An Act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2

Sponsor

Mark Holland  Liberal

Status

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

Summary

This is from the published bill. The Library of Parliament has also written a full legislative summary of the bill.

This enactment amends An Act to amend the Criminal Code (medical assistance in dying) to provide that persons are not eligible, until March 17, 2027, to receive medical assistance in dying if their sole underlying medical condition is a mental illness.

Elsewhere

All sorts of information on this bill is available at LEGISinfo, an excellent resource from 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-62s:

C-62 (2017) Law An Act to amend the Federal Public Sector Labour Relations Act and other Acts
C-62 (2015) Safer Vehicles for Canadians Act
C-62 (2013) Law Yale First Nation Final Agreement Act
C-62 (2009) Law Provincial Choice Tax Framework Act

Votes

Feb. 15, 2024 Passed 3rd reading and adoption of Bill C-62, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2
Feb. 15, 2024 Passed 3rd reading and adoption of Bill, (previous question)

Medical Assistance in DyingCommittees of the HouseRoutine Proceedings

October 31st, 2024 / 10:55 a.m.


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Bloc

Luc Thériault Bloc Montcalm, QC

Madam Speaker, my goal this morning was not to reignite the debate on mental disorders. We debated that with Bill C‑62. My goal today was to reignite the debate because the government refused to implement the the Special Joint Committee on Medical Assistance in Dying's key recommendation, which was to move forward and accept advance requests. Not only did it refuse to implement the recommendation, but it did not even start thinking about it because it thinks it is too complicated. Only now, after a year and a half, does it want to start talking to people. My goal today is to focus on the issue of advance requests and the Liberal government's inexplicable inertia. The government should be ashamed to have left such an important report to gather dust.

Medical Assistance in DyingCommittees of the HouseRoutine Proceedings

October 31st, 2024 / 10:25 a.m.


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Bloc

Luc Thériault Bloc Montcalm, QC

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

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

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

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

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

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

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

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

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

The committee report states the following, and I quote:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Message from the SenatePrivate Members' Business

February 29th, 2024 / 5:45 p.m.


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The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Alexandra Mendes

I have the honour to inform the House that a message has been received from the Senate informing the House that the Senate has passed the following bill: Bill C-62, an act to amend an act to amend the Criminal Code, medical assistance in dying, no. 2.

Business of the HouseOral Questions

February 15th, 2024 / 3:10 p.m.


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Gatineau Québec

Liberal

Steven MacKinnon LiberalLeader of the Government in the House of Commons

Mr. Speaker, I can assure you that nothing is scarier than driving down Conservative highways, whether it is in Kamouraska or Témiscouata. Conservatives vote against highway infrastructure and refuse to fund them.

Later today, we will be voting on third reading of Bill C-62, medical assistance in dying.

Tomorrow, we will resume debate on the motion respecting the Senate amendment to Bill C-35, the early learning and child care legislation.

Next week is a constituency week during which the House is adjourned. We will, of course, be in our ridings to serve our constituents.

Upon our return, the agenda will include Bill C‑58, an act to amend the Canada Labour Code and the Canada Industrial Relations Board regulations, 2012, which deals with replacement workers. On Wednesday, we will continue debate on Bill C‑61, an act respecting water, source water, drinking water, wastewater and related infrastructure on first nation lands. Finally, Tuesday and Thursday will be allotted days.

I thank the members for their attention and wish them a good week in their ridings.

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

February 13th, 2024 / 7:50 p.m.


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NDP

Alistair MacGregor NDP Cowichan—Malahat—Langford, BC

Madam Speaker, it has been reported in the media that some senators have been openly musing about blocking Bill C-62. Given that we are dealing with such a short timeline, I am just wondering whether my colleague has any thoughts about the unelected Senate's openly voicing blocking the democratic will of the House of Commons on such an important issue. What does he think the government should be doing to try to prevent that from happening when the bill makes its way to the red chamber?

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

February 13th, 2024 / 7:40 p.m.


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Conservative

Pat Kelly Conservative Calgary Rocky Ridge, AB

Madam Speaker, there is no danger of Bill C-62's not passing this House. I think perhaps there has been some failure of the combined party leadership negotiations to come up with an arrangement that would have expedited this.

I am not concerned about the bill's not passing. The programming motion is there. I certainly never had any intention to deliberately delay the passage of this bill. That is not what any Conservative has attempted or is attempting to do.

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

February 13th, 2024 / 7:35 p.m.


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NDP

Alistair MacGregor NDP Cowichan—Malahat—Langford, BC

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

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

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

February 13th, 2024 / 7:25 p.m.


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Conservative

Pat Kelly Conservative Calgary Rocky Ridge, AB

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

February 13th, 2024 / 6:50 p.m.


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NDP

Alistair MacGregor NDP Cowichan—Malahat—Langford, BC

Madam Speaker, my hon. colleague is mixing up the timelines here. He keeps referring to eight years; in fact, the essence of the bill we are talking about happened three years ago.

Now, if the member wants to talk about someone suffering from stage 4 cancer and just taking some painkillers, I will let him defend himself. However, on what Bill C-62 is doing, we are dealing with a March 17 deadline. This morning, the Conservatives voted against time management of the bill. However, he must understand that we only have two sitting weeks to get the bill to the Governor General's desk.

Why did Conservatives vote against that when we are dealing with a hard deadline, understanding that the law will change if we do not get the bill passed?

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

February 13th, 2024 / 6:35 p.m.


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Winnipeg North Manitoba

Liberal

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

Mr. Speaker, I believe it was the member from the Green Party who was just finishing his comments. I appreciate the fact that he put a great deal of emphasis on priorities. He mentioned a few issues, and I want to be sensitive to those issues concerning mental health, and the housing-related issues and so forth.

The motion today on Bill C-62 is important for us to get to the next stage. Whatever one's position is on the issue, we need to recognize, whether it is the Supreme Court of Canada or the Quebec Appeal Court, the need to address the issue.

I wonder if the member could pick up where he left off, before the debate came to an end, and give his personal opinion on why it is important, when we are communicating with people outside of the Ottawa bubble, that we be as factual as possible on the legislation.

Alleged Inadmissibility of Amendment to Motion, Government Business No. 34—Speaker's RulingPoints of OrderPrivate Members' Business

February 13th, 2024 / 6:30 p.m.


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The Deputy Speaker Chris d'Entremont

I am now prepared to rule on the point of order raised earlier today by the House leader of the official opposition. It concerns the admissibility of an amendment made to Government Business No. 34, namely the inclusion of a substantive amendment to Bill C-62, an act to amend an act to amend the Criminal Code, medical assistance in dying, no. 2.

The member argued that the amendment was inadmissible insofar as it was attempting to introduce a new proposition to the motion. He stated that the motion deals with programming and timetabling of the House consideration of the bill, while the amendment to the motion seeks to amend the bill itself. He claimed that such a proposal should take the form of a separate motion, following the necessary notice requirement.

Normally the House leader would be correct. Substantive motions to amend a bill would be moved at specific steps in the legislative process. It would thereby be possible to move a distinct motion of instruction to the committee or propose specific amendments during the clause-by-clause study or at report stage. However, government Motion No. 34 deals with passage of the bill at several of the stages simultaneously, including committee stage and report stage.

The provisions of this motion, if adopted, would not offer members any other opportunity to amend the bill itself. The member for Montcalm, wanting to offer his amendment to the bill, proceeded in the only way available to him, which was by amending the text of the government motion to include the specific legislative text he wishes to include in the bill. Due to the constraining effects of the motion and not having any other option available to the member to amend the bill, the Chair allowed the proposal amending the motion on Government Business No. 34.

On the argument that the amendment was beyond the scope of the motion because it veered away from straightforward programming or timetabling of the House’s consideration of the bill and into substantive alterations to the bill itself, the Chair’s view is that the scope does not need to be cast so narrowly. In this instance, the scope of the motion can be ascertained as an effort to direct the proceedings on Bill C-62 in a particular fashion, including in relation to its consideration at committee and report stage, which may or may not include legislative changes.

If it is the will of the House to adopt an alternate but still compatible course of action, that is to instead refer the bill to committee with instructions and include specific provisions amending the text of Bill C-62, the Chair finds that it is within the scope of the motion.

