Bill C-62

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

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.

Criminal Code

[Ya'ara Saks, Liberal, York Centre, ON]

moved that Bill C-62, an act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2, be read the second time and referred to a committee.

Mr. Speaker, I am pleased to have the opportunity to speak today about Bill C-62. This is a sensitive and very personal subject for so many around the country.

We have debated many of the core issues, but today we are talking about the legislation that proposes to extend 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.

I want to be clear: The question we are debating today is not whether mental illness can cause irremediable and intolerable suffering on par with that of physical illnesses. We know that it can, and that is not up for debate. We must proceed cautiously and we must get this right. We must ensure that the appropriate measures are in place across this country to affirm and protect our most vulnerable.

We have heard significant concerns from partners, provinces and territories and the medical community, regarding health care system preparedness. In its latest report, tabled on January 29 of this year, the Special Joint Committee on Medical Assistance in Dying found that while considerable progress has been made in preparing for the expansion of eligibility for persons suffering solely from a mental illness, an additional delay is needed to ensure that the health care system can safely provide MAID in these types of complex cases.

These concerns must be addressed before we can move forward with extending eligibility to persons whose sole underlying condition is mental illness. While that critical work is happening, we must also take action to ensure that vulnerable people are protected. Unless Bill C-62 is passed by March 17, 2024, the exclusion of eligibility for MAID will be automatically repealed. That means that individuals suffering solely from mental illness could be eligible to receive MAID as of that date, without the system being ready.

Although progress has been made to support the safe assessment and provision of MAID in complex cases, now is not the time to extend the exclusion, as highlighted by the letter we received from provinces and territories.

Over the past few years, the Government of Canada has been collaborating closely and carefully with partners to support the implementation of MAID. We have taken a compassionate and careful approach to this in our support of the safe assessment of MAID in complex cases, including where the sole and underlying medical condition is a mental illness.

I would like to take a few minutes to highlight some of the key areas of progress that have been made. As required under former Bill C-7, we appointed an independent expert panel with a mandate to provide recommendations on protocol, guidance and safeguards to apply to requests for MAID made by persons whose medical condition is a mental illness.

The final report, tabled by the expert panel in the spring of 2022, included 19 recommendations for governments and health system partners to support the safe expansion of MAID for persons suffering only from a mental illness. The panel noted that the recommendations would benefit all complex track 2 MAID assessments and provisions, even those where mental illness was not a factor. At the same time, the Special Joint Committee on Medical Assistance in Dying was also studying the question, and concluded that, at that time, they believed additional work was needed before moving ahead.

Both the reports by the Special Joint Committee on Medical Assistance in Dying and the expert panel highlighted the importance of education and training, consistent professional guidance, enhanced data and analysis, meaningful indigenous engagement and strong oversight. The government has taken these recommendations very seriously and has worked diligently to advance them.

In September 2022, Health Canada convened an independent task group made up of clinical, legal and regulatory experts to develop model MAID practice standards based on the expert panel's recommendations. Its mandate was to create resources that could be used by regulators to operationalize the expert panel's guidance with respect to complex MAID cases, including those based on a mental illness alone. The task group's efforts resulted in a model practice standard for MAID and a companion document, “Advice to the Profession,” which were both published in March 2023.

To date, the majority of provinces and territories have indicated that their practice standards for MAID have been updated or are in the process of being reviewed using these materials as a guide. The supporting “Advice to the Profession” document is being used to support and inform regulatory bodies, public authorities and health professional organizations, and is intended to support a consistent and safe approach to MAID practice across Canada.

In addition, Health Canada has been working closely with the Canadian Association of MAiD Assessors and Providers, also known as CAMAP, on a number of key activities to support preparedness among practitioners. Among them include funding the development of a nationally accredited bilingual MAID curriculum to support access to high-quality MAID training and a standardized approach to care across the country, while recognizing that differences in the delivery of health care services among provinces and territories do exist. As of the end of January, more than 1,100 clinicians have already registered with CAMAP to take the training.

We supported a knowledge exchange workshop on MAID and mental disorders that took place in June 2023. The workshop brought together MAID assessors and providers, as well as psychiatrists, from across the country to discuss the assessment of MAID requests based on mental illness alone, to build a network for ongoing knowledge exchange and to inform future practice. Additional knowledge exchange sessions are being planned for May 2024 and 2025 to support ongoing interjurisdictional lesson sharing and clinical guidance for complex case assessment, including for mental illness as the sole underlying condition.

When it comes to the question of eligibility criteria for MAID, we must consider all situations and all outcomes. While important work has indeed been done, we have heard clearly from our partners that they need to have sufficient time to implement safeguards and address capacity concerns that are expected to result from the expansion. As my hon. colleague, the Minister of Justice, has pointed out, we are trying to calibrate two fundamental ideas: the autonomy of the individual in terms of dignified decisions about the timing of their own passing, coupled with protecting vulnerable communities and individuals.

As the deadline to lift the exclusion of eligibility for mental illness approaches, calls to further extend the deadline have grown louder. We understand from our engagement and outreach with health stakeholders that there are varying levels of readiness to manage and assess requests for MAID where the sole medical condition is a mental illness. All provinces and territories have indicated that they are not yet ready to move forward. More work needs to be done.

On January 29, the Special Joint Committee on Medical Assistance in Dying tabled its most recent report examining the degree of preparedness for the safe application of MAID for persons whose sole underlying condition is a mental illness. While recognizing the considerable progress that has been made in preparing for the expected expansion of eligibility, the committee recommended an additional delay to ensure that the health care system can safely provide MAID in these types of complex cases.

I want to be clear: I understand that suffering from mental illness is just as real and just as serious as suffering from a physical illness. That is why we provided a clear timeline of three years before the lifting of the exclusion, which the provinces and territories and our health care partners can continue to work toward, and a firm commitment for parliamentarians to evaluate the progress after two years. That work will continue in earnest, and we can be assured that all the necessary measures are in place to move forward safely.

I understand there will be people who have suffered over many years without finding relief, and for whom MAID may be a serious consideration based on deep and personal reflection. This new development may truly be distressing for them. I want to say to them that we are committed to moving forward. However, we must do so in the most compassionate, responsible and prudent way possible. The system needs to be ready, and we need to get this right. It is clear from the conversations we have had that the system, at this time, is not ready. As I have said, we have worked hard to make sure that the necessary supports are in place for practitioners and our provincial and territorial partners to permit the expansion of the MAID eligibility to people whose sole condition is a mental illness. However, they have also been clear that more time is needed to prepare; that is why we are proposing a three-year extension.

The availability of nationally accredited training modules for MAID assessors and providers would help ensure that providers were clear on the requirements of the legislation and good clinical practice. However, it is going to take some time for individual physicians and nurse practitioners to integrate and internalize these practice standards.

Provincial and territorial regulatory bodies need to complete the work associated with updating standards. They need to ensure that health care clinicians have the training to ensure a safe and consistent assessment before the MAID eligibility is expanded through the lifting of mental illness as an exclusion. Existing assessment and support mechanisms also need to be examined and revised to ensure that the robust measures needed for these types of complex requests are in place. On that point, we are committed to continuing to support the provinces and territories and help system partners to further strengthen and improve mental health care services and supports, as well as data collection, to better understand who is requesting MAID and why, and appropriate support and oversight for practitioners.

While the management and delivery of health services, including MAID, is an area of provincial and territorial responsibility, the provinces and territories have been regularly engaged through a working group to facilitate information sharing and collaboration on MAID implementation. Through this group, provinces and territories have been and continue to be engaged in the work on the federally led model practice standards and are working collaboratively with all of us on all aspects of MAID.

The government has also made significant investments to support the provinces and territories in the delivery of mental health services. Budget 2023 confirmed the government's commitment to invest close to $200 billion over 10 years, starting in 2023-24, to improve health care for all Canadians. This includes $25 billion to provinces and territories through tailored bilateral agreements, focused on four key priorities, including improving access to mental health and substance use services and the integration of these services in all other priorities. This is in addition to the $5 billion committed in 2017 to support mental health and substance use services.

Our government has also invested more than $175 million to support the implementation and operation of 988, which will provide people across the country with access to immediate and safe support for suicide prevention and emotional distress.

As MAID continues to evolve, we need to ensure that accurate information is available to the public by providing clear information. We also take the concerns raised by those who might face systematic disadvantages very seriously. That is why we have expanded data collection on MAID to provide a better understanding of who is accessing MAID and why, including the collection of data on race, indigenous identity and disability. We can only address potential risks if we can uncover them.

We are continuing to engage with indigenous peoples through both indigenous-led and government-led activities to better understand their perspectives on MAID. This will culminate in a “what we heard” report in 2025. This will support transparency, provide insight into how the legislation is working, and maintain public trust in how MAID is accessed and delivered in Canada.

