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

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, my colleague from Thunder Bay—Rainy River is well aware of my great respect for him. However, in listening to his speech, I found it riddled with confusion.

I wondered whether he read the expert panel's report on mental illness as the sole underlying medical condition. I believe that our thinking may not be quite so different. I think that his practice has shown him the need to take care in adopting such an approach. However, in reading the report, he will see that there are many precautions in place and very specific guidelines.

Indeed, just because there are not very many mentally ill people experiencing tremendous suffering does not mean we must not move forward. One person experiencing unimaginable and intolerable suffering is, in my opinion, one too many.

I would like to know my colleague's thoughts on this.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Madam Speaker, I have not in fact read the report. At the moment, the problem is that we have 10 provinces and three territories that are all expected to come up with the appropriate safeguards, and I do not think any of them have actually publicly come forward with those safeguards.

I would further suggest that it ought not be the colleges of physicians and surgeons that are put in the position to have to put those safeguards in. It is up to us, the elected representatives who are accountable to the people, who ought to be the ones making those decisions, not the colleges of physicians and surgeons.

I would agree with the member that one person who stays in suffering is too many; however, I would also suggest that one person whose life is taken prematurely because of an overly liberal approach to MAID and the pain that that causes, particularly to the family, ought to be something we consider before making any decision that would allow that to happen.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Madam Speaker, when we voted on this legislation, we were told that Parliament would be able to review so we could tell whether or not we had overstepped and whether or not it had worked. We were never given that right. Instead, this was handed over to the unelected senators, who got it into their head that people who are depressed or who have a few problems should be able to die. We have to fix that. We never got to address whether or not these provisions were working, whether or not there need to be proper guardrails in place.

Would it not be better if this bill would just park this, stop it dead, until we can actually find out how this process is working for the people of Canada?

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Madam Speaker, my guess is that if this were to go to the Supreme Court, it might well say that this kind of difficult decision, which involves balancing competing ethical values, is best left to the elected representatives, who are accountable to the people. We are the elected representatives, not the Senate. I have a lot of sympathy with what my colleague has to say.

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Madam Speaker, I rise today to speak to Bill C-39, an act to amend an act to amend the Criminal Code (medical assistance in dying), introduced by the Liberal Minister of Justice. This is obviously a particularly delicate subject.

The bill corrects a mistake made by the Liberal government. Another mistake, some will say. This government makes hasty, last-minute decisions and, as usual, has to backtrack. It is correcting one of its mistakes, but in doing so it will make another.

Let us look back to fully understand where we are today. When the government was preparing to amend the medical assistance in dying legislation in accordance with the most recent directives of the Superior Court of Quebec in 2021, the Senate made an unexpected amendment that would allow, starting on March 17, 2023, the provision of medical assistance in dying to individuals whose sole underlying medical condition is a mental illness. The Liberals then said, yes, why not. the Liberal government accepted the amendment, which is now part of the legislation.

The amendment was accepted without study, reflection or any serious consultation. The date set, March 17, 2023, is completely arbitrary. What was the Liberal government's reasoning at the time for accepting this amendment? How did it come up with the date of March 17, 2023? It obviously relied on its political guesswork, and God knows just how much the Liberals govern haphazardly, without a compass, and by improvising in an indecent and dangerous manner. This decision is just one of many very bad decisions made by the Liberals since taking office.

There are two problems with this measure. The first is expanding medical assistance in dying to people whose only underlying medical condition is a mental disorder. The second is setting the date of March 17, 2023, an arbitrary date that was selected without argument or justification.

Let us look at what is being done elsewhere, and not just anywhere. Let us look at Quebec, where the subject of MAID and dying with dignity has seized Quebec parliamentarians for many years. I know, because I was there as an MNA and minister and I voted in favour of MAID. In my soul, my heart and my conscience, I believe that that was the right decision.