To support this conclusion, I refer the House to a similar programming motion that was adopted following a recorded division on April 28, 2021. It is found on page 853 of the Journals. An amendment to that programming motion had been agreed to. It specifically proposed amendments to a bill. In my opinion, the amendment to Government Business No. 34 is not much different from the example I just gave.

For these reasons stated above, the Chair finds that the amendment to the motion on Government Business No. 34 is in order. I thank members for their attention on this matter.

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

February 13th, 2024 / 5:20 p.m.


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Green

Mike Morrice Green Kitchener Centre, ON

Mr. Speaker, tonight, I rise in strong support of Bill C-62, which would delay expanding medical assistance in dying for those in whom mental illness is the sole underlying condition by three years. My reasons for doing so are the same as they were in my speech to Bill C-39, one year ago to this day, at the time when the government was willing to delay by only one year: First of all, this delay aligns with what I have heard from so many folks in my community; second, we know that this is what experts have been calling for, for some time; and third, as Greens, we believe we should spend more time filling in our social safety net before we expand medical assistance in dying.

Today, Greens also believe that we should be rushing this legislation before the March 17 deadline to ensure that MAID is not expanded for mental illness as the sole underlying condition because this is the next best thing to what Bill C-314 would have done. Bill C-314, which was proposed by the member for Abbotsford, would have avoided this expansion for good.

Substantively, in the process we are in right now, this bill has been moving ahead quite quickly to this point. I expect that, as votes follow over the coming days, we will continue to move based on the motion that was approved earlier in the day. This shows that the House of Commons can move quickly when there is an urgent priority to be addressed, as is the case with the March 17 deadline in the existing legislation. Really, what this is about in terms of moving quickly is not that we do not have the legislative tools but that we need the political will to do it.

When I think about this legislation in front of us, outside what I have shared so far in terms of why I am supporting it, why I have historically and why Greens have historically as well, my question is this: Where is the rush to support legislation that would substantively improve the quality of life of Canadians? Other members have reflected on and shared feedback, which I hope they have heard directly from people with disabilities across the country. Where is the rush on ending legislated poverty for people with disabilities?

The fact is that, to this day, 40% of people living in poverty across the country are people with disabilities. While some will talk all about a piece of legislation that was passed in June of last year, the fact is that a person with a disability is no better off today than they were before that legislation was passed. The benefit is not yet funded, and we have not engaged in and figured out negotiations with provinces and territories. It is shameful. It is an embarrassment that, in a country as rich as ours, we are in a place where people with disabilities continue to live in legislated poverty. The House of Commons could choose to act as urgently to end legislated poverty for people with disabilities as it is moving right now to ensure that the March 17 deadline is met.

The House of Commons could also push to actually address one of the core underlying issues here, which is the lack of supports to address mental health. In fact, at the time of the last electoral campaign, the Liberal Party promised a Canada mental health benefit. It was meant to be called the “Canada mental health transfer”. It was a $4.5-billion commitment, and it was not one of several bullet points in a health accord, the way we have now. One of the challenges is that, while we all want our health care to be delivered in a wholesome way, it is more helpful to have funding agreements that are specific, so we can have accountability on them. However, that is not the case when it comes to mental health. Instead, mental health is one of four bullet points in these provincial and federal agreements. As a result, it is up to the provinces, and it is unclear whether there is any accountability whatsoever on how many of the dollars in those agreements will go directly to mental health.

In this year's budget, we could see the government step up, be more clear and say it is going to make sure it directly funds what was supposed to be the Canada mental health transfer. In so doing, it would substantively improve the quality of life of Canadians, of folks in my community who are waiting on unreasonable wait times and lists to get access to a mental health professional.

If we were really serious about moving quickly on another core crisis in this country, we would move far more quickly on addressing the housing crisis. Again, for me, the little bit of hope I have, seeing what is happening right now, is that we know there are parliamentary tools available to do exactly that. The fact is, in my community, we just had a report come out today that continues to make calls with respect to dealing with people living rough, in encampments. In my community, the number of people living unsheltered has tripled in just the last three years.

We should not be in a place where this is happening, but we know why it is the case. Right now, for every one new unit of affordable housing that gets built, we are losing 15 units to the financialization of housing. Housing has increasingly become a commodity for large institutional investors to trade, rather than a place for a person to live.

This means that we continue to see large institutional investors buying up existing affordable housing, renovicting folks and increasing their rents. We wonder why that crisis is also getting worse. I do not think we would be in the place where we are right now if this Parliament, and the government in particular, were to get more serious about addressing the housing crisis.

After 30 years of underinvestment, where are we now? The fact is that we are at the bottom of the G7 when it comes to the social housing stock in this country; 3.5% of our housing is social housing. This means that, even if we were to double social housing, we would only be around the middle of the pack in the G7.

It means something after 30 years of underinvestment in communities across the country. I am thinking about someone I spoke with this past weekend, a nurse, who told me she cannot afford to live in our community as a result of the reality of the cost of housing. It means that, whether someone is a teacher, a nurse or a tradesperson, this is a generation that is looking at housing fundamentally differently than any one before it has. Why is that? In my community, since 2005, the cost of housing has gone up 275%, but wages have only gone up 42%.

Once again, if we were to truly fill in the social safety net and move as quickly on doing that as the government has moved today on meeting this March 17 deadline, we could substantively ensure that we see the funding necessary to address the affordable housing crisis. We could also address financialization, which is the fact that institutional investors have swept in to make the biggest buck possible, as quickly as possible, on the backs of some of the lowest-income people in my community.

Yes, I will be supporting Bill C-62. I think this is a really important opportunity for us all to mark that this Parliament can move quickly when it needs to on real crises that it sees. We have crises of housing, of legislated poverty for people with disabilities and of mental health, which this Parliament and the government should move a whole lot faster on.

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

February 13th, 2024 / 5:15 p.m.


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NDP

Alistair MacGregor NDP Cowichan—Malahat—Langford, BC

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

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

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

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

February 13th, 2024 / 5:05 p.m.


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Liberal

Francesco Sorbara Liberal Vaughan—Woodbridge, ON

Mr. Speaker, it is always an honour and a privilege to rise in the House on behalf of the wonderful residents of my riding of Vaughan—Woodbridge and all of the residents in the city of Vaughan.

I will be sharing my time with my friend and colleague from the wonderful riding of Kitchener Centre.

Before I begin my formal remarks, this is a debate on Bill C-62, medical assistance in dying, which is obviously highly personal to all members in the House. Remarks are being delivered today with much passion, substance and thought. I will add a few words on that front. I have provided my personal beliefs on medical assistance in dying, which I am obviously in favour of. I know many individuals in many families who made tough decisions that were not with regard to mental illness. That gives me great consternation and much thought.

I am glad that a pause will be put in place because mental illness is a complex subject. I am not an expert and will not profess to be an expert, but we all know someone who has struggled with mental illness. We all know family members or friends for whom mental illness continues to be an issue. Unfortunately, many folks have taken their lives, and we need to make sure there is a system in place that is robust, where people can get the help and assistance they need to live their full lives, which God has blessed them with.

I am convinced that our current MAID system is working well. I would like to take the next ten minutes to explain why Canadians should have confidence in our MAID legislation and its application over the past seven years. I also want to describe some of the activities that will help sustain that confidence when eligibility is expanded in March 2027, as proposed in Bill C-62.

When the law authorizing medical assistance in dying was originally passed in 2016, it included a number of mandatory eligibility criteria for anyone requesting MAID. The person must be an adult of at least 18 years of age and capable of making health-related decisions. The request must be voluntary. Their request must be fully informed, and the person must have knowledge of the options available to relieve their suffering. They must have a grievous and irremediable health condition, meaning it cannot be cured, which is defined as follows: They have “a serious and incurable illness, disease or disability; they are in an advanced state of irreversible decline in capability”, and they are experiencing “enduring physical or psychological suffering” that cannot be relieved under conditions that they consider acceptable.

In 2016, the law also required that the person's natural death be reasonably foreseeable. In 2019, the Quebec Superior Court ruled that this criterion violated the Charter of Rights and Freedoms. In March 2021, a revised version of the federal law was passed, extending eligibility for MAID to people whose natural death was not reasonably foreseeable as long as they met other eligibility criteria.