Finally, both the expert panel on MAID and mental illness and the special joint parliamentary committee highlighted the importance of case review mechanisms and oversight to support the safe assessment and provision of MAID. Most provinces and territories already have systems in place to do this work, but we understand that more can be done. We are working with the provinces and territories to explore enhanced models of case review and oversight, and, in particular, for more complex MAID requests, to support consistency and quality assurance across the country.

I understand that medical assistance in dying is a complex issue about which there are deeply held beliefs and opinions. I understand the concerns that have been raised with regard to the expansion of eligibility for MAID to include circumstances where the person's sole underlying medical condition is a mental illness. This 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.

The Government of Canada has also committed to a joint parliamentary committee to undertake a comprehensive review within two years after the act receives royal assent. This measure would further serve to examine progress made by provinces, territories and partners in achieving overall health care system readiness.

In the meantime, our government will continue to work with the provinces and territories to support ongoing improvements of the system to continue to ensure our laws protect those who may be vulnerable, reflect the needs of the people of Canada, and support autonomy and freedom of choice. That is why, after much deliberation, we have introduced Bill C-62 to extend the temporary exclusion of eligibility for MAID for persons suffering solely from a mental illness to March 17, 2027.

To put it simply, we need more time to get this right. I urge all members of the House to support Bill C-62.

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, the arrogance of the government knows no bounds.

In its brief, based on a “review of evidence, the Board of Directors of the Society of Canadian Psychiatry believes the process leading to the planned 2024 MAID for mental illness expansion was flawed, insufficiently responsive to evidence-based cautions and resulted in a lack of safeguards.” It is calling on this expansion not to be paused for three years but to “be paused indefinitely, without qualification and presupposition that [any] implementation can safely be introduced at any arbitrary pre-determined date”. It urges that it not be “driven...by ideological advocates”.

Why are the minister and the government continuing to press on when the experts have spoken? We should not be moving forward in this dangerous direction. It should be paused indefinitely.

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Speaker, I will acknowledge that there are many different opinions that have been shared on this view by many different experts. As a matter of fact, some of the members of the special joint committee are going to be participating in the debate we are having tonight.

We have to clear that this is not a matter of “if”. We are debating “when”. It has been recognized, and it is not up for debate, that a person suffering from mental illness, when it is irremediable, continued and impacting the quality of life of the individual, has the right and the dignity to make choices with their health practitioners.

The expert panel noted that there were differing opinions on this and concerns, but when we are debating this tonight, it is not about arrogance. It is about having compassion and understanding the right to an individual's choice and dignity when they have deep, prolonged and ongoing suffering.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I was pleasantly surprised to hear the minister say right off the bat that there was no reason to question whether there is such a thing as an irremediable mental disorder, but the Conservative members do not seem very clear on that. I do not know if she noticed the member for St. Albert—Edmonton's reaction when she said it. I would certainly be worried if I were her, because every time the House has held a debate on medical assistance in dying since 2015, we have been unable to reach a consensus. The Conservatives are always opposed to it.

On this bill, however, the Conservatives are in lockstep with the Liberals and in favour of indefinitely postponing access to MAID for people with mental disorders. Why is that? Is the minister not concerned about that? What evidence does she have to explain why, a year ago, the government said it was going to take a year to sort this out, but now it it is going to take three years? By then, the Conservative Party may have had the opportunity to take power.

I guess she knows very well that this is not going to happen. I am not talking about the Conservatives being elected; I am talking finally legislating on the issue of mental disorders.

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Speaker, this is why we have put a set timeline on this. We took the expert panel recommendations. There were 19 recommendations in that report, which included system readiness and a comprehensive set of modules for MAID assessors across the country to be able to do this work safely and compassionately. That is the work that we have done on implementation. Eleven hundred practitioners, including physicians and nurse practitioners, have participated in these training modules, but we have also been working with regulatory bodies. We want to make sure that there is quality and a standard of care across the country that sees people in their suffering, especially when they are vulnerable, and especially when mental illness as a disorder has caused such suffering and such harm over the years and over a prolonged period of time. We are very sensitive to the concerns of the member, and we are setting clear guardrails on the timelines for this.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, we need to have a reminder of why we are in the situation we are in. I was here in the 43rd Parliament when Bill C-7 was being debated. I remember very clearly the government's original charter statement, which included its rationale for excluding mental disorder as a sole underlying medical condition. I thought the charter statement was quite reasonable. However, we are in this situation because, when Bill C-7 went to the Senate, for some inexplicable reason, at the eleventh hour, the government did a complete 180° and accepted the Senate amendment. It changed the law before the hard work had been done.

I have been a member of the special joint committee from the get-go, and on that committee, we feel like we have been playing a game of catch-up ever since, having to do the work racing against an arbitrary timeline. That is why we have see letters from seven out of the 10 provinces and all three territories asking for an indefinite pause. I hope the minister and the Liberal government can take responsibility for putting Parliament in this position.

I would also like the minister to comment on the fact that there are so many populations, whether they are in rural or remote communities or urban centres, that simply cannot get the mental health care they need. When is her government going to step up to the plate and start servicing communities such as those in Cowichan—Malahat—Langford along with with those from coast to cost to coast? That is a huge problem that really needs to be addressed before we entertain any kind of a change to the law.

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Speaker, my colleague and I are in lockstep in understanding how important a robust and integrated set of mental health services and substance-use services are. They must be available within health jurisdictions throughout the country. That is exactly why last year we committed to $200 billion to improve the health of Canadians. That is exactly why there are bilateral agreements that are tied to our four key principles, which include mental health. Provinces had to ensure that there were plans as part of their agreements and show a clear commitment to providing mental health services and substance-use services for those who are struggling with those disorders.

That being said, we also want to make sure that our health care systems, when it comes to MAID, have the level of system readiness, consistency and quality assurance across the country. We do not want a pick-and-choose system. We want to make sure that our most vulnerable are safe and that those who make this decision are doing it not only to acknowledge the dignity—

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

I have to give the opportunity for further questions.

The hon. member for St. Albert—Edmonton.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, at the beginning of her speech, the minister stated that irremediability is not up for debate. Respectfully, it is the core of the debate about whether MAID can be expanded in cases where mental disorders are the sole underlying condition. The overwhelming evidence from leading experts, including psychiatrists, is that it is difficult, if not impossible, to determine irremediability. That was the conclusion of the government's own expert panel, at page 9 of the report. The special joint committee heard evidence that clinicians could get it wrong 50% of the time. In other words, it is like flipping a coin with people's lives. Is the minister comfortable with that risk?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Speaker, I will remind the member that we cannot speculate on treatment. Treatment is something that a patient decides with their health care provider. There is a lengthy process of assessments that are done for those who struggle with mental illness.

That being said, the criteria of eligibility are crystal clear. It has to be prolonged. It has to be determined irremediable, not only by the patient but also by a group of expert assessors. There needs to be a full assessment of what treatments have been engaged. I know there has been some debate in the House in the past asking about future treatments and all of that.

We are looking at an individual and their prolonged suffering. I would ask the member to really contemplate it. Does an individual's own lived experience with prolonged mental illness, and the suffering that goes with it, not weigh in, beyond that of the experts who have not walked in their shoes?

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, here we are again, just as we were last February. We are faced with an arbitrary deadline set by the Liberals for their radical plan to expand MAID for mental illness. The Liberal government is completely unprepared and, therefore, needs to bring in eleventh hour legislation to extend the implementation deadline that it set in the first place.

I cannot think of another time or another issue in which a government has effectively had to bring in emergency legislation twice to extend a deadline for the implementation of its own law. It is truly shambolic. How did we get into this mess, thanks to the Liberals? Very simply, what we have across the way is a radical and reckless government that put blind ideology ahead of evidence-based decision-making. That has been the consistent pattern, in terms of decisions the government has made with respect to this planned expansion. This started with David Lametti, the former justice minister, who accepted a radical Senate amendment back in 2021 to implement MAID for mental illness and then set an arbitrary two-year timeline for implementation.

It should be noted that the charter statement for the bill in which Lametti accepted that radical Senate amendment provided a rationale for excluding MAID in cases of mental illness. The minister said at the time that he and the government were against MAID for mental illness because there were inherent risks and challenges. Indeed, he was right, but then he suddenly flip-flopped and rammed the amendment through with very little debate, one and a half days of debate. There was no parliamentary study, no consultation with experts and affected groups, and no evidence that MAID for mental illness can be implemented safely and appropriately.

The Liberals got it completely backwards. Instead of studying the issue first to determine whether this could be implemented safely, they decided to move full steam ahead and study the issue after the fact. Had they approached this matter responsibly, they would have learned very early on that there are significant clinical, legal and ethical problems with expanding MAID in cases of mental illness.

