Bill C-39

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

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.

Criminal Code

[Daniel Blaikie, NDP, Elmwood—Transcona, MB]

Madam Speaker, one of the ways we can help people who are suffering and who may at some point consider medical assistance in dying is by supporting the establishment of a Canada disability benefit and supporting the level of income that this benefit would deliver to be something that raises people out of poverty. New Democrats have suggested, for instance, that the level of that benefit should be set at $2,200 a month to ensure that people living with a disability actually have the means to live with dignity, to afford a roof over their head and to afford to feed themselves and their families. Is this something the member supports?

[Leslyn Lewis, Conservative, Haldimand—Norfolk, ON]

Madam Speaker, Conservatives support supporting our most vulnerable, and we believe that among those are individuals who are suffering from mental health issues. They deserve all of the supports needed to help them get through this dark time in their lives.

[Mike Morrice, Green, Kitchener Centre, ON]

Madam Speaker, I would like to follow up on the question from the member for Elmwood—Transcona, because there are many members in this place who are talking about people deserving a dignified life, and people with disabilities certainly deserve that. There is an important call for the governing party to fund the Canada disability benefit. Does the member for Haldimand—Norfolk join us in that call?

[Leslyn Lewis, Conservative, Haldimand—Norfolk, ON]

Madam Speaker, I thank my hon. colleague for his concern and compassion over the most vulnerable. The most pressing thing right now in order to make sure MAID is not extended to those with mental health issues is to make sure the Liberals live up to their promise of caring for those with mental health issues, and that is not through providing assisted dying.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Madam Speaker, I am proud to rise on behalf of my compassionate and caring residents of Renfrew—Nipissing—Pembroke. Like the majority of Canadians, my constituents strongly oppose state-sponsored suicide for those living with mental illness. That is why I will support the legislation to delay this from happening. This bill to delay providing assisted suicide is critical. It is a matter of life or death that this expansion be delayed.

Many Canadians are wondering, “How did we get here?” To describe this process as a slippery slope is to understate how greasy this rapid descent has been. How did we go from the Supreme Court reversing a precedent granting the right to die to those with incurable illnesses causing intolerable suffering and whose deaths are reasonably foreseeable to the point where the Quebec College of Physicians and Surgeons is advocating for the killing of newborn babies? How did we get here?

Obviously, first and foremost, the decision by the Supreme Court was to overturn the previous Supreme Court decisions and allow for a limited exception to the Criminal Code. The court found that the prohibition on assisted suicide is intended to protect vulnerable persons from being induced to die by suicide. The court ruled that the total ban on assisted suicide was overly broad because it also applied to non-vulnerable people and prevented them from receiving the assistance of a willing physician. The court said that it was up to Parliament to strike the right balance between Canadians suffering grievous and irremediable illness who want access to physician-assisted dying and those who may be put at risk by its legalization.

Then, Parliament debated legislation and Bill C-14 was passed in 2016. People whose deaths were reasonably foreseeable, meaning they were dying, and who were suffering intolerable pain could seek medical assistance. Despite widespread reservations, many Canadians view medical assistance in dying as compassionate.

Then, one judge said this was a violation of equality rights. The judge ruled that someone whose death was not reasonably foreseeable but who was suffering intolerable pain had the same right to assistance in dying. The progressive government did not appeal the case. It embraced the ruling and brought forth legislation to expand physician-assisted death to people who were not dying.

When that bill was before committee, the justice minister explained why physician-assisted suicide could not be expanded to include people whose sole condition was mental illness. The minister said there was no consensus. The bill then went to the Senate, where suddenly a secret consensus was discovered, unbeknownst to the medical community. The government flipped and flailed, and embraced this expansion to include mental illness.

The minister claimed the government would strike an expert panel to shape the necessary protocols to ensure that only the non-suicidal would be eligible for physician-assisted suicide. Last May, that expert panel returned with a protocol, albeit with two fewer members than when it started, after they resigned in protest. What did the expert panel have to say?

There is limited knowledge about the long-term prognosis for many conditions, and it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient.

The expert panel, handpicked by the Liberal government, said it was impossible to make accurate predictions about future prognosis. Despite that admission, the Liberals still went ahead with recommending a protocol for allowing physician-assisted suicide for people whose sole condition is mental illness. The government claims it is listening to the experts, yet two of the experts on the panel resigned. They were prevented from providing a dissenting report. They are not the only experts speaking out.