In addition to these eligibility criteria, the law also sets out many procedural safeguards that a clinician must meet before administering medical assistance in dying. Here are a few of them: Two independent practitioners must provide a written confirmation of the person's eligibility. The person who is requesting medical assistance in dying must be informed that they can change their mind at any time and in any way and that their wishes must be respected. Also, the person must reconfirm their desire to receive medical assistance in dying immediately before receiving it.

When a person's natural death is not reasonably foreseeable, a series of enhanced safeguards must be respected. I will talk about some of those critical safeguards.

First, at least one of the two MAID assessors must have expertise in the person's medical condition. If they do not have that expertise, they must consult another practitioner who does. Second, the person must be informed of the means available to alleviate their suffering and be offered meaningful consultations. Third, these means must have been discussed, and both MAID assessors must agree that the person has seriously considered these means. Fourth, at least 90 days must pass between the beginning of the eligibility assessment and the day on which MAID is administered. These are legislated safeguards that all practitioners must abide by.

We know that MAID practitioners across the country exercise considerable professional judgment in providing this service by keeping patients' interests and wishes at the forefront.

Practitioners work hard to ensure that MAID is a last resort. They compile essential information about the person's medical condition, their treatment history and their use of support services. They have the necessary conversations to ensure that their patients are aware of the services available to them that might alleviate their suffering. It is about exploring treatment options, facilitating referrals and following up on the results.

If the person who wants to receive MAID consents to involving family members and loved ones, the practitioners will encourage their involvement and include them in the discussions that are part of the overall assessment process.

Practitioners are also aware that they do not always have the necessary expertise in the patient's condition to conduct a full assessment. In these situations, they have to consult the relevant experts and other health professionals who have the necessary expertise to make an informed decision. Some provinces or regional health care authorities have put in place MAID care coordination services or case consultation mechanisms that rely on a team or network of doctors, nurses and other professionals, such as social workers and spiritual leaders, to support the assessment process.

What does that mean for the future, once we begin allowing MAID requests based on enduring and intolerable suffering resulting solely from mental illness? Are our existing legislative safeguards sufficient? How can we be sure that the same level of care, diligence and consistency in the provision of MAID will be the norm?

In 2021, as mandated by the former Bill C-7, an expert panel reviewed the issue and concluded that the existing legal framework for eligibility criteria and safeguards is sufficient, provided MAID assessors apply the existing framework appropriately, with guidance from MAID standards of practice that have been developed as well as specialized training.

In the time I have left, I would just like to say that we all rise in this most honoured House on many topics. One of these topics, probably one of the most personal ones that we have risen on in the number of years I have been here, is medical assistance in dying. I look forward to questions from the hon. members in the House, who have been sent here by their constituents. This is an important debate for us to have, and it is an important topic to discuss.

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

February 13th, 2024 / 4:45 p.m.


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Bloc

Andréanne Larouche Bloc Shefford, QC

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

February 13th, 2024 / 4:25 p.m.


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NDP

Alistair MacGregor NDP Cowichan—Malahat—Langford, BC

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

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

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

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

February 13th, 2024 / 4:15 p.m.


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Liberal

Majid Jowhari Liberal Richmond Hill, ON

Mr. Speaker, it is with a sense of profound responsibility and pride that I address the House today regarding the government's proposed bill, Bill C-62, aimed at extending the temporary suspension of eligibility for medical assistance in dying, MAID, for individuals suffering exclusively from mental illness, for an additional three years. This discussion is not just about policy but about the very essence of compassion, dignity and the complexity of human suffering.

The concept of MAID resonates deeply within the Canadian societal fabric, touching upon the core values of autonomy and the right to end intolerable suffering. In Richmond Hill, as in communities across our nation, I have engaged with constituents, health care professionals and advocacy groups. These conversations have revealed a spectrum of beliefs and underscored the critical importance of adopting this issue with sensitivity, respect and an unwavering commitment to the well-being of all Canadians.

Since MAID was introduced, our office organized three community council meetings to deeply engage on this topic. We also partnered with the Canadian Mental Health Association, among many other professional associations, to enhance the dialogue with our constituents. Following the special joint committee's report, we convened our latest community council to gather our constituents' views and insights. Their response was clear and united in support of the delay. This active involvement with our community underlines the importance of careful reflection and thorough examination in addressing this issue.

The proposed extension under Bill C-62 is not merely a procedural delay. It is a crucial break that would let us look more closely into how mental illnesses and the final choice to end a life interact with each other. Mental health issues are complex and different for everyone, making it hard to fit them into our usual ideas about illness that leads to death. We need to look at each situation individually, taking the person's pain seriously while making sure there are strong protections in place to prevent hasty choices.

Our government acknowledges the importance of the data and reporting in relation to MAID, so much so that the original 2016 legislation obligated the Minister of Health to collect and report annually on MAID assessment and delivery. The formal monitoring system is important to inform our understanding of who applies for MAID in Canada, the medical conditions prompting requests, and trends in MAID activity since the 2016 legislation. As such, we have been working in collaboration with the provinces and territories and with health care professionals to establish a robust monitoring system. It is important to emphasize that this is a significant collaborative commitment.

As members know, on March 17, 2021, revised federal legislation was passed, expanding MAID eligibility to persons whose natural death is not reasonably foreseeable, providing they meet the remaining eligibility criteria.

Since the passing of the new legislation, the vast majority of MAID deaths, that is 96.5%, involved individuals whose death was reasonably foreseeable. Of course, two-thirds had a cancer diagnosis. In 2022, just 3.5% of total MAID deaths, which is 463 deaths, were attributed to individuals whose death was not reasonably foreseeable, representing less than 0.2% of all deaths in Canada. Of those 463 deaths, nearly 50% reported that the main underlying medical condition was neurological, such as ALS or Parkinson’s disease, while the remaining cases involved a variety of other complex conditions, including multiple comorbidities, cardiovascular disease, organ failure and respiratory illnesses.

Although the current sample is small, 2022 data also shows that where death was not reasonably foreseeable, 64% of individuals were approved for MAID, compared to 83% of individuals in cases where death was foreseeable. Each MAID request where the person’s natural death is not reasonably foreseeable is complex and unique, and early indications show that approvals for MAID in this stream are much lower than when the person’s death is reasonably foreseeable.

The decision-making process for MAID, especially in the context of mental illness, is fraught with complexity. It necessitates a meticulous evaluation of the individual's condition, an exploration of all viable treatment options and a profound understanding of the person's lived experience. This process is not undertaken lightly. It is grounded in empathy, clinical expertise and a rigorous adherence to ethical standards.

I also previously engaged in discussions on this matter in 2016 and again in February 2023. Today marks my third address to the House on this subject, which holds personal significance for me and, undoubtedly, affects numerous households in Richmond Hill and beyond.

I wish to highlight the government's consistent commitment to thorough and collaborative investigation, in concert with provincial, territorial and societal stakeholders, to ensure that MAID is administered with rigorous safeguards to protect the vulnerable while respecting the rights and dignities of applicants.

In pursuit of these objectives, the government enacted Bill C-39 last year, extending the moratorium on MAID for those with mental disorders as their sole medical condition until March of this year. This extension was pivotal in facilitating the safe provision of MAID, allowing for the broader dissemination and adoption of essential resources among medical and nursing professionals and ensuring the readiness of our health care infrastructure.

Moreover, this period provided the government with a crucial window to review the conclusive report by the Special Joint Committee on Medical Assistance in Dying. The one-year extension has proven invaluable, enabling the special joint committee to conduct a review in October 2023 concerning Canada's preparedness to accommodate MAID requests for mental disorders.

On January 29, 2024, the committee tabled its third report, which outlined recommendations regarding Canada's readiness for the safe execution of MAID under these circumstances. Following the committee's recommendations, the government, via Bill C-62, seeks to extend the pause on MAID for those with only a mental disorder until March 17, 2027. This aims to give our health care system enough time to prepare for MAID under these conditions.

We have held detailed talks with health care experts and the public, which showed a clear need for more time to maintain the integrity of this process. This time would also help in creating and sharing specialized training for health care workers, developing detailed policies and encouraging discussions on this important matter. The goal is to create a system that acknowledges mental illness complexities, protects those at risk, respects individual rights and dignity, as well as the Constitution, and ensures the proper safeguards.