Among those problems are two fundamental clinical issues. The first is the difficulty of predicting irremediability. In other words, it is difficult to predict whether someone with an underlying mental health condition will get better. That is problematic in two major ways.

One is from the standpoint of the law. Under the Criminal Code, in order to qualify for MAID, a person must have an irremediable condition. More specifically, an irremediable condition is defined as one in which a person has an incurable disease or illness and is in an irreversible state of decline. If it is not possible to accurately determine that someone with a mental illness is in an irreversible state of decline and will not get better, then how can MAID for mental illness be carried out within the law? It cannot.

More significantly, from an ethical standpoint, if it is difficult to predict whether someone will get better, what that means with certainty is that persons who could get better will have their lives prematurely ended. Such persons could go on to lead a healthy and productive life. This was underscored by evidence heard by the special joint committee on MAID, during both its initial study two years ago and its more recent study this past fall. The special joint committee heard evidence that clinicians can get the prediction around irremediability wrong 50% of the time. In other words, it is like flipping a coin with people's lives. Is that a risk that members of the House are prepared to take?

When I posed that question to the minister responsible for mental health, she essentially answered in the affirmative. She doubled down on her support for an expansion of MAID for mental illness in three short years. Flipping a coin, gambling with people's lives, is what MAID for mental illness will result in.

A second fundamental problem is difficulty on the part of clinicians in distinguishing a rational request for MAID from one motivated by suicidal ideation. That is underscored by the fact that, in 90% of suicide deaths, persons suffer from a diagnosable mental disorder, not to mention that suicidal thoughts are often a symptom of mental disorders. This is why psychiatrists who appeared before the special joint committee said that it is not possible to distinguish MAID for mental illness from suicide. At the very least, MAID for mental illness significantly blurs the line between suicide prevention and suicide facilitation. It fundamentally changes the character of MAID and transforms it into something akin to state-facilitated suicide. This demonstrates just how far down the slippery slope we have gone under the Liberals.

To paraphrase the minister, she said that there are robust safeguards in place in that persons with a mental illness would only be able to qualify after years of receiving treatments and not getting better. However, that is simply not accurate; no such safeguards are found in any legislation put forward by the Liberals. In fact, the expert panel that the Liberals appointed, incredibly, recommended that there be no additional safeguards. Therefore, under the MAID expansion, it is simply not accurate that one must go through treatments or that one must be suffering over an extended period of time in order to qualify. In fact, the Liberals expressly rejected such additional safeguards.

In the face of those political challenges, Conservatives called on the Liberals to put an indefinite pause on this expansion. Likewise, in the lead up to the March 2023 deadline for implementation, the arbitrary deadline set by the Liberals, the chairs of psychiatry at all 17 medical schools called on the Liberals to pause this expansion.

What did the Liberals do? Essentially, they kicked the can down the road. They introduced Bill C-39, which merely extended the deadline for implementation from March 2023 to March 2024. In other words, once again, the Liberals put ideology ahead of evidence-based decision-making, making what amounted to a political decision with a new arbitrary deadline.

Nearly a year has passed, and with respect to resolving the fundamental issues and problems regarding safely implementing MAID for mental illness, where are we today? No progress has been made.

Indeed, when the special joint committee heard from psychiatrists, the message was loud and clear that we should not move ahead with this. It is not safe, and it cannot be implemented appropriately. The responsible course for the government to take is to acknowledge that it simply got it wrong and put an indefinite pause on the expansion.

It is no surprise that, in the face of these challenges, there is a professional consensus against the expansion. We saw that last week, when a survey from the Ontario Psychiatric Association was released. It indicated that a full 80% of Ontario's psychiatrists do not believe the health care system in Canada can safely implement MAID for mental illness. Last week, seven of the 10 provincial health ministers, plus the health ministers from all three territories, called on the Liberals to put an indefinite pause on this expansion.

What did the Liberals do in response? Once again, they kicked the can down the road with Bill C-62, which is before us. They defied experts, the provinces and territories, and common sense. This bill is basically the same bill we were debating a year ago. Instead of a one-year pause, it provides a three-year pause, with absolutely no evidence to indicate that fundamental clinical problems can be resolved. These problems include predicting irremediability and distinguishing between a suicidal request versus a rational request.

We have a government that is telling us to forget the evidence. The minister said it is not even up for debate, that the government does not want to talk about evidence as part of this issue. She basically said to forget about irremediability. The bottom line is that we have a Liberal government that is determined to implement this radical policy against a consensus among psychiatrists and other advocates.

Indeed, to get an insight into the mindset across the way, last week, in a press conference, the Minister of Health said that there is a moral imperative to get ready for MAID for mental illness. What is the moral imperative? Is it to give up on people who are struggling with mental illness? Is it to offer death through the provision of MAID to persons who are struggling with mental health issues?

That is what these Liberals characterize as a moral imperative? I say it speaks to the moral bankruptcy of these Liberals after eight years of the Prime Minister.

When the Liberals talk about MAID and mental illness, they are always very vague about what they mean. They know that if Canadians fully understood what MAID for mental for illness meant, most Canadians would be absolutely appalled. The model practice standard, which I believe the minister alluded to, that was prepared by the government's so-called task group of experts provides that a mental disorder would include anything in the DSM-5. Any condition listed in the DSM-5 is what these Liberals are contemplating as constituting a condition that would qualify someone for MAID in the case of mental illness.

What are the conditions listed in the DSM-5? They include personality disorders, depression, schizophrenia and issues when persons suffer from addictions challenges. That is what we are talking about when it comes to MAID and mental illness. It is truly repulsive, it is morally bankrupt to the core and it says everything Canadians need to know about the values of these Liberals.

There is only one piece of good news in all of this, which is that this legislation provides a three-year pause, and what will happen between now and the expiration of those three years is a federal election. Canadians will have a choice. They can choose between a Liberal government that wants to provide death to persons who are struggling with mental illness or they can choose a common-sense Conservative government that will not give up on anyone, will be committed to offering persons struggling with mental health issues hope and health, and will permanently scrap this radical Liberal experiment that gambles with the lives of vulnerable Canadians.

[Yasir Naqvi, Liberal, Parliamentary Secretary to the Minister of Health]

Madam Speaker, there are two points I want to raise quickly and hear his response on. One, he talked about a consensus in the psychiatric community, and I do not know what consensus he is referring to. There are varied views on providing services and cures to people with mental illness. However, my question is in regard to rights of individuals. We have a decision by a Quebec court that required this Parliament to act on the ruling to ensure the rights of individuals guaranteed under the Charter of Rights and Freedoms are protected. I would like to hear his views as to how we will reconcile with those rights and what his plan would be to ensure the rights of Canadians, whether they have mental illness or not, are protected under our charter.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, I would submit that 80% of psychiatrists in Ontario saying MAID should not be expanded in the case of mental illness is approaching a professional consensus. The member I would hope would be concerned by a government policy to expand MAID in cases of mental illness significantly impacting vulnerable persons and that he would question the appropriateness of such a policy in the face of opposition from so many experts.

With respect to the Quebec court decision he alluded to, and I believe he is referring to the Truchon decision, there was no pronouncement of the Quebec Superior Court on the question of mental illness. That was not part of the fact pattern in the case. The plaintiffs were not suffering from an underlying mental health disorder. There is no binding precedent forcing the government to enact this legislation. This is a political decision made by these Liberals.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, as my colleague knows, I have been on the Special Joint Committee on Medical Assistance in Dying from the get-go.

If he will recall, in the 43rd Parliament, when this House was dealing with Bill C-7, the government's original charter statement, which provided its rationale for excluding mental disorders as the sole underlying medical condition, was fairly well reasoned, and explained that section 7 and section 15 of the charter can be involved here. However, we have to remember section 1. Sometimes we may need to limit rights.

For me, personally, I am big believer in the charter, but I struggled through this whole process in how to find that balance between an individual's charter-protected rights but also the need of society to sometimes step in and protect the most vulnerable.

Could the member tell us how he personally approached finding that balance, and to also put it in the context that so many people in Canada, whether they are in rural or remote communities or in our urban centres, are marginalized and do not have access to the proper mental health care supports they so desperately need?

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, I enjoyed working with my colleague, the member for Cowichan—Malahat—Langford, on the special joint committee.

The manner in which I approached this issue was by following the evidence to determine whether this expansion could be implemented safely and appropriately. The overwhelming evidence is that it cannot. It need not have been this way. We need not be here for a second time on the eve of an implementation date that was arbitrarily set by the Liberals.

We could have studied this issue. We could have heard from experts. We could have heard from other groups about this, without moving ahead with legislation before undertaking that important consultation.

Let me simply say that the Liberal government has gotten it backwards. It has gotten it wrong. What the government should be doing is coming back to this House and putting an indefinite pause on this expansion.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, I do not think the member is fully online on this. There is a Quebec court decision. That decision does put in a deadline that the government does need to respect and respond to.