I would encourage all my colleagues to get their hands on the article in the Globe and Mail, published last November, entitled “Canada will allow assisted dying for mental illness starting in March. Has there been enough time to get it right?”, written by Erin Anderssen. The article introduces readers to Dr. Madeline Li, a psychiatrist at Princess Margaret Cancer Centre. Many of my colleagues here may remember Dr. Li from her appearance before the Special Joint Committee on Medical Assistance in Dying. While the article touches on a number of the regressive aspects of expanding assisted suicide, I feel this passage is particularly relevant to our conversation:

But among the many experts who have lined up to express their objections to the direction and pace of Canada’s euthanasia laws, Dr. Li’s deserves particular attention. She led the creation of MAID protocols at the University Health Network, a group of Toronto-area hospitals that together form the largest health research group in the country. At the national association for MAID providers, she is the scientific lead currently developing the government-funded assisted-dying curriculum for doctors. She has administered assisted deaths directly to patients, and provided oversight to hundreds of cases as the MAID program lead at the UHN.

All that experience, she said in an interview, has made her personally opposed to expanding MAID for patients without a foreseeable death, especially those with mental illness. The debate among doctors has become too ideological, she said, and the current system doesn’t have enough safeguards to prevent unconscious bias from factoring into decisions.

Can doctors—a mostly healthy, privileged group of people living in a society that routinely stigmatizes people with disabilities—objectively judge what makes life worth living? Dr. Li says she once watched a doctor use an actuarial chart to calculate that an older woman seeking MAID after a fall had, on average, three years left to live; he approved her for MAID, over the objections of three other physicians. “What if it had been six?” she asked. “How many years is enough?”

Dr. Li worries that since many psychiatrists won’t participate in MAID, there will be “an echo chamber of a few assessors who will all practice in the same way,” leaning hard toward patient autonomy. Already, she argues, MAID assessments are too often focused on whether a patient is eligible for an assisted death, rather than exploring why a patient wants to die in the first place.

The federal expert panel recommended that decisions should be made on a case-by-case basis, with the doctor and patient reaching a shared understanding. But while the law requires that patients must give “serious consideration” to clinically recommended treatments to relieve their suffering, they can refuse those treatments if they don’t deem them “acceptable.”

For instance, Dr. Li described the case of patient in his 30s, who asked for an assisted death, even though multiple doctors said his cancer was curable. Two assessors approved him for MAID. Faced with his adamant refusal to get treatment, and his progressing condition, Dr. Li said she helped him die “against her better judgment.” If MAID didn’t exist as an option, she believes he would have gotten treatment, and still be alive.

The government and its hand-picked experts assure us they can devise protocols rigorous enough to prevent vulnerable people from receiving assisted suicide. The expert panel says that despite it being impossible for doctors to predict a future prognosis of mental illness, Canadians should trust the opinion of doctors in making a determination of intolerable mental suffering, yet Dr. Li, against her better judgment, went ahead with assisting in the death of a man in his 30s who had a treatable cancer.

Unlike cancer, where we can have an objective test to determine a prognosis, we are supposed to just trust the opinion of doctors. Dr. Li was of the opinion the young man's death was not foreseeable. His condition was treatable, yet she assisted in his suicide. She is opposed to expanding this. How reluctant will physicians who support assisted suicide be when assessing people with mental illness?

Finally, while Dr. Li feels the debate has become too ideological, Canadians following the debate in this House might be confused. We have seen social Conservatives, small “L” liberals and socialists all raising serious concerns. We all seem to have the same goal of the maximum amount of compassion and care, while protecting the vulnerable.

I imagine there are about three million Canadians who grow angry hearing the Minister of Justice centre this debate on balancing the protection of vulnerable Canadians while preserving individual autonomy. On this issue, the minister seems to be more concerned with the autonomy of individuals to make their own medical determinations, while less concerned with the impact on vulnerable people.

[Dave Epp, Conservative, Chatham-Kent—Leamington, ON]

Madam Speaker, virtually all medical health experts contend that mental illness is not irremediable. Why the delay for a year? What is going to change in this next year that should not be dealt with right now?

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Madam Speaker, the question is whether we can get it right in a year. I have to ask this back: Can we ever get something like this right? It is incalculable that we have come so far. We have not gone down a slippery slope; we have jumped off a ledge.