In conclusion, we know that the MAID regime has provided relief from suffering for thousands of Canadians so far, the vast majority of whom are already at the end of life, and that individuals living with intolerable suffering will continue to explore MAID as an option in the future.

We have made a commitment to transparency and accountability across all levels of government to support public confidence in the MAID regime. I am also confident that we are honouring that commitment by providing Canadians with accurate and reliable information on MAID as it continues to evolve in this country.

As I stand before you, Mr. Speaker, acknowledging the profound impact of this issue on myself, the constituents of Richmond Hill and countless other Canadians, I am confident that this bill would facilitate the careful and considered approach required to address this sensitive matter appropriately.

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

February 13th, 2024 / 4:15 p.m.


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Liberal

Yasir Naqvi Liberal Ottawa Centre, ON

Mr. Speaker, I thank my colleague for his question.

Partnership with provinces, including Quebec, is extremely important in order for the legislation around MAID to be applied properly. As we know, delivery of health care is a provincial responsibility. It is really important that our provinces have all the tools and the time necessary to administer MAID in an appropriate manner.

That is why the work that is happening around setting of curriculum, training and the tools that regulatory bodies need to ensure that the training and curriculum is being met, as well as that the safeguards are being complied with, is important. This is also why the three-year extension under Bill C-62 is absolutely necessary.

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

February 13th, 2024 / 4 p.m.


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Ottawa Centre Ontario

Liberal

Yasir Naqvi LiberalParliamentary Secretary to the Minister of Health

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

February 13th, 2024 / 3:25 p.m.


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NDP

Alistair MacGregor NDP Cowichan—Malahat—Langford, BC

Mr. Speaker, following up on the question from the member for Fredericton, I was a member of that special joint committee, and I agree with her that its work was quite important. I think that every member, both from the House and the Senate, approached the subject matter with the responsibility and gravitas it demanded. However, I will put an asterisk beside that because the committee, in its last iteration, was afforded only three meetings of three hours each with witnesses. Unfortunately, there were a lot of witnesses we could have heard from. We did not even have time to go over the briefs that were submitted because there were so many of them and there simply was not time to translate them into both official languages.

This is mainly a comment for the parliamentary secretary to respond to: I am glad to see that we actually have a legislative requirement built into Bill C-62 that the special joint committee would be reconvened. I hope it would be done with plenty of runway to give this particular subject the time it deserves, which I frankly would say most Canadians expect.

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

February 13th, 2024 / 3:25 p.m.


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Winnipeg North Manitoba

Liberal

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

Mr. Speaker, I appreciate the fact that the member emphasized how this is a deeply personal issue, to use her words. That is why, at the beginning of my comments earlier today before question period, I tried to amplify why it is so important that the House reflect on what brought us here today.

I reflect on the debates that took place in early 2016, which were conducted in more of a non-partisan approach where members of all political parties talked about what is a very important issue. Nothing has changed in the sense of the importance of the issue. We are talking about an issue of death, and we see that Conservatives are putting a twist on it in an attempt to politicize the issue to the degree that there is some silliness as to what is being implied.

I like to think that anyone who is even entertaining the idea of accessing MAID takes it very seriously. That is the reason why, in good part, I believe that every member of the House, party politics aside, should be looking at what the Supreme Court of Canada right back to 2015, and the Charter of Rights, said our responsibility is as legislators: to come forward with good, sound public policy. I believe that over the years, including today with Bill C-62, we have been addressing a very important issue and that the three-year extension is needed because of the response we are getting from stakeholders, in particular our provinces.

Alleged Inadmissibility of Amendment to Motion, Government Business No. 34Points of OrderGovernment Orders

February 13th, 2024 / 3:20 p.m.


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Conservative

Andrew Scheer Conservative Regina—Qu'Appelle, SK

Mr. Speaker, I appreciate your accommodating the timing of this. I apologize to the members who are involved in debate, but because the matter is currently under consideration by the House, I think giving the Speaker as much time as possible to consider it would be appropriate.

I am rising to ask that you rule the amendment made to the motion, Government Business No. 34, out of order, since according to Bosc and Gagnon, at page 541, it introduces a new proposition which should properly be the subject of a separate substantive motion.

The main motion proposes two things in relation to Bill C-62. Part (a) would establish committee meetings on the subject matter of Bill C-62. It proposes one hour to hear from a minister and two hours to hear from other witnesses.

Part (b) deals specifically with the time and management for each stage of the bill. Part (b)(i) would order the consideration by the House of a second reading stage and provides for the number of the speakers, length of speeches, length of debate and deferral of the vote at second reading. It would also restrict the moving of dilatory motions to that of a minister of the Crown. Part b(ii) would deem that Bill C-62 be referred to a committee of the whole and be deemed reported back without amendments, and it would order the consideration of third reading on Thursday, February 15, 2024.

Nowhere does the motion deal with the substance or the text of Bill C-62; it is a programming motion dealing with process, not substance. While this can and has been done by unanimous consent, it cannot be done by way of an amendment. The consequence of an amendment to allow for the expansion of the scope of Bill C-62 and, at the same time, proposing to amend the text of Bill C-62, is that it would, if accepted, expand the scope of the motion.

The process to expand the scope of the bill outside of unanimous consent is to adopt a stand-alone motion after the proper notice and procedures were followed. Page 756 of Bosc and Gagnon describes that procedure as follows:

Once a bill has been referred to a committee, the House may instruct the committee by way of a motion authorizing what would otherwise be beyond its powers, such as...expanding or narrowing the scope or application of a bill. A committee that so wishes may also seek an instruction from the House.

Alternatively, a separate, stand-alone bill would suffice to introduce the concept of the subject material that is under the amendment for MAID. It is not in order to accomplish this by way of a simple amendment to a programming motion dealing with the management of House time on a government bill.

If you were to review the types of amendments to programming motions, and I am not talking about unanimous consent motions, they all deal with the management of House and committee time, altering the numbers of days, hours of meetings, witnesses, etc. As recently as December 4, 2023, the House disposed of an amendment that dealt with the minister's appearing as a witness and the deletion of parts of the bill dealing with time allocation. This was also the case for the programming motions for Bill C-56, Bill C-31 and Bill C-12.

Unless the main motion strays from the management of time and routine procedural issues and touches on the actual text of the bill, an amendment that attempts to amend the bill is out of order. For example, on May 9, 2023, the House adopted a programming motion for Bill C-21, the firearms act. Part (a) of the main motion then stated that:

it be an instruction to the Standing Committee on Public Safety and National Security, that during its consideration of the bill, the committee be granted the power to expand its scope, including that it applies to all proceedings that have taken place prior to the adoption of this order...

The motion went on at some length, instructing the committee to consider a number of amendments to the act. This in turn allowed the Conservative Party to propose an amendment to the programming motion and offer its own amendments to the bill itself, which addressed illegal guns used by criminals and street gangs and brought in measures to crack down on border smuggling and to stop the flow of illegal guns to criminals and gangs in Canada, to name just a few.

The point is that if the main motion does not address the text of the bill, an amendment cannot introduce the new proposition of amending the text of the bill to the programming motion, which should properly be the subject of a separate substantive motion.

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

February 13th, 2024 / 1:40 p.m.


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Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Madam Speaker, members of the Conservative Party might not like what I have to say, but it is the truth, and sometimes the truth hurts. If we go back to the original debates in May, we will find a great deal more compassion being expressed on the floor of the House of Commons, on all sides. Whether they were Liberals, Conservatives, New Democrats or any others, members demonstrated very clearly the difficulty of what Parliament had to do in bringing in MAID to respect the Supreme Court of Canada decision. Today during the debate, we witnessed the leader of the Conservative Party standing on a point of order on something completely irrelevant to the debate, to attempt to table a document. Why did he? He just could not wait until question period, I guess, which begins after statements by members that start in about 15 or 20 minutes.

We should listen to what some of the Conservative speeches have been about. Some Conservatives, the last couple in particular, have stood in their places and given a false impression that the legislation would be like suicide on demand. The member for Battlefords—Lloydminster said that today someone feeling depressed due to mental health issues could go to a doctor and book an appointment to commit suicide, with the government's support, on Friday. Members of the Conservative Party are spreading misinformation on such a sensitive issue. These are very difficult things that Canadians have to deal with every day.