At the beginning of his arguments, the member was trying to pass the blame. Let me remind the member that it was Stephen Harper's government, the same government which he worked for, back in 2015, that chose to do nothing, ignoring the issue. That was based on a Supreme Court decision.

Would the member not recognize that the issue cannot just be ignored? That is the track record of the Conservative Party.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, if the member is referring to the Truchon decision, that was not what the Truchon decision provided for.

That was outside the scope of the Truchon decision. Evidenced by that is the fact that when the Liberals responded to Truchon by introducing Bill C-7, mental illness as the sole underlying condition was expressly excluded from the legislation.

This is a political decision brought on by the Liberals.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, my colleague is always very eloquent when it comes to defending the “no” camp and the pro-life camp. Does his position represent the position of the Conservative party? Is that the official position of the Conservative Party?

I just want us to be able to understand what is at stake in this debate today. Essentially, to him, irremediability is something that can never be proven. That means that, under a Conservative government, people who are suffering intolerably, who are dealing with intolerable suffering because they are victims of a mental disorder, could never be relieved of their suffering.

What I am also hearing is that he claims that he can solve the problem of suffering and irremediable mental disorders by injecting a lot of money into the health care system to make access to health care something that can help these people put all their suffering behind them.

Is that what he is telling us?

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, the member for Montcalm is a thoughtful member on this issue.

With respect to irremediability, I am absolutely not comfortable with moving ahead with this expansion if it cannot be accurately determined. We have psychiatrists come before committee and say it is like flipping a coin, that clinicians get it wrong 50% of the time. That is not an appropriate risk. That is evidence of a policy that has not been well thought out, and that is dangerous and will negatively impact vulnerable persons on a matter of life and death.

With respect to the position of the Conservative Party, yes, the position is that a common-sense Conservative government would permanently scrap this radical and dangerous expansion.

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, the arrogance and incompetence of the members opposite on this issue is truly alarming and frightening. Are they not aware that 30 legal experts wrote a letter to the former justice minister and cabinet saying, “Parliament is not forced by the courts to legalize MAID”.

What does the hon. member make of this argument, from the minister who spoke earlier, that somehow, in her words, the debate is over?

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, it is arrogance, it is recklessness and it is incredible. It is incredible in the sense that they hide behind a Quebec court decision. It is a decision, frankly, they should have appealed but did not. It did not pronounce on the question of MAID and mental illness, and they are now using that as the basis to say we need to move forward with this legislation, even though, when they initially responded, they said they were going to exclude mental illness from the legislation. They are trying to have it both ways.

They got into this mess because David Lametti accepted a radical Senate amendment and it has been a three-year mess ever since.

[Anthony Housefather, Liberal, Mount Royal, QC]

Madam Speaker, I rise on a point of order. I made a technical error in my vote on PMB Motion No. 86 on the seventh vote today, and I would very much appreciate the House's unanimous consent to allow me to change my vote to no.

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

Is that agreed?

[Some hon. members]

Agreed.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I never thought I would end up debating medical assistance in dying in the House again, or reliving what we went through when we passed Bill C‑14, a bad law. I never expected that the Liberals would again be in the same position, or show the same lack of courage they did with Bill C‑14, which was prescribed by the Carter-Taylor decision.

Quebec passed its legislation on end-of-life care before the Carter decision. In the Carter decision, the court ruled that Quebec had to revise its legislation to include more than end-of-life issues only. The Parliament of Canada, which had never considered this before, was also told that it had to address not only end-of-life issues, but also degenerative diseases like those afflicting Ms. Carter and Ms. Taylor. Ms. Carter had spinal stenosis and Ms. Taylor had amyotrophic lateral sclerosis. In its decision, the court ruled that Parliament had to legislate because both women's right to life was being infringed.

Why was their right to life being infringed? The right to life is not a minor right. This should be of interest to the Conservatives, who are pro-life. I am too, in that sense. The right to life was being infringed because these people had to shorten their lives when they would have liked to live until their suffering became intolerable.

As members of Parliament, as representatives of the state and the people, our duty is not to decide what the patient needs when it comes to an issue as personal as their death. The role of the state is to ensure the conditions needed for them to exercise free will, so that they can make a free and informed decision. That is the role of the state. Otherwise, we get into government paternalism.

I invite my Conservative colleague to do some reading in clinical ethics and not to limit himself to what psychiatrists in Ontario are saying. We know that psychiatrists are divided on the issue. In fact, if there is one discipline in which medical paternalism continues to reign, it is psychiatry. We would never have seen the progress that we have seen in clinical ethics if medical paternalism in general still ruled supreme.

What happened for patients to be given back control over their end of life? We find the answer to that question in the bioethics literature. In the past, some doctors who had cancer said they did not want treatment. Now, we have good medical practices, whereas in the past, aggressive treatment was the standard. The doctors said that they wanted to live the two years they had left without undergoing treatment that would leave them bedridden. They claimed that they wanted to spend quality time with their loved ones. It took doctors with cancer demanding that option for patients to be able to discuss these sorts of things with their own doctor. In the 1960s, there were patients who only found out that they were dying of an incurable disease and were in fact at the end of their life when the priest came to their room to administer the last rites. They were not even told that they were terminally ill. That was medical paternalism.

Over time, the right to die was granted. Patients were granted the right to die and the opportunity to refuse aggressive treatment. That is when we began providing the palliative care that is so important to my Conservative friends. Before that, palliative care was called passive euthanasia, and it was not allowed.

Medical paternalism has been gradually set aside. What has this led to?

It has led to the right to refuse life-saving treatment, to stop treatment. These are all rights we have today.

We have before us a bill that perpetuates suffering indefinitely for people with a severe mental disorder who have been unable to relieve their suffering through treatment. That is no mean feat. They have spent 10, 20, 30 years suffering, trying multiple treatments and being stigmatized by the society in which they live.

We are able to establish the decision-making capacity of people living with a severe mental disorder. For those capable of making decisions, the court told us that it would be discriminatory and stigmatizing if, just because they have a severe mental disorder causing suffering that psychiatry is unable to properly change or relieve, they were told what was best for them and that they should continue to suffer forever, while psychiatry need only provide a palliative care option until the end. That is what we are discussing today.

I will calm down. It is just that I heard some nonsense earlier.

Then what happens? There was Bill C‑7, which was rather cautious. It set a two-year deadline for creating an expert panel. Who read the report of the expert panel in the House? Who read it before voting? This is the second vote we are having on this subject. We have to read the report of the expert panel. Indeed, the irremediable aspect is something that is hard to implement. Admittedly, there is an additional difficulty, but the expert report does set out guidelines. That is what this is about.

Then the Liberals show up today with a clause they added that says we are going to work with an expert panel for two years and create a joint committee. The problem is that the joint committees have always been set up at the last minute, too close to the deadline.

When we submitted our report the last time, we were forced to admit that, before moving forward with the issue of mental disorders, we needed to assess the situation in the field. Even though I think the group that was supposed to work on it had developed important guidelines and standards of practice, it was obvious to me that there was still not quite enough time. Everyone told us so, including the Collège des médecins du Québec—I will have more to say later about its criteria and guidelines for proceeding that I find useful.

How is it that, a year ago, the government gave itself a one-year deadline and thought that would be enough time? A lot of work has been done in that year, yet the government is saying we should put it off until 2027.

We heard what the Conservatives just said. We can forget about MAID if they form government; they will put it off indefinitely. That means that people will continue to suffer indefinitely, and that suffering will be intolerable because psychiatry is unable to provide relief other than by rendering them virtually incapacitated. Somehow, people find that morally acceptable. I honestly do not know where the morality lies in that. Some people have very flexible morals. In any case, it has nothing to do with suffering.

When people claim that someone living with depression could have access to medical assistance in dying, it is simply not true. Just because someone applies for MAID does not mean they will be able to access it. The assessors will do their job. Stefanie Green was saying that a person in a suicidal crisis is not eligible for medical assistance in dying. Someone who raises their hand and says that they want MAID simply because we allow mental disorders to be eligible grounds for MAID would not have access to it because they have not received proper care.

However, there would be an opportunity for prevention, because we could provide treatment at that time. It is wrong to say that 90% of people who have suicidal ideation and commit suicide received proper care. No, they did not receive proper care. Very often, when people commit suicide, no one saw it coming at all.

What are we going to do? What are the Conservatives going to to with people who are desperate and suffering and who currently still have hope that we are going to consider their suffering and find a solution so that things are done properly and by the law? What do they think those individuals are going to do in their despair? Is suicide morally acceptable? Suicide attests to the failure of our system and our society. I will never, ever accept suicide. That is why, when we talk about medical assistance in dying, we are not in the same page at all.