With a view to now expanding medical assistance in dying, in its great wisdom, the Parliament of Quebec is taking its time, thinking and studying. The Quebec National Assembly set up a multi-party Select Committee on the Evolution of the Act respecting end-of-life care. It closely examined whether the scope of medical assistance in dying could be broadened. It tabled its report, which was unanimously adopted by the National Assembly in December 2021. This is recent.

Imagine. The Select Committee on the Evolution of the Act respecting end-of-life care does not recommend that medical assistance in dying be made available when a mental disorder is the sole underlying medical condition. It was obvious to the MNAs who sat on the committee that Quebeckers are not there and that there is no social acceptance of this issue.

However, the Quebec committee did not stop there. It went even further. In order to eliminate any possible grey areas, the committee recommended that the Government of Quebec amend its act to specify that medical assistance in dying is not available in instances where a mental disorder is the sole underlying medical condition.

On page 58 of the committee's report, it states, and I quote:

The Committee recommends that access to medical aid in dying not be extended to persons whose only medical condition is a mental disorder; that, to this end, section 26 of the Act respecting end-of-life care be amended.

The committee added:

This recommendation is in line with the precautionary principle that Québec has upheld since the beginning of work on medical aid in dying. We believe that the risks associated with extending access to medical aid in dying to persons whose only medical condition is a mental disorder would entail too many variations and could therefore not be closely monitored.

It goes on to say:

In order to implement this recommendation, we believe that section 26 of the Act respecting end-of-life care should be amended to avoid the possibility that a mental disorder as the only medical condition give access to medical aid in dying.

The committee refused to extend access because of problems relating to incurability, social acceptability, diagnosis and lack of consensus among members of the public and within medical professional organizations.

The committee therefore opted to follow the precautionary principle. As I said before, this is the element that was so regrettably lacking from the Liberal government's decision-making process. Once the Quebec committee completed its work and submitted its unanimous report, the Government of Quebec introduced its Bill 38 in May 2022, which was less than a year ago. The Government of Quebec endorsed the committee's recommendation. To be clear, Bill 38 was never passed because there was an election, so it died on the order paper.

The bill would have amended section 26 of the act by adding a prohibition on administering medical aid in dying to a person whose only health condition is a mental disorder. I will quote clause 13 of the Government of Quebec's Bill 38:

A patient who meets the following criteria may make a contemporaneous request:

(1) be of full age and capable of giving consent to care;

(2) be an insured person within the meaning of the Health Insurance Act...

(3) suffer from a serious and incurable illness or a serious and incurable neuromotor disability;

(4) be in an advanced state of irreversible decline in capability;

(5) experience constant and unbearable physical or psychological suffering which cannot be relieved under conditions that the patient considers tolerable.

What I am about to say is important:

For the purposes of subparagraph 3 of the first paragraph, a mental disorder is not considered to be a serious and incurable illness.

Canada does not exist in a vacuum, and it is not disconnected from what is happening in Quebec. The difficulties experienced by Quebec exist across the country as well. We are not prepared for this expansion. If we do not take action now, if we do not pass this bill, in less than one month, people living with a mental illness could have access to medical assistance in dying. We do not want that, Quebeckers do not want that, and Canadians do not want that. Canadians would not understand our lack of action. That is why we need to vote in favour of this bill.

However, we will vote for it reluctantly and with heavy hearts. We do not want the change to take effect on March 17, 2023, but there is another catch in this bill.

Bill C-39, introduced by the Minister of Justice, extends the deadline by one year. The bill extends the March 17, 2023, date to March 17, 2024. Why is it one year? Why not push it back two years? Why not suspend or abolish this section altogether? Why rush the expansion of MAID to people living with mental illness when the country does not want it and when doctors themselves are divided on the issue?