Yesterday the member for Cumberland—Colchester referred to 12,000 or 13,000 people being killed in a very ad lib fashion, implying that the legislation just allows people to be killed. From my perspective, the decision to access MAID is not easy; it is a very difficult one. Family members and individuals are experiencing some very difficult times in dealing with a real-life situation. Conservatives, yesterday and today, are virtually making a mockery of it and spreading misinformation on such an important issue. What happened to the compassion of 2015-16 and even 2017? At that time, there seemed to be a sense in the chamber that, yes, at times there are going to be disagreements if members feel very passionate about an issue, as they should, but there was also a much higher sense of co-operation as members shared the experiences they were being told about by their constituents.

The member for Portage—Lisgar said that people are going to food banks and are thinking of committing suicide because of the cost of living. There are a number of things that come to my mind that speak to the manner in which individuals across the way make those types of stupid statements. That is, quite frankly, what they are; they are not legitimate contributions, such as discussion about supports and services would be, to the debate on such an important issue that the House is having to address.

In the debates taking place in 2015-16, we heard a great deal about issues like hospice and palliative care. We wanted to ensure that MAID legislation would not in any way be utilized as a direct result of not having proper services and systems in place to provide assurances to those individuals who were feeling so compelled to actually access MAID. Those are the types of things that I think really contributed a great deal back then.

Today, in contrast, Conservatives will say, “What about the $4.5 billion that the Liberal Party made a commitment to?” Members are right in that there was a substantial commitment by the government to deal with the issue of mental health, and the commitment was significant: several billions of dollars over five years. It is one of the reasons that the health care agreements we have put into place, which were highlighted last year, of just under $200 billion over 10 years, are to support health care not only today but also in future generations that will benefit by that sort of investment. Furthermore, the Minister of Health is working with provinces, coming up with agreements that deal with things like mental health and services. We recognize how important it is to ensure that these services are being supported.

Unlike a number of members from the Conservative Party, and I do not want to label them all, at least not at this point, this is a government that has continued to work with, in particular, provincial jurisdictions and other stakeholders in different forums in order to provide assurances that the people who are accessing MAID are, in fact, being informed in a very tangible way of the types of services available. In no way whatsoever is it as simple as their just saying, “I want this and I will get it”, and then two days later receiving it. We can look at the amount of public attention and debate that has taken place on issues such as palliative and hospice care since the MAID introduction, which I believe have been greatly enhanced.

I would like to think that provinces, which are ultimately responsible for the public administration of health care services, have taken note and understand that they too have a responsibility because they are the ones delivering the services that Canadians expect. The federal government has recognized that by supporting things such as the encouragement of long-term care standards and by providing substantial finances to ensure that provinces are better able to meet the demands on health care services. With respect to what I said earlier in regard to mental health, there are serious commitments that we continue to live up to and work on with other jurisdictions.

I have confidence, as I indicated yesterday, in the health care professionals, the social workers and the other individuals who have the expertise and confidence in the individual who feels that MAID might be the avenue for them to pursue. There is a great deal of effort put into every situation, and I have confidence in the system.

Members can correct me if I am wrong, but I cannot recall one province or premier in Canada that has clearly said that MAID is not working. The provinces are asking for the three-year extension in one aspect of MAID: where mental health is the sole reason for the request. The issue of the sole underlying medical condition being a mental illness was added to the original MAID legislation, then brought in as a form of legislation and allowed a period for provinces and jurisdictions to have time to get what is necessary in place so Canadians could be served.

We then found that the provinces required more time. There were a number of provincial governments not saying to get rid of MAID, but rather saying that they needed more time for the implementation of that aspect of it. That is in essence why we have the legislation that we have before us today.

However, if we listen to members of the Conservative Party, we will find that they give no indication of supporting Bill C-62. It will be interesting to see how they actually vote. Logically, I would think they would vote in favour of the bill. If they do not vote in favour of Bill C-62, and, for whatever reasons, the legislation were not to pass, ultimately the criterion of sole underlying medical condition of mental illness would take effect on March 17 of this year. Therefore, it is important that members, no matter what side of the debate they happen to be on, would be in favour of the legislation because it is a direct response to what is being asked of the Government of Canada by our partners that are ultimately responsible for administering the legislation.

Members opposite will often try to say that it is up to the government. It is important to highlight what I mentioned at the very beginning: The reason we have MAID legislation today is that in 2015, the Carter decision by the Supreme Court in essence said we had to bring it in. There was no choice, if, of course, we respect the Charter of Rights and Freedoms. I will repeat what I said yesterday: There was a great deal of consultation, literally hundreds of hours of different types of meetings, including standing committees, chamber debate, outside meetings in ridings, canvassing and petitions. Even though there were all sorts of mechanisms to provide input, at the end of the day, I believe that the legislation met a threshold to, in good part, deal with the concerns of the Supreme Court of Canada and to respect the Charter of Rights.

That was followed by a decision in appeal court in Quebec giving us another obligation to improve the legislation and that is exactly what we did.

We continue today to look for ways to improve the legislation. I believe it is a reflection of the Canadian Charter of Rights and Freedoms. If members of the Conservative caucus are saying that they do not support the MAID legislation, then I would question whether they actually support the Canadian Charter of Rights and Freedoms.

I would further add that the leader of the Conservative Party's general attitude—

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

February 13th, 2024 / 1:35 p.m.


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Winnipeg North Manitoba

Liberal

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

Madam Speaker, I am not too sure if the member actually understood the question that was just posed to him. It points out a major issue within the Conservative Party. The Conservatives have said that they do not support it, yet they did not vote in favour of the motion that ultimately, by it passage, will guarantee that this motion is able to pass Bill C-62.

What is the essence of Bill C-62? It is to provide a three-year waiting period, so the concern that he has does not take effect come March 17 this year. If this legislation does not pass, what the Conservatives are complaining about will actually turn into a reality. One would think that they would understand that. I can appreciate that a majority, in listening to the discussion, is of the same opinion as the member across the way. If they support what they say, then they should support Bill C-62. If they do not vote for Bill C-62 and the bill does not pass, there will be no three-year extension.

I am very disappointed in the manner in which this issue is being debated. It is a very serious issue. I remind members that the reason we have the debate today is because of a Supreme Court of Canada decision back in 2015, which the then prime minister Stephen Harper did not act upon. That was back in early 2015.

After the 2015 general election, when we assumed office in November 2015, one of the first things we did was look at the legislative agenda. We did some positive things, but one of the things we had to deal with was the Supreme Court of Canada decision, which the Conservatives actually ignored. That meant we had to bring in MAID legislation. It was not an option.

Is there a member of the Conservative Party today who would stand up and say that there was an actual option, that we did not have to respect the Charter of Rights, the rights that are guaranteed to Canadians from coast to coast to coast?

If one reflects on the debates that took place back then, it is quite the opposite with respect to what we are witnessing today. Back then—

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

February 13th, 2024 / 1:05 p.m.


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Conservative

Rosemarie Falk Conservative Battlefords—Lloydminster, SK

Madam Speaker, the decisions made in this place have a direct impact on the lives of Canadians. That impact can be no greater than when it is a matter of life or death, and this is exactly the case with this piece of legislation. As members of Parliament, we have a duty to serve in the best interests of Canadians; this duty must extend to the protection of the most vulnerable in society.

I should note that I will be splitting my time with the member for Portage—Lisgar.

The expansion of medically assisted death to those suffering from mental illness is dangerous and, simply, reckless. It is inevitable that the expansion of MAID to those suffering solely from a mental illness would result in the deaths of Canadians who could have gotten better. This is not to say that those with mental illness should be left alone to suffer. Recovery is possible, and we cannot give up on these individuals and their loved ones. Canadians suffering from mental illness need and deserve support and treatment. They may feel that their situation is hopeless, but the antidote is hope, not death. They deserve government policy and a health care system that are compassionate and responsive to their needs. Where there are gaps or shortfalls in our care system, we should prioritize working alongside our provincial partners to address them. That, not expanding MAID, should be the priority.

