Maybe my colleague can speak about some of those public safety personnel in his riding who have suffered through PTSD or some trauma and how important it is we get the proper resources to support them, especially those heroes who have put their lives on the line and the sacrifices they made, as we know coming from rural Canada.

Criminal CodeGovernment Orders

February 13th, 2023 / 8:35 p.m.

Conservative

Jeremy Patzer Conservative Cypress Hills—Grasslands, SK

Mr. Speaker, I really appreciate the member's question, because too often people from rural Canada are forgotten about. With the uniqueness of working with the provinces, letting the provinces decide how that is going to be spent is going to be beneficial. Every province has a different geography. They have different programs. They have different needs and different ways of having that set up. There might be a federal workforce like CBSA, but the provinces are going to be best situated to make sure the funding gets rolled out properly. There is a healing lodge in my riding, and it would have the opportunity to advance cultural practices that would be suitable to the needs of indigenous people. Allowing each region of the country to have a bit more control of that funding would be appropriate.

Criminal CodeGovernment Orders

February 13th, 2023 / 8:35 p.m.

Conservative

Tracy Gray Conservative Kelowna—Lake Country, BC

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

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

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

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

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

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

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

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

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

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

I was very touched by some of the correspondence from my own residents in Kelowna—Lake Country. I often try to be the voice of my residents in Ottawa.

Judith, in Kelowna, wrote to me with her concerns after hearing about the delay in the planned expansion of MAID for those with mental illness as the single underlying cause. She acknowledged that many people have brought forth many concerns to the government, and she was surprised that the Liberals were now just delaying the expansion.

Not every community has the same mental health services, especially rural areas. I was speaking in person to a young man last week who was movably shaken by the thought of medical assistance in dying being considered to be made available to individuals whose sole underlying condition is mental illness. His deceased mother had struggled with mental illness, and he was extremely angry to hear that the Liberal government had not cancelled outright the option for people to seek MAID under these parameters. Instead, this legislation delays it.

The public outcry and concern about this is really what forced the government to take this first step of MAID delay for people with the single underlying cause of mental illness. There are mental health stories from people I know or have met that I could share in the House, but I am not going to because I would not be able to get through them.

I do not want to give up on people, and the government is giving up on those experiencing mental illness. We must focus on giving people help and hope. We must focus on treatment for mental illness rather than assisted death. Conservatives do not want to give up on people.

As I said earlier, this legislation only creates a new arbitrary deadline. Parliament would be better served in our responsibility to Canadians, particularly vulnerable Canadians who feel lost in their lives, to abandon this reckless expansion of MAID to those with mental illness as the sole underlying condition. We cannot, and should not, give up on persons experiencing mental illness, and we must make it clear and ensure support is there for help and treatment.

Medical assistance in dying cannot be the most accessible solution for individuals with mental illness. Instead of bringing forth changes to expand MAID to persons with mental illness, the Liberals should instead be focusing on proposals to bolster mental health support for Canadians, many of whom are facing challenges in a postpandemic world and the impacts of the last eight years of the Liberal government, which has divided families and neighbours, and of its inflationary policies, which are squeezing peoples livelihoods.

The Liberals have failed to keep their pledge from the snap election in the summer of 2021 for a permanent multi-billion dollar mental health transfer to the provinces and territories, which was to ensure that they have the funding and support needed to expand mental health care. We are in a mental health crisis, yet the Liberal promise appears to have gone to the back of the line.

We have to remember that it was the Conservative member for Cariboo—Prince George who spearheaded a three-digit suicide prevention hotline in Canada, 988. All parliamentarians unanimously supported this motion in the House of Commons. This was over 900 days ago, and it still does not exist.

Now, that is not surprising considering the Liberals gave the task to their catch-all department, the Canadian Radio-television and Telecommunications Commission, the CRTC, to implement. What did the Liberals do instead?

They did not bring in legislation to cancel the implementation of MAID for those with the sole underlying condition of mental illness, they just delayed it. Building the mental health support systems Canadians need to live healthy, fulfilling lives will be a top priority for Conservatives in this Parliament and a future Conservative government.

People deserve mental health resources to help them. People deserve hope. Families deserve hope. This is what we will be focused on.

Criminal CodeGovernment Orders

February 13th, 2023 / 8:45 p.m.

Winnipeg North Manitoba

Liberal

Kevin Lamoureux LiberalParliamentary Secretary to the Leader of the Government in the House of Commons

Mr. Speaker, I support the need for additional mental health for Canadians. That is why I am very proud of the fact that we have a $198-billion agreement with the provinces now over the next 10 years, as provinces will determine how best to use that money. There are some qualifiers for that. There is going to be more accountability. There is going to be transparency.

Let us contrast that, as Conservative members stand up and are critical of the government, saying that we are not doing enough on mental health. I think we need to be honest with Canadians in what the Conservative Party is proposing to do on mental health, which is nothing. There is no commitment coming from the Conservative Party to deal with mental health, rural or urban. If there is, I ask the member to please tell me where the announcement is. What is the Conservative Party doing? Give me another half-hour, and I will be more than happy to explain what it is the Liberal Party is doing in support of mental health.

Depression is not going to be used as access to medical assistance in dying. I have more confidence in our medical profession.

Criminal CodeGovernment Orders

February 13th, 2023 / 8:45 p.m.

Conservative

Tracy Gray Conservative Kelowna—Lake Country, BC

Mr. Speaker, we have to look at the results of the government. The Liberals have been in government for eight years, and one result of the government, which I gave as an example during my speech, was to implement a 988 suicide hotline across the country. It was unanimously supported by the House, but here we are more than 900 days from it happening. This is one very small step and the government cannot even implement it.

We have to look at some of the other results. We have to look at the mental health and addiction crisis we have across the country. We have to look at the results of eight years of the government. When looking at the cost of living, we see the price of houses has doubled in eight years and we have record-high inflation.

Regardless of what the Liberals say they are doing or hope they are doing, we have to look at the results of their actions after being in government for eight years, and it is not very good.

Criminal CodeGovernment Orders

February 13th, 2023 / 8:50 p.m.

NDP

Gord Johns NDP Courtenay—Alberni, BC

Mr. Speaker, we know that the government has not delivered a single dollar after its promise of mental health transfers. The member talked about the importance of support. We agree with her given what I heard in her speech.

The government still has not tabled legislation to create parity between mental and physical health, which is absolutely critical. We have heard from the disability community, especially people who are suffering with mental health issues as their underlying illness, and they are all saying they need better supports, such as access to treatment. They are also saying that it is tough to pay their bills, buy groceries and pay for rent.

We put forward a proposal for a guaranteed livable income for those living with disabilities and for seniors. We know tax breaks are not going to help people in that category because they do not have the income. I am hoping my colleague can talk about some of the solutions to help support those who are struggling so they are not considering medically assisted dying for an underlying mental illness.

We can talk about solutions. I know the Liberals want to deflect because they do not want to talk about their track record. That is what they just did in the question to my colleague. I am hoping we can hear more proposals to help support people.