I would like to close by saying that medical assistance in dying is a sensitive issue that speaks to our values and our history, too. What we are asking of the Canadian government is not to simply postpone the date. We are asking the government to give us time, as parliamentarians and as Canadian citizens, to take the time needed. I believe that rushing such matters is always ill-advised.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Madam Speaker, I have read the recommendations of the committee of the Quebec National Assembly. I am interested in this, as the member is a Quebecker who seems to be opposed to it. The perception of a lot of us outside of Quebec is that the greatest support for more liberal approaches to medical assistance in dying is from Quebec. Is this not the case? Would she like to comment on that?

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Madam Speaker, I think Canadians are on the same page as Quebeckers. I think it would be in our best interest to take all the time we need to really think through this very sensitive and delicate issue, which involves very personal and deeply held values, so that we can properly assess all the consequences.

To be honest, I am concerned that the one-year delay will not change anything, let alone address the issues that are already being raised about expanding medical assistance in dying to people living with a mental health condition. Quite frankly, I do not think we are there at all. We would be rushing things if we move forward, and that would be dangerous for our society.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I commend my colleague who is a member of the Special Joint Committee on Medical Assistance in Dying.

I would just like to provide her with a bit of context. Bill C‑7, which is the fruit of a compromise with the Senate, was meant to respond to a requirement in a court ruling to allow Ms. Gladu and Mr. Truchon to have access to medical assistance in dying.

No one in Quebec considered the passage of Bill C‑7, which allowed Ms. Gladu and Mr. Truchon to have access to medical assistance in dying, to be reckless. There was a consensus on it. It needed to be passed. We passed it while creating a special panel of experts that was meant to table a report within two years to inform a joint committee, which was tasked with reviewing the report and making recommendations that would come later.

We have to be careful when we talk about rushing things. Let us take our foot off the gas. By March 2024, we will have been thinking about this for three years.

What is more, when my colleague says that the public is not on board, I would like her to show me some polls to support that claim. In any event, the current problem is that her party wanted the committee to table a report in June because the Conservatives were against giving the joint committee any extensions on its deadlines so that it could do a good job. Each time, we fought for an acceptable deadline to do decent work. I think they are being a bit hypocritical.

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Madam Speaker, I think it would be better for my colleague to choose his words more carefully.

Unless I am mistaken, last week we heard him say in an interview that there was no agreement on the issue of MAID for those with a mental illness. My colleague also went to the trouble of stating that one in two experts did not agree.

I will close by citing the panel he spoke about.

The evolution of many mental disorders, like some other chronic conditions, is difficult to predict for a given individual. There is limited knowledge about the long-term prognosis for many conditions, and it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient.

I will stop there.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Madam Speaker, there is another crisis underlying the discussion we are having right now, and that is the mental health crisis in this country. The government promised to put funding in place for Canadians to get help, but the Liberals have really been dragging their feet on that.

I would like to hear my colleague's thoughts on the current situation. Does she think the government should provide more resources and make sure that mental health issues really are recognized as a serious problem?

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Madam Speaker, the member is absolutely right. Mental health is a very serious issue in our society. Rather than talking about medical assistance in dying for people with mental health disorders, the government should make funding available, and quickly, so that everyone in this country living with mental health challenges, whether in rural or urban areas, has access to care.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, I rise today to speak to Bill C-39, an act to amend the Criminal Code with regard to medical assistance in dying. It is a bill I will be supporting to protect the most vulnerable Canadians from the Liberal government's reckless expansion of medical assistance in dying to Canadians who are suffering solely from a mental illness.

Unbelievably, if Bill C-39 does not pass, Canadians struggling with a mental disorder or illness will be able to access MAID as early as next month. As the Canadian Association for Suicide Prevention said, “Just as life is getting harder in Canada, it is getting easier to die.”

It is important to be perfectly clear that when considering MAID in the context of someone who is not dying as a result of their condition, such as a mental disorder alone, we are talking about suicide. It is almost as if the Liberals have given up. Instead of protecting the most vulnerable in society, they have opted for the easy way out. They have chosen a dangerous path, a slippery slope. They have opened medical assistance in dying to the most vulnerable in our society, and now they want to stop the clock, buy more time and find another politically expedient reprieve without doing anything to help.