The Special Joint Committee on Medical Assistance in Dying heard loud and clear from the mental health experts and advocates that the planned expansion of MAID was dangerous. The current Liberal government has already had to introduce eleventh-hour legislation to delay the expansion of MAID by one year from the date that it had arbitrarily set. We find ourselves, ironically, now in the same position as we were in last year. Bill C-62, once again, would only offer a temporary delay in the expansion of MAID to persons suffering from mental illness. The risks and dangers that exist today would continue to exist in three years. However, the Liberal government is intent on its expansion.

It is truly frightening to see that the Liberal government wants to continue to expand the access to MAID, despite clear concerns about safeguards of vulnerable people. The Liberals' careless approach was already evident when the Liberal government decided not to appeal the Truchon ruling and, instead, introduced legislation that went much further than the ruling had required.

What we have seen repeatedly from the current Liberal government is the willingness to offer MAID to more and more Canadians, without prioritizing supports or treatment. This continues to be the case with those in the end stages of life. Through pain management and psychological, emotional and practical supports, palliative and hospice care provides relief from pain, stress and symptoms of serious illness. Palliative care has proven to improve the quality of life not only for the patient but also for their family. However, access to this is not universal here in Canada.

The government's own report on the state of palliative care in Canada, released this past December, confirms that access to palliative care is indeed not universal. We do not have the necessary safeguards in place to protect vulnerable Canadians when access to MAID is more universal than access to palliative care is. When Canadians suffering from serious illness do not have access to appropriate care, they can be left feeling hopeless. Personal autonomy is not increased when a person feels as though they have no other choice.

When the current Liberal government removed the “reasonably foreseeable death” clause from the MAID framework, it opened up to persons with disabilities who are not close to death. Disability advocates raised alarm bells with this decision, and the news stories that have emerged in recent years have underscored the risks and the danger in that decision. Reports showing that poverty, not pain, is driving Canadians with disabilities to consider assisted death are truly heartbreaking.

For persons with disabilities, the pressures of the cost of living crisis are compounded. Their basic living costs are generally much more significant. As the prices go up on everything, their costs are even greater. It is unacceptable that there are persons with disabilities turning to MAID because of their cost of living situation.

This NDP-Liberal government's inflationary spending and taxes are fuelling the affordability crisis in this country, and what is even more shameful is that, despite the pain and suffering it is causing Canadians, there has been no course correction for this costly coalition. It has continued to mismanage tax dollars. It is intent on quadrupling the carbon tax, which is increasing the cost of just about everything.

Let us not forget that not a single disability payment has gone out to those who want it and have been asking for it. Bill C-22 was sped through the parliamentary process, but those who are desperate for financial assistance are still waiting.

The affordability crisis is continuing to surge across the country, and it is further putting persons with disabilities in a vulnerable position. Medically assisted death should not be more readily available to persons with disabilities than the supports and accommodations they need to live a full, healthy and dignified life.

Repeated reports that Canadians are being offered medically assisted death without first requesting it is also very alarming. It suggests that safeguards have not been put in place to ensure that vulnerable people are not being pressured or coerced into seeking medically assisted death. No person should feel that the health care system, the infrastructure that is meant to provide care and support, sees no value in their lives.

There are serious concerns with the existing MAID framework and the framework's ability to protect the most vulnerable in our communities. These are concerns that are not being addressed by the Liberal government and that ultimately should be the priority of the government on an issue such as medically assisted death. When the risks and concerns that exist with the current framework are already proven to be warranted, we should certainly heed the clear warnings against its expansion.

Experts have said that it is impossible to predict in any legitimate way that mental illness is irremediable. This means that individuals suffering solely from mental illness can recover and can improve. Their mental health state is not destitute nor without hope. If medical assistance in dying is offered to persons suffering solely from mental illness, it is inevitable that vulnerable Canadians will die who could have gotten better.

Experts have also made it clear that it is difficult for clinicians to distinguish between a rational MAID request and one motivated by suicidal thoughts. Persons with mental illness are already disproportionately affected by suicide and suicidal ideation. To extend access to medically assisted death to this group of individuals contradicts and undermines suicide prevention efforts. Every single person's life has value and purpose. It is not acceptable to have government policies in place that devalue the life of a person, and the Liberal government's intention to expand access to MAID fails individuals suffering from mental illness in this country.

Whether it happens in March of this year or in three years, the expansion of MAID will still be dangerous and reckless. The delayed expansion of MAID will ultimately still fail vulnerable Canadians. Bill C-62 does not go far enough to protect those suffering with mental illness. The Prime Minister must immediately and permanently halt the expansion of medical assistance in dying to persons with mental illness. We cannot give up on an individual who is suffering. They deserve support and treatment, not death.

Common-sense Conservatives know that recovery is possible for persons suffering from mental illness. We do not support policies that abandon people when they are in their most vulnerable state. Death is not a treatment for suffering. We will stand with them and their loved ones. Above all else, when we consider medically assisted death, we must be gripped by a resolve to protect the most vulnerable because, in matters of life and death, there is simply no room for error.

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

February 13th, 2024 / 12:45 p.m.


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Bloc

Luc Thériault Bloc Montcalm, QC

Madam Speaker, that is a rather accurate summary of what happened in committee. The government decided to include in legislation the committee's main recommendation on mental disorders. My colleague sat on the committee that produced the report tabled in February 2023, which recommended allowing advance requests.

Why has his government not introduced a section on advance requests after a year of waiting? I think that would have been good for people who are currently suffering and who cannot make an advance request. Why is this not included in Bill C‑62?

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

February 13th, 2024 / 12:35 p.m.


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Etobicoke—Lakeshore Ontario

Liberal

James Maloney LiberalParliamentary Secretary to the Minister of Justice and Attorney General of Canada

Madam Speaker, I will be sharing my time with the member for Saanich—Gulf Islands.

It is a pleasure to speak today to Bill C-62. The bill proposes to extend the temporary mental illness exclusion, so that the provision of medical assistance in dying, or MAID—

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

February 13th, 2024 / 11:40 a.m.


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Bloc

Luc Thériault Bloc Montcalm, QC

Mr. Speaker, I would like to know whether my colleague thinks that, one day, it will be possible to alleviate the suffering of people struggling with an irremediable mental disorder.

I would also like to know whether he agrees that it would have been wiser for the government to implement the joint committee's leading recommendation regarding advance requests and to take advantage of the introduction of Bill C-62 to add that component.

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

February 13th, 2024 / 11:25 a.m.


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NDP

Gord Johns NDP Courtenay—Alberni, BC

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Motion That Debate Be Not Further AdjournedGovernment Business No. 34—Proceedings on Bill C-62Government Orders

February 13th, 2024 / 10:35 a.m.


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Bloc

Luc Thériault Bloc Montcalm, QC

Mr. Speaker, the minister did not answer one aspect of my question.

Why the double standard?

The minister had a full year to implement the recommendation of the Special Joint Committee on Medical Assistance in Dying concerning advance requests. An Ipsos poll of 3,500 people showed 85% support across Canada. If the minister does not know that, he is not staying on top of his file.

As far as postponement is concerned, the minister has implemented the recommendation to the letter. Three years is too long. He knows that. However, he could have added another dimension to Bill C‑62. He had a year to do it. Will he introduce legislation on advance requests, yes or no?

Bill C‑14 is bad legislation.

The minister says that he worked carefully. People have been forced to go on hunger strikes to meet the reasonably foreseeable natural death criterion. Is that what he means by protecting vulnerable people?

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

February 12th, 2024 / 1:55 p.m.


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NDP

Alistair MacGregor NDP Cowichan—Malahat—Langford, BC

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

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

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

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

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

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

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

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

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

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

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

February 12th, 2024 / 1:20 p.m.


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Bloc

Luc Thériault Bloc Montcalm, QC

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I therefore move the following amendment:

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

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

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

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

New section 241.21

Medical assistance in dying eligibility criteria for advance requests

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

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

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

February 12th, 2024 / 12:40 p.m.


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NDP

Alistair MacGregor NDP Cowichan—Malahat—Langford, BC

Madam Speaker, this is obviously a week when the House of Commons as a whole has to step up to the plate because we really only have two sitting weeks left on the parliamentary schedule until the March 17 deadline.