A person who is feeling suicidal is not eligible. Someone who has just been taken into care and diagnosed is not eligible. Applications take structural vulnerabilities into account. Just because someone is poor and does not have access to care does not mean that they will be eligible for medical assistance in dying. They would not be eligible, because they would have to have tried every possible treatment. Someone who unjustifiably refuses treatment that could improve their condition will not be eligible. If accessible and effective treatments are available and the person refuses them, they are ineligible. If the assessors cannot agree that the criteria have been met, the person is not eligible either.

The Collège des médecins du Québec told us that it remains at the discussion stage, that it has established its guidelines and it still needs time in order to eventually get there. Personally, I think one year would have been enough, otherwise we might give up. We could end up being hypocritical and leave it to chance. We might as well flip a coin.

The Liberals need to work hard if they want to win the election. If not, they are going to be leaving the fate of those who are suffering in the hands of people who just told us today that this will not happen on their watch, that they support suffering for life everlasting, and that they know what is moral and right for these people.

The Quebec college of physicians said, and I quote, “the decision to grant MAID to someone with a mental disorder should not be viewed solely as an episode of care. Rather, the decision should be made following a fair and comprehensive assessment of the patient's situation.” We are talking about taking the time to establish the chronicity of the condition.

The college of physicians also set out a second condition. It said, and I quote, “the patient must not exhibit suicidal ideation, as with major depressive disorders”. It might be a good idea for the members of the Special Joint Committee on Medical Assistance in Dying to hear that, although they are on the same committee as I am and that was said in committee.

That is a far cry from the grandstanding Leader of the Opposition who stands up in the House and asks the Prime Minister, in prime time, whether medical assistance in dying is the only thing he has to offer those who are depressed and having a hard time making ends meet. That is a bit much.

The third criterion laid out by the college of physicians states that the patient must “experience intense and prolonged psychological suffering, as confirmed by severe symptoms and overall functional impairment, over a long period of time, leaving them with no hope that the weight of their situation will ease. This prevents them from being fulfilled and causes them to see their existence as devoid of meaning.”

The experts tell us that they cannot apply irremediability and suffering metrics to mental health, and that prevents them from creating a category as a grounds for MAID. It has to be done on a case-by-case basis. All questions of clinical ethics, in terms of clinical assessment, are examined on a case-by-case basis. Some seem to think that going on a case-by-case basis is hell and that it is not a rigorous process. It is very rigorous.

The fourth condition states, “the patient must have been receiving care and appropriate follow-up over an extensive period of time.” Access to care must have been available. Otherwise, no access to medical assistance in dying will be provided for mental disorders. It seems to me that we heard the same thing in committee. We heard the same criteria.

At some point, we have to have the courage of our convictions. I believe that we have to offer relief to people experiencing intolerable suffering, who have reached their limit. I also believe that we must not make decisions about their life or quality of life for them. They alone can decide what is tolerable or intolerable.

When people talk to me about a slippery slope, they seem to be working on the assumption that all health care workers are evil. However, people who work in health care need to be kind. As far as I know, gaining admission to medical school is not easy. I imagine that the selection criteria are quite strict and challenging. The same goes for nursing.

The fifth condition states, “requests [from social workers] must undergo a multidisciplinary assessment, including by the physician or specialized nurse practitioner in the field of mental health who has treated the individual”. This is in the case of a follow-up assessment, not in the midst an episode. A person cannot get medical assistance in dying simply by saying that their life no longer has any meaning. Making a request does not mean one is eligible.

The Collège des médecins du Québec concluded by saying, “Under these conditions, it would be possible, in the CMQ's view, to provide individuals suffering from a grievous and irreversible mental disorder with access to MAID. It is important to prevent situations where individuals opt for MAID out of desperation, because they do not have access to proper care or do not consider the care available to be acceptable, such as an extended stay in a facility without the prospect of gaining more autonomy.”

That is the exact opposite of the nonsense we heard earlier. We were told that this was like a house of horrors, that we were dealing with experts and doctors who simply wanted to harm people's physical integrity. We have to be careful.

To access MAID, the individual must first make a request, which is then followed by informed consent. When it comes to mental disorders, doctors currently perform a daily assessment of a person's decision-making capacity if they have a mental disorder and a comorbidity, an additional illness that is hastening their death. Everyone agrees that these people are capable of choosing and consenting to medical assistance in dying. MAID practitioners have long been determining the decision-making capacity of people with a mental disorder. Just because someone has a mental disorder does not mean that their right to self-determination and to make decisions should be violated. That is discrimination and stigmatization.

When people tell me they want to protect the vulnerable, I wonder who could be more vulnerable than someone who has suffered for decades with a mental disorder and has tried every treatment. Who could be more vulnerable than someone grappling with a paternalistic psychiatrist—I am choosing my words carefully—who thinks he knows better than his patient what treatment they need, then chains them to a palliative care pathway and throws away the key because he cannot bring himself to admit that he is unable to provide relief to his patient?

At committee, I put the question to some psychiatrists who told us we were on the wrong track. They admitted that, in 25 or 30 years of practice, they had seen some patients fall through the cracks. Indeed, it is for this small group of people who fall through the cracks in psychiatry that this expansion is necessary. We need to show a little humanity here in the House.

[Lloyd Longfield, Liberal, Guelph, ON]

Madam Speaker, I extend my sincere thanks to the member across the way for the details and the compassion with which he made his comments about patient-centred decisions and things around the Charter of Rights and Freedoms that we protect in the House. Right now, I understand the Quebec legislature is debating the Superior Court decision. I was hoping we would have a more fulsome debate tonight, and I was surprised the Bloc did not support having that debate.

I spoke with a nurse practitioner in my area who comes from Ottawa to Guelph to provide service, and she can only do it as a volunteer because she is not paid by the province to work outside of Ottawa. On the ground, we really have problems building capacity. Something that this bill tries to address is building the capacity of our health care system within the provinces to be able to provide MAID effectively in our communities.

Could the member maybe reflect on the need for us to work with provinces and their health care systems to build our capacity and, at the same time, to work with legislatures, both provincially and federally, so that we can get this across the line together, and comment on the amount of time that could take?

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, that is an interesting question.

I would like to point out to my colleague that the committee had very little time to assess whether the system was ready. We had two or three meetings to determine that and the deadline was ridiculous. However, many people came and told us that the system was ready.

The Quebec National Assembly took a stand in 2021. Bill C‑7 was passed after that, after a lot of work had been done and brought to a halt in Quebec. The Quebec college of physicians said that it still needed a little more time. However, there is a big difference between needing a little more time to ensure that everything is done safely and properly and putting off indefinitely the need to deal with the suffering of people with serious mental disorders.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, it was a pleasure to work the member for Montcalm on the Special Joint Committee on Medical Assistance in Dying. We have both been on that committee from the get-go, and we have both been exposed to a wide range of witness testimony and the briefs.

Following up slightly on the earlier question, our responsibility here in the federal scene, of course, deals primarily with just the Criminal Code. Once we complete our task with the Criminal Code, the oversight and accountability of the system falls largely on the provinces.

It is not insignificant that seven out of 10 provinces and all three territories had their health ministers and ministers responsible for mental health and addictions sign a letter, in which they referenced the fact that back in November, they were already raising concerns, and they have clearly called for an indefinite pause. I understand Quebec was not a signatory to this, but the very fact that seven provinces and three territories are, and those ministers are responsible for the oversight of those medical systems, I do not think that is insignificant.

I am wondering if the member for Montcalm can reflect on that. When we have clear direction from ministers responsible for the system saying that they are not ready, how does he respond to those concerns?

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, that is an excellent question. In the supplementary report that I tabled, I note that, if we had had more time, we could have engaged with these people. By engaging with these people, we could have understood exactly what their concerns were.

A certain number of associations did tell us that everything was ready for us to do this. The member knows that. For example, the Association of Medical Assistance in Dying Assessors and Providers came and told us after Bill C‑14 and Bill C‑7 were introduced that not all doctors were trained to be MAID providers. There was only a small number and they would be able to meet the demand. When it comes to mental disorders, we are talking about an even smaller number still. The people from this association felt that they were able to do this safely. There was also the Canadian Psychiatric Association, the Canadian Bar Association, the Association des médecins psychiatres du Québec, the Federation of Medical Regulatory Authorities of Canada, the Nova Scotia department of health, and so on.

It comes down to the way people followed the debate and the way they debated within the governments because they sometimes have other concerns. I would have liked to hear them. The government did not call on us as soon as Parliament returned so that we could do a review and ask all of the questions we had. We could have even gone out into the community to see what was missing, but we were unable to.

Here is what I think: We could do it right now, in the next year. We need to work together, get out there and explain it, see what is going on, and share the guidelines. Then, if we need another year, we can take it. Waiting until 2027 to do this is definitely not a progressive way of going about it.