I listened intently to the debate today, and honestly, it almost makes me ashamed to be a politician. Earlier today, the minister said that we need more time. Yes, we do. I have said this since the very first debate we had on MAID in 2016. During my intervention back then, I said as a new member of Parliament that nothing prepares one to adequately debate or intervene on such a weighty issue. We need to ensure we get this right, yet the Liberals rushed it through.

We have all heard very real stories: an Ontario man requesting MAID because it was more preferable than being homeless, the woman who has applied for MAID after seven years of not finding affordable housing and Canadians accessing food banks and asking for help with MAID. More and more Canadians are struggling, and we should be doing everything to support them, not giving up on them. We have also heard the unbelievable stories of Veterans Affairs employees suggesting MAID to veterans who are struggling with post-traumatic stress disorder. These are real stories; they are not sensationalism.

As the Canadian Mental Health Association has said, “Canada is failing to meet its human rights obligations when [Canadians] with a mental illness cannot receive the programs, supports and resources they need to be well and live with dignity.” The government is failing to provide even the most basic programs and supports.

This is a topic that my constituents feel very strongly about. It is a divisive topic, to say the least, and I respect people's decisions, but one thing is clear: A majority of my constituents, and indeed Canadians all across our beautiful country, are against the expansion of MAID for Canadians solely dealing with mental illness or disorders.

Canadians need to know what we are fighting for today. We need to look beyond what we are debating. The simplicity of Bill C-39 is a contradiction to the complexity of the issue. What we are really talking about is the ability for those suffering with mental illness to end their lives. Instead, we should be here today talking about what we can do to help those in need and what we can do to provide the services that will save lives.

Earlier today and throughout the debate, the Liberals have tried to explain away the provisions that included mental illness in MAID. They have attempted to shift the focus from what is actually happening to what is politically expedient, with the exception of our hon. colleague from Thunder Bay—Rainy River, whose speech I truly appreciated. Instead of addressing the issue head-on, they are looking for us as parliamentarians to buy more time to find a soft landing.

I will be voting in favour of Bill C-39, but I cannot support the addition of suicide to MAID ever. Let us be honest that this is exactly what we are talking about. There are times when partisan politics are called for and this not one of those times. We can disagree on tax hikes, we can disagree on gun legislation and we can disagree on who is best prepared to move our country forward. However, we cannot disagree on the importance of life and the importance of fighting for those who are struggling and who believe their only way out of the hardship they are experiencing is death. Is that not what we are here for? Is that not what all of us, all 338 members of Parliament, ran on? Was it not to stand up for those who are struggling, Canadians from coast to coast?

We need to be doing everything we can to make sure we are helping those who are struggling and who are the most vulnerable. We should be focused on offering help and treatment rather than assisted death.

Just two short years ago, all members of the House stood and voted in favour of creating an easy to remember three-digit suicide prevention hotline. It has been a long road forward, but this fall, Canadians who find themselves in trouble will have a chance to get the help they need. When seconds matter, they will not be forced to google a 10-digit number. They will simply pick up their phone to dial or text 988, and they will be able to talk to a person to start the process to get help.

The 988 hotline will not be the end point. It will be the beginning. It will provide one more tool with which those who are suffering can reach out for help.

As many of my colleagues know, I have dedicated my life to fighting for those who suffer silently or struggle with mental illness. I have sat with so many families devastated by suicide whose only hope is that we do everything in the House to ensure other families never experience what their families have. There is so much pain and so much guilt. Through my work, I have met many who have struggled with mental illness or mental injury due to their service.

I think about my friends. Jason is a giant of a man who was a firefighter. He was gripped with PTSD and wanted to die by suicide, but instead, he chose life. Now he helps others on their journey to beat PTSD and OSI. My friend Kent continues to serve our community each and every day. I think about their families every day and how I am so thankful my friends chose life.