[Blake Richards, Conservative, Banff—Airdrie, AB]

Madam Speaker, we have seen how slippery this slope has become with what I would call a botched expansion of MAID by the Liberal government.

A few short years ago, MAID was seen as a procedure that would be used in exceptional circumstances and that would require very strict criteria to be placed around it. Now MAID is being administered under increasingly questionable and concerning circumstances. The criteria has become looser and is wildly subjective, and many of the safeguards that once existed seem to have evaporated.

The recent scandal at Veterans Affairs around medical assistance in dying has revealed how bad the Liberals rushed and mismanaged it, and, I would say, how careless the expansion of MAID has become. Since Canada's inception, our men and women in the Canadian Armed Forces have fought and sacrificed to defend freedoms here at home and all around the world. Whether that be on the ground, in the air or at sea, they have done so with valour and distinction. In doing so, many of them endure physical, psychological or other injuries during their service.

There is nothing that we as Canadians can do to fully repay them for what they have done for Canada, but at the very least, it is incumbent upon us to remember and honour their sacrifices and ensure that when they transition out of service, they are fully supported and cared for as veterans. Sadly, under the Liberal government, Veterans Affairs Canada has fallen into disrepair. I have heard from many veterans that Veterans Affairs Canada feels more like an insurance company focused on reducing its financial liability and placing an unfair onus on veterans to have to prove their disabilities or illnesses over and over again.

I can think of a lot of examples, but one of the worst examples I can think of is a veteran I met who is in a wheelchair. He is missing both of his legs from his time serving our country, and every single year, he has to prove to Veterans Affairs that he is still missing his legs. Can anyone imagine what it must feel like for that veteran to prove every single year to Veterans Affairs that he is still missing his legs and is required to have a wheelchair because he served this country? That should never be the case.

I can think of another veteran who has been fighting Veterans Affairs Canada for years to have a wheelchair lift installed in her home. She is in a wheelchair because of her service, and she simply wants a wheelchair lift installed in her home. She has faced repeated delays and denials, and she still does not have the wheelchair lift she needs in order to access her home. She is forced to crawl across her driveway and up and down her stairs because of that. Is that what a veteran deserves after a life of service?

When I thought about the context there, I was that much more alarmed and disturbed when Global News broke a story last summer about an anonymous veteran who had been pressured to consider medical assistance in dying by Veterans Affairs Canada. We learned that the veteran had gone to Veterans Affairs Canada seeking help and support for injuries that he sustained while he was serving in our armed forces.

Initially, he was experiencing positive improvements in his mental and physical health. To him and his family, that must have been very promising. Then he got a call from a Veterans Affairs service agent who suggested that he consider medical assistance in dying.

The service agent brought the suggestion up repeatedly, even after the veteran asked her to stop. The service agent further asserted that she had helped another veteran successfully access medical assistance in dying and that the veteran had gone through with the procedure and was now deceased. In describing how she helped this veteran access medical assistance in dying, she concluded that it was preferable to traditional forms of suicide, like, as she said, “blowing [your] brains out all over the wall or driving [your] car into something.”

After learning about those accusations, the Conservatives demanded that the Minister of Veterans Affairs and his officials come before the Standing Committee on Veterans Affairs and answer for those appalling accusations. The minister came to the committee about this disturbing incident and indicated that it was, in his claim, isolated to one employee and was not indicative of a pattern of behaviour or a systemic issue. In fact, between the minister and his officials, they described the incident as isolated six different times. However, later in that very same meeting, they admitted that there was a second case involving the same employee.

That did not quite seem right either, so we asked the minister and his officials to come back to the committee, and the very night before the minister came back to testify that second time, another anonymous veteran came forward. He told the Operation Tango Romeo Trauma Recovery podcast that he too had been offered medical assistance in dying by Veterans Affairs Canada and that he too had felt pressured. This employee told the veteran, in the veteran's recollection, that they could help end his suffering because they had helped someone else end their suffering.

The next day at the veterans affairs committee, the minister confirmed that he was now aware of four cases involving one employee, but those did not include the allegations that were made the evening before on the Operation Tango Romeo podcast. Now we are talking about a situation where, after being told it was an isolated incident, we are aware of five different instances of this happening with two different Veterans Affairs employees at minimum. When we called on the Minister of Veterans Affairs to fire the employee who was involved in this, he refused to answer the questions, only saying instead that this employee was no longer in direct contact with veterans.