That being said, I think it is worth it for us to remember why we are here. We have to go back to Bill C-7 and the Liberal government's 11th hour, inexplicable decision to accept a very consequential Senate amendment to it, which got us into this mess in the first place. The Senate changed the law without having done the proper research and consultations. Ever since, it feels like we have been playing a game of catch-up. That is why Bill C-39 was necessary last year, and why we have found ourselves in the same situation with Bill C-62.

Is the parliamentary secretary prepared to accept some responsibility on behalf of his government and issue an apology for setting that arbitrary deadline and getting us into the mess we now find ourselves in?

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

February 12th, 2024 / 12:35 p.m.


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Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

It is unbelievable.

Madam Speaker, at the end of the day, these are not easy decisions, and the member opposite feels these 13,000 were just killed.

The government puts in a great deal of effort to get things in a state of readiness, so that we are able to provide the types of services Canadians want and need.

I make reference to the 988 suicide crisis line. Some might try to give the impression that because this is just a three-digit number, all we have to do now is say that we are going to have it and click our heels, and then it appears. The idea came up a number of years ago from, I believe, a member of the Conservative Party, who was being very genuine. That does not take away from the fact that other members, associations and stakeholders were also talking about it. As a government, the minister responsible ultimately did the sharing and the networking that were necessary in order to be able to present to the House of Commons a program that ultimately received the funding that was necessary, and worked with the different provinces, territories and stakeholders to turn it into a reality.

Today, the 988 number is live. People having suicidal thoughts can feel comfortable knowing there will be someone at the other end of the line when they call 988 who can help them in different languages and understand and appreciate different cultures. I would suggest this is an example of how things come to the government, actions are ultimately taken and then something is put in place.

The same principles have applied here. The Supreme Court makes a decision based on the Charter of Rights; the government brings in legislation, which is thoroughly debated and on which amazing consultation and input take place, with hundreds of hours of dialogue; and the legislation is passed by a majority. It is passed by members of all political parties and then ultimately put into place.

It is a policy that is then administered and, as I pointed out earlier, there is at times the need for changes. We saw that need. One of them was amplified through the Quebec court. We make the change. We listen to what the Senate said. The issue of mental health is something that was brought to our attention. This legislation, Bill C-62, like the previous one that delayed the implementation, is going to continue that delay. To that end, I believe we will in fact have sound, solid legislation, and hopefully it will not have to be revisited. Time will tell us on that.

With those few words, I hope members can appreciate why the need for the programming of the legislation is being put into place and why the legislation is so critically important. Indeed, I would suggest that delaying it for three years is a reflection of what a vast majority of Canadians want and what the different stakeholders are requesting.

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

February 12th, 2024 / noon


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Winnipeg North Manitoba

Liberal

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

Mr. Speaker, it is a pleasure to rise to speak to a very important issue. This is a deeply personal and complex issue, one that has had a great deal of debate in the House for number of years now.

We are not directly speaking to that. Rather, we are speaking to the motion that would enable the government to get the MAID issue resolved for the next few years. The motion would ensure that the legislation actually passes. I will give a little background on that.

There is a time limit for us to ultimately get Bill C-62 passed in order to fulfill our commitment to the court. Obviously, we want to keep the law validated, appropriately. The motion we have brought forward today would allow for the House, while providing some time for the Senate, to pass and give royal assent to the bill before the House breaks in March for a couple of weeks. In essence, it allows for a little more debate this week, when it will ultimately pass.

It would then afford the Senate, in the week following the break, the ability to deal with the legislation and hopefully pass it without amendment. This is very important, as that would then enable the legislation to receive royal assent before the deadline.

I know some members may be a little uncomfortable with respect to this programming motion before us today, the limitations that it puts on members and the importance of the subject matter itself. As some members may recall, last week I stood in my place and asked for unanimous consent to sit late in the evening. That way, members would have had more opportunity to have debate on this issue. Unfortunately, we did not get unanimous consent. As a direct result, we have to work within the time frame of when the House allows us to sit. As a result, in order to meet the deadline, we have brought in a programming motion.

I made reference to the very beginning, about when we started to talk about the issue of medical assistance in dying. It came up in 2015. A Supreme Court of Canada decision, Carter v. Canada, made it very clear that we, as a government, and Canadians, through the Charter of Rights, needed MAID legislation. That was decided midway through 2015, but no action was taken, knowing full well that we had to bring in a law to address what the Supreme Court had put in place.

We all know that an election took place. Shortly after that election, it was made very clear that as a government we needed to bring in the legislation. An approach was made to the Supreme Court to take into consideration what had taken place over the last number of months following its decision, including an election.

The Supreme Court ultimately provided grace to the House of Commons so that we could, in fact, get the necessary legislation brought forward to the chamber and ultimately passed. We did have to ask for yet another extension back then. I do not think that surprised anyone.

From the day we can recall, in 2015, there was a great deal of discussion that had taken place. In fact, I suspect, if one were to take a look at the different pieces of legislation, today, we call it Bill C-62, and the original legislation was Bill C-14. We have had legislation in between those bills, which the government had to bring into the House.

On occasion, when the government brings in legislation for debate, there is fairly extensive debate not only in the chamber but also in committees. I can remember, quite vividly, a lot of the debate, the issue for which the special committee was put together to deal with the issue and to provide some thoughts, recommendations and ideas to the chamber and the members who were directly involved.

There is no lack of interest or input from the many different stakeholders, of all different natures, in every region of the country. Everyone had an opinion on the issue. In the end, the amount of dialogue that went into the legislation and the creation of MAID, was probably greater than 90% of all other forms of legislation that come to the House.

We saw that in the passion of the debates presented at the time by members of Parliament on all sides of the House. It was not just Liberals, New Democrats, Conservatives or the Bloc, or even the leader of the Green Party at the time, where one could see the emotional toll of the debate. That is why I talk about it being of a very deep, personal nature. There are complex choices and decisions that have to be made on this.

When I reflect on that debate, there were tears inside the chamber. There were all sorts of emotions as members tried, in the best way they could, to explain why they were taking their positions on it. Different members voted for different reasons and so forth.

In the end, Bill C-14 ultimately passed, after many hours of debate inside and outside. When I say outside, I go even further than outside of standing committees. There were emails, correspondence and discussions that I had on this issue, and it was fairly intense. People wanted to know how I felt about it. I am sure all members of Parliament were questioned about what they had to say on the legislation.

I do have differing opinions from members across the way and maybe even, quite possibly, within my own caucus. I genuinely believe that the need for MAID is there. There is no question about that.

However, where I fall on the side that it seems to be acceptable, at least for a good percentage of people I represent, is to have trust and confidence in our system of health care professionals, social workers and support people whom family members go to when the time comes to make difficult decisions, such as another family member, a local pastor or anyone else. Having that confidence has allowed me to feel comfortable as we have gone through this legislation, virtually from day one.

There was a need for changes. To bring in substantive legislation for the first time that so profoundly impacts the lives of Canadians and to expect that the legislation would be perfect and would not require change is somewhat naive. That is in fact what took place. There was a need to make some changes to the legislation. That is why, ultimately, we had the second go-round of the legislation.

There was a fairly wide discussion on that second attempt and, through amendments, something that is now very challenging was brought in, which deals with mental health as a sole condition for MAID. I know that has stirred the emotions of a lot of members and, ultimately, when the legislation passed to allow it, there was a lot more resistance to it than there was to Bill C-14. It did not surprise me, because of the delicacy of the issue.

Again, I fell back to what I believe a vast majority of my constituents are comfortable with, which are the health care professionals and others, because I am not a medical doctor. I do not understand the issue to the same depth as do the different professionals. As a direct result, I feel more comfortable taking the same position as the government took on the issue.

However, we also need to recognize the reality that other jurisdictions are very concerned about the implementation and about the degree to which we are ready to implement the legislation that was passed. That is really the crux of it. Therefore, we have Bill C-62 today, which would allow for that ongoing exemption to continue. That would enable the system, which is large and complex, to ensure that everything is ready. Then, if the legislation takes effect, people would not be let down, and we would still be able to meet the constitutional requirements. Let us remember that the amendment to the original legislation, in part, came from an appeal court in the province of Quebec, which obligated members of the House to bring forward other legislation.