I think about my own life and how at one point, I was struggling. It was one intervention, one by chance intervention that made me chose life. When someone is struggling with a mental injury, it is sometimes tough to see the forest through the trees. Sometimes people cannot see the light through the darkness. Sometimes people just need someone to tell them they are fighting for them and to help them get the assistance they need.

I live every day to fight for those who are struggling. We need to be doing everything we possibly can to make lives easier for Canadians, to give hope when it seems there is none. We need the government to be working with stakeholders to find the means to support those with mental illness. We have spent far too long talking about it. We have spent far too much time on studies that sit on shelves somewhere and gather dust. We have spent far too long doing nothing.

I will be supporting this legislation, but I will never support the inclusion of mental illness in MAID. It is a slippery slope. We need to take the next year or longer, find out how we can provide real support and figure out where we can actually make a difference. We need to spend the next year at least working on solutions that will keep Canadians alive.

A few weeks ago, I had a meeting with a man whose young daughter had ended her life by suicide. We spoke over Zoom for almost an hour, and I listened to his story. I heard the grief. I heard the despair, and I heard the regret.

Those who have children know what I am talking about. We live our lives to make our children’s lives better. We want the world for them. We want to give our kids everything we never had. We want this place to be better for them, and we want them to know we care.

What I heard in that man’s voice was utterly devastating. It was heart-wrenching. He said to me, “Todd, I can live with the death of my daughter, but thinking of what she had to go through, how many hoops she had to jump through just to access help, and how she had to navigate her crisis all alone is unbearable.” He said that he can live with the death of his daughter.

I honestly do not know how someone can listen to those words and think that what we are doing here is totally acceptable. I do not mean the year-long reprieve the government wants us to support. I mean the fact that we are even at this point, having this discussion. Until we have provided every support, exhausted every means, done everything we possibly can to help someone through their pain and suffering, my God, how can we even be here talking about this? The impact of that meeting will live on with me forever: the pain in his voice, the hurt, and the image of his daughter reaching out for help that was not available.

Conservatives do not believe that medical assistance in death is an acceptable solution to mental illness and psychological suffering. Our health care system should help people find the hope that they need to live, not assist in their deaths.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I thank my colleague for his touching testimony.

I want to tell him that, in a debate like this, it is important to be able to distinguish between various realities. This is not a debate about mental health. A debate about mental health means talking about prevention. This debate is not about all mental disorders but rather incurable mental disorders. We must accept that there are people with mental illnesses such as schizophrenia which is incurable and irreversible.

The suicidal state to which he refers, as he demonstrated both through his own testimony and that of other friends, is reversible. If he reads the expert panel's report, he will understand that this is not what is being discussed here and not what we will legislate. A suicidal state is reversible. No effort will be spared to provide the resources needed to reverse that state.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, the intervention of our hon. colleague across the way and others from the Bloc today have absolutely frustrated me to no end, but I appreciate their points of view. I believe recovery is always possible.

As our colleague from Thunder Bay—Rainy River has said, even the experts do not agree with what our Bloc colleague is saying. There are some who can recover and lead healthy and viable lives. Those are the people we should be fighting for all the time, making sure that they know we are there putting in the supports so they do not have to jump through a million hoops just to get the help they need.

[Blake Desjarlais, NDP, Edmonton Griesbach, AB]

Mr. Speaker, I thank my colleague for what I believe is an important intervention and intersection between health care, mental health and this bill. Of course, it is no secret that Canadians from coast to coast to coast are enduring an incredible level of poverty. Poverty is one of the driving forces that contribute to folks' mental health and the fact that they cannot see a light at the end of that tunnel when they fall behind.

Does the member support the New Democratic Party's call for a guaranteed livable basic income, which would raise folks out of this kind of poverty? I hear the Conservatives laughing right now about this, but a guaranteed livable basic income would ensure that folks actually have a chance to get out of poverty to begin a path of recovery. The member just stated that he believes everyone deserves a chance at recovery and that everyone can. Does he support this bill, which would ensure everyone has the resources to survive?