[Marie-Hélène Gaudreau, Bloc, Laurentides—Labelle, QC]

Madam Speaker, from what I understand there are inconsistencies between the processes in the different provinces. Quebec has done its part.

What I am hearing this evening is often what individuals may have experienced. We are talking about human suffering. I know what I am talking about because I have experienced it. Everything my colleague is talking about, everything he got out of all these experts, I experienced it.

Beyond a potential fear of getting to the bottom of things, of figuring out what else is needed to make an informed choice, there is urgency. I would like my colleague to tell me what our dear colleagues here might be lacking to make an informed decision on the fate of human life.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, briefly put, I would say they lack courage. In this place, courage and compassion are lacking, and action is based far too much on ideology.

As I said earlier, only the individual can compare their life in one condition to their life in another condition, and this does not mean comparing two different lives. In that sense, we cannot turn a deaf ear to suffering. We have to listen and we have to act to make sure that these people receive care, of course. That is our goal. However, no matter how difficult it may be to determine whether a condition is irremediable, it would be intellectually dishonest to claim today that psychiatric treatment can relieve the suffering of everyone with severe mental disorders. For those whose suffering cannot be relieved and who request MAID in a considered and coherent manner, with all the safeguards I mentioned earlier in place, we have a duty to listen to what they think and to legislate accordingly.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, I am pleased to be standing in the House today to join debate on Bill C-62. Forgive me if I am feeling a bit of déjà vu right now, because it was precisely one year ago, in February 2023, that the House was in a similar position with the earlier bill, Bill C-39.

That bill, of course, extended the delay of the implementation of the acceptance of mental disorders as a sole underlying medical condition to access MAID. That bill kicked the can down the road by one year. As a result, we find ourselves in a position where we are now approaching the deadline of March 17, 2024.

To go into a bit of detail on what Bill C-62 contains, it is not a very complex bill. It should be clear that the bill itself is not relitigating the issue that was first brought in by Bill C-7. I will get into Bill C-7 in a moment. This bill is seeking to further delay the implementation of MAID for mental disorders as a sole underlying medical condition until March 17, 2027, essentially three years down the road from now.

I also think an important part of the bill is that it inserts a legislative requirement that the Special Joint Committee on Medical Assistance in Dying be reconvened in advance of that change, so that a committee of parliamentarians made up of members of Parliament and senators can review our country's readiness and make a determination in advance of that date.

I have been a member of the special joint committee from the beginning, all the way back in the 43rd Parliament, and, speaking for myself, I am very glad to see that we do have that legislative requirement in Bill C-62 and that, more importantly, the committee is actually being given the time it should have had to study this very complex and sensitive issue in advance of its implementation. That is something we could have been much better served by in previous iterations of this legislation.

I think it is important that we explore a little of the history of how we got to this moment. As a member of this special joint committee, I personally have felt that we have been playing a game of catch-up to the change in law that was made in advance of any serious inquiry into this matter.

Bill C-7, in the 43rd Parliament, was, of course, the Government of Canada's response to the Truchon decision. It specifically created a separate track in the Criminal Code for people whose death was not naturally foreseeable. Previous to that, one had to have a medical condition in which one's natural death was foreseeable, so essentially it was for people who were suffering terminal stage cancer, who were going through a great deal of suffering and so on.

It is important to note, though, that when the government first brought Bill C-7 in, there were already questions at that time, in advance of the legislation, about what we do with people who are suffering from mental illness, who have suffered, in some cases, as my colleague pointed out, for decades, for whom treatments have not worked. What were we to do with that?

In the original version of the legislation, by law, the government was required to have the bill accompanied by a charter statement, but mental disorders were specifically excluded from the original version of Bill C-7. The government provided what I thought at the time was a fairly well-reasoned charter statement. It was understood that by excluding this, one could potentially engage two prominent sections of the Charter of Rights and Freedoms, namely section 7, which is the security of the person, the fact that everyone essentially has the right to make a decision about what happens to their own body, and section 15, the equality clause, that the law has to treat everyone equally. With reference, those two sections may potentially be engaged by an exclusion.

The government identified the following in its charter statement:

First, evidence suggests that screening for decision-making capacity is particularly difficult, and subject to a high degree of error, in relation to persons who suffer from a mental illness serious enough to ground a request for MAID. Second, mental illness is generally less predictable than physical illness in terms of the course the illness will take over time. Finally, recent experience in the few countries that permit MAID for people whose sole medical condition is a mental illness (Belgium, Netherlands and Luxembourg) has raised concerns.

That is what the government's original position on Bill C-7 was.

The House passed Bill C-7 and it went off to the Senate. There, for reasons that remain shrouded in mystery to me to this day, the government decided to accept a Senate amendment, essentially at the eleventh hour, which had significant repercussions for the bill. Essentially, the Senate was reversing the government's original position on whether mental disorders qualified for MAID.

The government accepted that Senate amendment. Of course, Bill C-7, because it had been amended, had to come back to the House, and the government managed to cobble enough votes together to get it passed.

Therefore, we, as parliamentarians, were left with a law that had been changed in advance of the hard work being done to properly consult, research and discuss the issue with expert witnesses and with the health systems that have primary responsibility for the oversight of the change in law.

Yes, an expert panel was convened. The special joint committee was convened. Of course, its work was interrupted by the unnecessary calling of an election in the summer of 2021. Some very valuable time was lost there, because, of course, we then had to reconvene in the 44th Parliament, and a considerable amount of time was lost due to that.

However, it is important to realize that everything that has transpired since then has been as a result of that Senate amendment being accepted by the government. Again, I feel, and as a member of the special joint committee I think my feeling has some validity here, that we have been trying to play catch-up ever since that moment.

My time on the special joint committee has been difficult. It is not an easy subject for anyone to sit through, because the opinions of the people with lived experience and those who work in a professional capacity really are on all sides of the spectrum and everywhere in between. It can be quite difficult for a parliamentarian to work their way through that to try and understand the complex legal and medical arguments that exist behind this issue, but it is important.

I would say that, personally, my work on the committee has really been a struggle to find a balance between two concepts that sometimes seem to be in competition with each other. I am a firm believer in the Canadian Charter of Rights and Freedoms. I think it is a very important document in Canadian history, and I believe that we have to respect an individual's right to make decisions over their own body, but that belief system of mine was always struggling with another concept, which is that sometimes society finds itself in a position in which it is necessary for it to step in and protect its most vulnerable members. I think those two themes were echoed, not only for me but for many of the witnesses who appeared before our committee and in the many briefs we received.

I also want to note that our special joint committee has existed twice in this Parliament. We tabled our second report in February last year, in advance of Bill C-39. The committee's mandate at that time was guided by five themes that we had to look at, and mental disorder as the sole underlying medical condition was one of those. Of course, we were reconvened after the passage of Bill C-39, but as my colleague from Montcalm pointed out, our runway was extremely short. It did not do justice to the amount of time that we actually needed and to the extreme complexity of this issue.

Just to give this clarity for people listening, I believe our first meeting as a committee was on October 31, and we had to conduct some committee business, and elect the chairs and vice chairs. We really had only three three-hour meetings with witnesses, so nine hours of testimony. We excluded, by necessity, a lot of people who I would dearly liked to have heard from, namely administrators of our public health system, elected officials of provincial governments and so on.

Because of the short timeline, we did not even have enough time to properly translate all the submissions that were sent to our committee because, of course, before they can be distributed to committee members, they have to be translated into French and English. That is a requirement that honours the fact that we are a bilingual country. We, as committee members, did not even have the opportunity to review important submissions, and those submissions came from people who had lived experience, who were dealing with the situation at home, but they also came from many professionals whose practice is involved in this specific area.

I have taken a position on this. The member for Abbotsford, in the fall, had introduced Bill C-314, and I did vote for that, so my vote on this matter is quite clear. I have been informed by the fact that at our committee, there has been a significant amount of professional discomfort expressed by people who practice medicine in this area, psychiatrists and psychologists. Sure, some of them may be acting in a paternalistic way, but I do not think that can be applied equally to everyone. I think for some of them, we have to review their opinions. We have to take them in the context in which they are given. I think we have to afford them a measure of respect, given the fact that these are their lifelong career choices and, in many cases, we can measure their experiences in decades.

I want to take a little time to read from some of the testimony we received from witnesses. We did hear from Dr. Jitender Sareen from the department of psychiatry at the University of Manitoba, who was there also on behalf of psychiatry departmental chairs at the Northern Ontario School of Medicine, McMaster, McGill, Memorial University, the University of Ottawa and Queen's University. His testimony was that they strongly recommended “an extended pause on expanding MAID to include mental disorders...because we're simply not ready.” He was quite emphatic on the point that we are not going to be ready in another year.