However, it got worse from there. Another veteran, Christine Gauthier, came to testify before the veterans affairs committee on something completely unrelated, but she revealed that she too had been offered medical assistance in dying. She was simply trying to get some help for her home to have a lift installed. Then, unprompted, a suggestion was made by another Veterans Affairs employee that if her pain was so unbearable, MAID was something she could consider as an option. In private conversations since then, I have learned of at least a couple of other veterans who have been offered MAID, so that makes about eight veterans and about four different employees, at minimum, whom we are aware of.

This whole thing has gone down a very bizarre trail, and we get repeated denials. The minister came out at one point and said, after he had admitted there were four cases, that Veterans Affairs has never offered this. Then, the very next day, he told us they fired the employee who was involved in the four cases. It is a story that no one on that side of the House can seem to get straight, and it is really concerning. Those are the kinds of inconsistencies that we are seeing.

When veterans go to Veterans Affairs Canada looking for help, support and assistance, whether with physical injuries or mental injuries, they should feel comfortable and safe when they are dealing with Veterans Affairs. There should be a level of trust there. However, instead of being offered help with things they need to help them live their lives, they are being told that maybe it would be better if they just went off and died. That is a pretty sad situation. Veterans are being betrayed by the very people and institutions they are supposed to be able to trust, and that creates further damage. That creates what is called sanctuary trauma, and that can further isolate veterans and further prevent them from wanting to get the help they need.

I hope a long, hard look at this is taken in the next year. If the Liberal government cannot even stop its own employees from pushing MAID on veterans, how can it assure Canadians that the necessary safeguards can be put in place to protect vulnerable people from being pressured into accessing medical assistance in dying?

[Mark Gerretsen, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons (Senate)]

Madam Speaker, perhaps my intervention will be more of a comment than a question, but I am happy to hear the member's thoughts on it.

Let us be absolutely clear on what happened with this one particular individual. There was a case worker in Veterans Affairs who should never have been giving any kind of advice regarding MAID. They were certainly not qualified to do that, and that individual no longer works for Veterans Affairs. That is the reality of the situation. Pertaining to medical advice, that should only ever come from an individual's physician and the medical experts who are qualified to do that.

Let us be clear that this was an isolated incident. The individual no longer works for Veterans Affairs. It is very clear what has happened with this individual and the fact is that they are no longer employed by Veterans Affairs.

[Blake Richards, Conservative, Banff—Airdrie, AB]

Madam Speaker, I am glad the member raised this because it is really important to understand we are talking about this kind of slippery slope we are leading down when we talk about expanding this into mental health.

I mean, there are many veterans in this country who struggle because of the service they have given this country. They struggle with psychological injuries, mental injuries, and PTSD. They may feel that, if they go to Veterans Affairs, which is where they need to go to get the help they need, there is a chance that, instead, they might be counselled on how they could end their life.

This has happened. We know of at least six cases where it has happened, and who knows how many others there might be. However, if a veteran has to feel that way about going to Veterans Affairs, might that mean they will not get the help they need? We should never be in a situation where a veteran feels they cannot get the help they need from the government.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I invite my colleague to read the expert report, which clearly states that, when treatment exists, people are not automatically eligible for medical assistance in dying just because the treatment is hard to get.

That is the shortcut the Conservatives have been taking since the start of this debate. Just because a person with depression asks for MAID does not necessarily mean they will get it. Just because someone somewhere is considering MAID because they are depressed does not mean they will have access to it. That is what they do not understand. There are assessors, providers, professionals whose job is to provide care for people whose condition is reversible. Is anyone here going to suggest that depression is irreversible?

Our colleagues talked about the experiences of people who attempted suicide. In every case, the condition was reversible. In fact, some Conservative members even talked about their own experience. They are here to tell the tale. We have to see things clearly. There are 16 key recommendations that are worth reading. I invite them to read the report.

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

We have to move on to Private Members' Business.

The hon. member for Banff—Airdrie will have about two minutes after Private Members' Business to continue with questions and comments.

The House resumed consideration of the motion that Bill C-39, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Madam Speaker, I note there are a number of inconsistencies in what my colleague is saying about MAID for people with a mental health issue as the sole underlying condition. The expert panel reported on MAID and has made a number of recommendations. I know the extension we are seeking today is about ensuring that all of our systems can be in place, so I am wondering if my friend could reflect on what the expert panel has said in clearly outlining what is required and the safeguards in place for MAID to be extended to those with a mental health issue as the sole underlying condition.