I know my friend opposite, from the Conservative Party, says that we had a choice and that we could have appealed that decision to the Supreme Court of Canada. As a number of them said, we could have attempted to kick the can down the road. Ultimately, it was a decision made and supported by a majority of members of Parliament in the House. Even though the Liberal government had a majority, when it came to Bill C-14, members know full well there were members from all sides who supported it.

Today we have a minority situation, and the only way we can pass legislation through to have the support of other political entities inside the chamber. I would like to think that what we learned through this process has enabled us to look at other things we have been able to do directly.

During many hours of the debates, people talked about palliative care, hospice care and about the lack of that type of care being provided to the people of Canada. It has been a genuine concern for many years, probably a good 20-plus years, where we needed to see more invested in hospice and in palliative care.

Far too often we see individuals who are panelled in our hospitals because there is no place for them to go outside of the hospital. If we look at what took place during the pandemic, we saw that care facilities had to close the doors to people from outside to protect those on the inside. Those on the inside were often dying prematurely, and we know that as fact. Organizations like the Canadian Forces or the Red Cross were involved.

If we take a look at the bigger holistic picture, are we collectively, and contrary to what some might say, it is not just Ottawa, doing enough to be able to deal with these social issues that Canadians have a high standard for? They want politicians of all political stripes and of all levels of government to invest more resources. I am talking about not only money, but also time and debate.

There are probably better ways in which we could spend some of the money that is spent in areas such as health care, social services and so forth. One could take a look at the process for someone who might, first, end up in a hospital situation, and while in the hospital, they find out that things are not good and that their life is going to come to an end in a relatively short time.

One of the things that happen is that hospitals can provide only so much in terms of treatment. There is no consistency within a province, let alone the nation, as to which individuals are being kept in the hospital. Because there are not enough supports in a home atmosphere and there is no other place for an individual to go, far too often they become panelled in a hospital facility in one form or another. I believe the debates we have seen on MAID amplify that.

These are the types of discussions and debates that we should be having, not only here in Ottawa but also in our communities and at the different legislatures. Quite frankly, there are some fairly significant stakeholders out there who also have to play a role, like non-profit organizations. That is what I recall about some of the discussions we have been having over the years in regard to MAID legislation. Unfortunately, as I pointed out, the original thoughts in regard to MAID and the need for us to bring in legislation and the types of debates that we saw then are in contrast to today, as it is becoming more of a politicized issue. Politics seems to be more important than the issue itself in some ways.

That is why at the very beginning I referred to the fact that it is not a good thing that we had to bring in a programming motion, but it is important that we do it today, because we were not successful at getting the consensus required to be able to sit longer to allow for a consensus to emerge as to how the legislation could pass through the system. However, we still have an opportunity. The motion talks about going to the Standing Committee on Health as the subject matter.

When this motion passes, it will enable the Standing Committee on Health, as its first priority in terms of the resources of the House, to meet. A minister will in fact be there for a good hour. There will be an opportunity to have a few other witnesses. It will ultimately have to go through the committee. If we can get this motion passed, after this legislation goes through committee it will come back here to the House of Commons for third reading later this week, before being dealt with in the Senate in the last week of February to March 1. That time frame will enable it to ultimately get the necessary royal assent in order for it to be enacted into law.

Based on what the legislation would actually do, I would think that the Conservatives, in particular, would support it. The essence of the legislation is to put in a three-year extension. It provides for particular provinces and jurisdictions to be able to get things in a better state of readiness, so that, at the end of that period of time, we are able to provide the types of services that are necessary. This means, in good part, that there will be ample time for us to continue to have that dialogue and debate, and if there is a need to do and bring forward other things, whether it is through private members' business or government business, that there are opportunities. However, I suspect, by passing Bill C-62, that a sound majority of the House will be content with the modernization, if I can put it that way, of the legislation.

In one part, it reminds me of the issue of the suicide crisis helpline, and I say that for two reasons.

One reason is that some members often will make reference to how the legislation as a whole is enabling individuals to virtually have suicide upon request, which is just not the case. We know that is not the case, and the members who say it know that is not the case but unfortunately we still see some members give that false impression. I find that to be somewhat unfortunate, because it is definitely misleading and does a disservice in terms of the legislation and the thorough process that we have gone through. I cannot imagine the number of hours, and we are talking three digits and more of hours of different types of discussions in many different forums. To try to simplify it by calling it “suicide on demand” does a great disservice to the legislation and to the law that we currently have in place.

The reason I bring up the suicide helpline is that someone indicated to me that there are people who, at times in their lives, give it thought. When they heard about the MAID legislation, they made inquiries, and because of those inquiries they were able to get the type of assistance that made things better for them. In other words, MAID legislation, on occasion, I would ultimately argue, has actually even saved lives.

Business of the HouseOral Questions

February 8th, 2024 / 3:10 p.m.


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Gatineau Québec

Liberal

Steven MacKinnon LiberalLeader of the Government in the House of Commons

I would first like to thank my hon. colleague and his colleagues in the official opposition for finally letting Bill C-57, the Canada-Ukraine free trade agreement, come to a final vote. That is good news for Canada and our Ukrainian friends, with whom we stand in solidarity.

As for the business of the House, we will continue to have ongoing discussions that would see us dealing with Bill C-62, medical assistance in dying, next week. We are, of course, well aware of the deadlines that are looming. I remind all members of this House that there is a March 17 deadline attached to this very important legislation.

I would remind the House that we wanted to allow all parties in the House, as well as in the Senate, to participate in a process that could guide the government's choices on medical assistance in dying. We produced a report that resembled a consensus, and the bill reflects that consensus.

We will also give priority to bills that have been examined and amended by the Senate and are therefore now in the final stage of debate in the House. These include Bill C-29, which would create a national council for reconciliation, and Bill C-35 on early learning and child care in Canada.

As I said at the outset, we will continue to consult with the opposition parties. My door is always open. If necessary, we will make adjustments so that the House can continue to work in an orderly fashion.

Business of the HouseOral Questions

February 8th, 2024 / 3:10 p.m.


See context

Conservative

Andrew Scheer Conservative Regina—Qu'Appelle, SK

Mr. Speaker, as it is Thursday, I am very excited to ask the Thursday question. I was wondering if the government House leader can update members as to the business of the House for the rest of this week and into the next week.

I will take this opportunity to ask how the government plans to manage Bill C-62. Bill C-62, as members will know, is the response to a court deadline to protect vulnerable people with mental health afflictions. The government has had over a year to deal with this, yet here we find ourselves again on the eve of an expiration of a court-imposed deadline with not a lot of House time.

If the government could enlighten members as to how it foresees Bill C-62 will move through the House in time for that court-imposed deadline so that vulnerable Canadians are not in any way victimized by the regime around MAID, I am sure members from all sides would like to know that.

Presence in GalleryOral Questions

February 7th, 2024 / 3:20 p.m.


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Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Mr. Speaker, there have been discussions among the parties and, if you seek it, I believe, or at least I hope, you will find unanimous consent to adopt the following motion. I move that, notwithstanding any standing order or usual practice of the House, for today's sitting, the ordinary hour of daily adjournment shall be midnight, and after 6:30 p.m., no quorum calls, dilatory motions or requests for unanimous consent shall be received by the Chair, and when no member wishes to speak on the motion for the second reading stage of Bill C-62, an act to amend the Criminal Code, medical assistance in dying, No. 2, or at midnight, whichever is earlier, the debate on the said motion shall be deemed adjourned, the House shall adjourn until the next sitting day, and the debate, pursuant to Standing Order 38, shall not take place.

Business of the HouseOral Questions

February 1st, 2024 / 3:15 p.m.


See context

Gatineau Québec

Liberal

Steven MacKinnon LiberalLeader of the Government in the House of Commons

Mr. Speaker, I thank my colleague from Quebec. I assure him that the House of Commons is in for a good time. There will always be interesting things to debate because we keep introducing good bills in the House.

Tomorrow, Bill C-57, an act to implement the 2023 free trade agreement between Canada and Ukraine, will be the subject of debate.

When we return on Monday, we will call Bill C-59, the fall economic statement implementation act, 2023.

I would also like to inform the House that Tuesday and Thursday will be allotted days. On Wednesday we will begin debate on Bill C‑62 on medical assistance in dying, which was introduced earlier today by my hon. colleague the Minister of Health.