Dr. Trudo Lemmens, who is a professor of health law and policy in the faculty of law at the University of Toronto, was there to clarify some constitutional arguments. He was really trying to underline the fact that we have to keep the section 7 and section 15 rights in balance with section 1 and that this issue has not actually been decided by the courts, contrary to what we heard from some witnesses. Previous speakers on tonight's debate have also pointed out that the Truchon decision did not include any reference to mental disorders. That is an important point we have to make.

Dr. Sonu Gaind, who is the chief of the department of psychiatry at the Sunnybrook Health Sciences Centre, pointed out that:

MAID is for irremediable medical conditions. These are ones we can predict won't improve. Worldwide evidence shows we cannot predict irremediability in cases of mental illness, meaning that the primary safeguard underpinning MAID is already being bypassed, with evidence showing such predictions are wrong over half the time.

Scientific evidence shows we cannot distinguish suicidality caused by mental illness from motivations leading to psychiatric MAID requests, with overlapping characteristics suggesting there may be no distinction to make.

He also commented on the fact that the curriculum used does not teach assessors to distinguish between suicidality and psychiatric MAID requests, and so on.

We also heard from Dr. Tarek Rajji; he is the chair of the medical advisory committee at the Centre for Addiction and Mental Health. He stated:

CAMH's concern is that the health care system is not ready for March 2024. The clinical guidelines, resources and processes are not in place to assess, determine eligibility for and support or deliver MAID when eligibility is confirmed to people whose sole underlying medical condition is mental illness.

These provide a snapshot of the widespread professional discomfort that exists out there, and I do not think we can discount those voices.

I would agree that there were also a number of professionals on the other side who did feel we were ready, and that is what makes this such an incredibly complex and sensitive subject to try to navigate as a parliamentarian. Again, we as a committee should have been afforded the time and space to really delve into these issues and to greatly expand our witness list to make sure we were in fact ready.

Members will note that our recent committee report had only one recommendation in it. I recognize that the recommendation was a result of the majority of the committee members. There were some dissenting opinions, notably from the senators who were part of the committee. However, the committee did recognize that Canada is not prepared for medical assistance in dying where mental disorder is the sole underlying medical condition, and we did not attach an arbitrary timeline to the recommendation. Our specific call was that MAID should not be made available in Canada until the minister of health and the minister of justice are satisfied, based on recommendations from their respective departments and in consultation with their provincial and territorial counterparts and with indigenous peoples, that it can be safely and adequately provided.

We keep getting ourselves into trouble by setting arbitrary deadlines for ourselves. Setting up an arbitrary timeline is not an adequate replacement for the qualitative work that needs to be done by these departments. I would much prefer that we satisfy the qualitative requirement in the recommendation, where departments, experts and our provincial and territorial colleagues are in fact saying that they are going to be okay with that.

The recommendation and my reference to the provinces and territories is a great segue to the fact that there was also a letter sent to the Minister of Health. It was signed by seven out of 10 provinces and all three territories. The signatures include those of all the ministers of health and ministers responsible for mental health and addictions in those provinces, including Adrian Dix and Jennifer Whiteside from my own province of British Columbia. They quite clearly say:

The current March 17, 2024, deadline does not provide sufficient time to fully and appropriately prepare all provinces and territories across Canada....

We encourage you and [the] federal Justice Minister...to indefinitely pause the implementation of the expanded MAID eligibility criteria to enable further collaboration between provinces, territories and the federal government.

I will wrap up by saying that this is a very sensitive issue. I do think we should pass Bill C-62 and honour the calls we are hearing from the professions intimately involved in this issue and the calls coming from the provinces and territories. We need to step up to the plate and make sure we have a fully ready system in advance of the changing of any laws.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

Madam Speaker, it is always a pleasure to rise on behalf of the people from Kamloops—Thompson—Cariboo.

Before I begin my question, I want to recognize the life of Rino Piva, from our community of Kamloops, who has passed away. He leaves behind his wife of 63 years, Dina, and his children, Laura, Dennis and Mario. I know them all well and wish them all the best in this difficult time of condolence.

I will move on to my question for my colleague. So many times, the Liberal government was told that we could not have MAID proceed in the manner that it did, yet the government pressed on. Why, does he believe, the government just did not listen?

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, honestly, I do not know.

I was here for Bill C-7. I thought the government's original position with respect to that bill was quite clear. For some reason, the Liberals did a complete 180 when it came to the Senate's amending the bill. To this day, I do not think I—

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

I have to give a chance for another question.

The hon. member for Montcalm.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I appreciate the comments of my colleague, who always speaks very calmly and moderately. It is a pleasure to serve with him.

The NDP voted against Bill C‑14, which did not address the Carter decision's requirements at all. Bill C‑7 met the Carter decision's requirements with additional changes that required hard work, to clarify the issue.

Is the NDP saying no to the idea of one day moving forward on mental disorders, or would it rather put the subject off indefinitely?

We could start working on this tomorrow morning, and I am convinced that within a year, we could come up with something very promising.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, I would love to see the committee be given the time and space to adequately explore this issue. I think that was what was lacking from the get-go.

I am not saying a firm “no”; I just have a problem with the arbitrary deadlines. Ultimately I want my decision to be informed by a fulsome discussion that involves a much wider array of experts and representatives of the provincial and territorial governments. That is what was lacking. We have been playing a game of catch-up ever since, and we are seeing the consequences of that through the deliberations on the bill.

The House resumed from February 7 consideration of the motion that Bill C-62, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2, be read the second time and referred to a committee.

[Élisabeth Brière, Liberal, Parliamentary Secretary to the Minister of Families]

Mr. Speaker, I am pleased to have the opportunity to rise in the House this evening in support of Bill C-62.

I will note, in particular, the government's commitment to respecting people's autonomy and personal choices, while supporting and protecting Canadians living with mental illness who may be vulnerable. I will also talk about the major investments that our government has made to improve access to mental health services for all Canadians.

We recognize that mental illness can cause suffering that is on par with suffering that results from a physical illness. That is not up for debate. We also know that persons with a mental illness are capable of making decisions with respect to their own health, unless individualized assessment suggests this capacity is lacking.

However, while we respect the autonomy of those who choose MAID in response to severe and irremediable suffering, we have an equally important responsibility to protect Canadians who may be vulnerable, including those suffering from mental illness or who are in crisis. That is why federal legislation provides rigorous safeguards and criteria that must be applied to all MAID assessments.

The experts who made up the expert panel on MAID and mental illness were of the opinion that the existing legal safeguards provide an adequate structure for assessing cases where a mental disorder is the sole underlying medical condition, provided those safeguards are interpreted correctly and applied appropriately. In its final report, the group made 19 recommendations, including the development of model MAID practice standards and training for clinicians.

Our government has made significant progress, in collaboration with the provinces and territories and other health care stakeholders, to implement the recommendations of the expert panel and to prepare for the expansion of MAID eligibility. However, the provinces and territories have expressed concerns regarding the current March 2024 timeline and are asking for more time.

The Special Joint Committee on Medical Assistance in Dying also recognized the progress made in preparing for the expansion of eligibility for MAID. However, as noted in the committee's recent report, it is recommended that additional time be provided to ensure that eligibility for medical assistance in dying can be safely assessed for individuals whose sole medical condition is a mental illness.

The three-year extension we are proposing in this bill will allow more time for the adoption and integration of the necessary resources, such as the model MAID practice standards and the training program recommended by the expert panel. This will ensure that MAID assessments for people with complex conditions, such as people suffering solely from mental illness, are conducted with the appropriate level of rigour.

I believe that any Canadian who is suffering grievously and wishes to consider MAID as an end-of-life option should be free to do so. I also think that, in parallel with the implementation of MAID for those who are assessed and deemed eligible, we also need to commit to improving our mental health care system.

As such, it is important for all Canadians who are struggling with mental illness and/or thoughts of suicide to have timely access to critical mental health resources. As parliamentary secretary, I am pleased to speak about our ongoing and future investments as well as progress being made on key interventions to support the needs of Canadians with regard to mental health and substance use care.

Budget 2023 confirmed the government's commitment to invest more than $200 billion over 10 years starting in 2023-24 to improve Canadians' health care. Of that amount, $25 billion will go to the provinces and territories through adapted bilateral agreements that will focus on four key pillars, including improving access to mental health services and addictions-related services. Other key investment include $598 million for a mental health and well-being strategy with distinction-based funding for indigenous communities, and $350 million for the substance use and addictions program since 2020.

Thanks to the mental health promotion innovation fund, the Public Health Agency of Canada is investing $4.9 million a year in community-based programs for mental health promotion focused on reducing systemic obstacles.

I am also very proud to recall that we have recently taken an important step to provide suicide prevention support for people who need it, when they need it most. Canada's new three-digit suicide crisis helpline, 988, launched on November 30, 2023. It is available to call or text, in English and in French, 24 hours a day and seven days a week across Canada. An experienced network of partners, as trained responders, are ready to answer 988 calls and texts. Responders provide support and compassion without judgment. They are here to help callers and texters explore ways to keep themselves safe when things are overwhelming.

We understand that the past few years have been hard and that many people have been struggling to cope. There is still a lot more to do, and we are committed to continuing to work with our partners to address Canadians' needs in the areas of mental health and substance use. In the future, we remain determined to improve access to mental health care services and to help those with substance use issues.

To that end, the Minister of Mental Health and Addictions and I met with a wide range of partners and stakeholders, including the provincial and territorial ministers responsible for mental health and addiction, to discuss their priorities and needs. This commitment will ensure that mental health and substance use services and programs are based on core expertise.

We have been listening to Canadians with lived and living experiences, to health care professionals on the front lines and to experts to make evidence-based investments and interventions to support timely access to mental health care needs. However, we recognize that no matter what treatments and services are available, sometimes they are not able to relieve intolerable suffering in a manner acceptable to an individual. That is when MAID may be an option for individuals who make a request and who are deemed eligible by two independent medical practitioners.

Ultimately, we are committed to respecting the personal autonomy of each and every Canadian, while protecting the interests of those who may need more care. The three-year extension we are proposing will enable us to do all we can to train and support clinicians who will assess complex cases, including those in which mental illness is the sole medical condition. In the meantime, we will continue to invest in resources and support for mental health and substance use problems.

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

Mr. Speaker, the fact the government had to put forward this legislation is a demonstration of its profound repeated failure on this file. Conservatives put forward a private member's bill, which was voted on in the fall, that would have forever killed this terrible idea of medically facilitated suicide for those with mental health challenges.

Government members, in the main, voted against that bill, and now they are coming back to the House. They have not learned the error of their ways. They do not recognize that, fundamentally, the medical system facilitating the suicide of those with depression and other mental health challenges is inconscionable. They have not realized that. Instead, they said that they just want a little more time to figure it out.

This is a terrible idea. It is never going to be a good idea, and they should have voted for the Conservative private member's bill to kill it when they had a chance. Nonetheless, we are ready to, after the next election, pass the legislation required to make sure this horrible idea never becomes a reality in Canada.

[Élisabeth Brière, Liberal, Sherbrooke, QC]

Mr. Speaker, with all due respect, this question demonstrates that the Conservatives are clearly not here to listen to Canadians.

I think it makes sense for our laws to adapt to the population's needs. That is particularly true in Quebec, which is even prepared to open up the right to advance requests. MAID has come a long way, both legislatively and in the opinion of the entire population, since the first iteration of the law came into force in 2016.

In contrast to the Conservatives, we are demonstrating that we are capable of adapting, that we listen to everyone's opinions and comments and that we ensure we take them into account while protecting those with additional needs.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, I have two questions for the member for Sherbrooke.

First, her minister acknowledged that Quebec's interdepartmental action plan for 2022-26 was excellent. We have heard a number of people here say that mental health services need to be improved. What is she waiting for to transfer the money to Quebec?

Second, given what our Conservative colleagues have said, does she realize that by postponing the decision until 2027, the Liberals are passing the buck to a potential future Conservative government that will put an end to any hope of relief for people suffering from mental disorders?

[Élisabeth Brière, Liberal, Sherbrooke, QC]

Mr. Speaker, I thank my colleague for his two questions. I would also like to acknowledge his exemplary and always highly professional work on this issue. Having sat in on several meetings of the Special Joint Committee on Medical Assistance in Dying, I have personally witnessed his passion for this subject.

As far as mental health transfers are concerned, we continue to make very significant investments. We are always working with Quebec to ensure that the money flows and is put to good use.

With regard to the second question, I would say that I truly and sincerely hope that the next government will be a Liberal government and that we can continue to move forward with the implementation of Bill C-62 and medical assistance in dying, both for advance requests and for people whose sole medical condition is a mental illness.

I agree with him that Quebec is truly one step ahead.

[Joël Lightbound, Liberal, Louis-Hébert, QC]

Mr. Speaker, it is a gripping topic. I think that very reasonable people can have different views.

My colleague just talked about Quebec, which is indeed one step ahead. However, let us not forget that in June 2023, the National Assembly voted in legislation that completely excluded medical assistance in dying for persons suffering solely from a mental illness, following testimony from psychiatrists from throughout Quebec. Psychiatrists from Université Laval in my riding shared with me their reservations about moving forward on this issue. In my view, what the government is suggesting today is to slow down because we are clearly not ready. There are so many questions that still need to be answered about opening up MAID for this specific category of patient.

Without being against MAID in general, I would like to know what she thinks about comparing what the government is doing and what the National Assembly of Quebec has decided.

[Élisabeth Brière, Liberal, Sherbrooke, QC]

Mr. Speaker, I thank my colleague for the great discussion that we had on this subject recently.

I agree with him. That is what Bill C-62 is for. This is a very controversial subject. Like my other colleagues, I get letters from various institutions and groups that show that there are differing opinions in our society about people whose only underlying medical condition is mental illness. We need to make sure that everything is in place, including standards, tools and practitioner training, so that patients' eligibility is properly assessed and practitioners are comfortable applying this measure.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Mr. Speaker, for a lot of us in the House, this feels like a case of déjà vu. It was pretty much a year ago that we were dealing with the exact same issue, and the government is doing the same thing, making the play to just punt the ball down the field yet again. Of course, it is talking about the issue of expanding assisted suicide to make it available for people suffering from mental illness. However, after the Liberals decided to open the door to that, they took a tiny step back and said, “We should wait for a year to go by before it can really begin.”

At that time, we Conservatives said, during the debate, that there was no possible way for one year to ever be enough time. For one thing, the Liberals rushed to expand MAID without carefully and thoroughly reviewing the concerns that already existed under the original program. That turned out to be another empty promise, and they recklessly pushed ahead with making assisted suicide more widely available. It became clearer than ever that they were not going to make any serious effort to protect vulnerable Canadians from all the harm that this new government decision will inflict.

One year is a very short amount of time, especially when the slow speed of bureaucracy is involved. At least now, the Liberals seem to finally realize that it was ridiculous for them to act as though this could just be delayed for a year and then everything would be fine. That year flew by quickly, and now we are back where we started. This time, they want to postpone it for three years instead of one.

When we hear the Liberals talk about this new bill, it is clear that they still have not learned the more important lesson from their terrible mistake. After the bill before us passes, the sad reality is that the Liberals have not closed the door that they opened a few years ago. They never should have opened it. In fact, it is quite the opposite: They are choosing to leave it open, despite all the red flags and the public outcry. It is the same game they were playing last year, except for one major difference: The Liberal plan to offer MAID for mental illness will come into effect after the next election. They have already indicated that this is what they want to happen eventually, if they get their way. However, they also know that they have pushed things way too far and that they cannot get away with it anymore. Enough is enough.

Canadians do not support the Liberals' out-of-touch agenda. This decision, like so many others, will make it harder for them to win another election. An Angus Reid poll discovered that three in 10 Canadians, fewer than the number who voted for the current government, support expanding MAID to those suffering exclusively with mental illness. Therefore, once again, the government will try to cover up its failure. While it tries to do that, Conservatives proudly stand on the side of common sense for the common people. We will reverse the government's terrible decision to expand assisted suicide. As the official opposition, we have already started to work on it.

Conservatives introduced Bill C-314 to repeal the Liberal plan to offer assisted suicide for mental illness once and for all. However, as expected, last fall, the Liberal government broke ranks with its coalition partner and voted it down. Even though it did not pass, it called the government's bluff. Liberals showed their true colours that day and made it absolutely clear where they stood. They are not interested in doing what it takes to protect the lives of Canadians who struggle with their mental health. The real reason for their delay is to use it as a stalling tactic for a government that is clearly in decline; despite that, we are glad to see that the bill will prevent tragic deaths from occurring before a Conservative government can bring in permanent protection for Canadians. We know that it needs to happen. There have been many troubling stories, which the government apparently chooses to ignore.

Last summer, a woman in Vancouver went to a hospital looking for support. She was experiencing suicidal thoughts and did not feel safe at home. During assessment, a clinician told her that there were not enough hospital beds and that the system was overwhelmed. Then she was asked: “Have you considered MAID?” She felt shocked and told her story, and I will read something she said in the Global News article. It reads: “No matter how much you struggle with mental illness or disability or chronic illness, no one should make a judgment about the value of your life or if it’s worth living.” That should not be a controversial thing to say, but the Prime Minister and his government have brought us to a dark place.

Only a couple of months ago, a 52-year-old grandfather who had cancer was waiting for chemotherapy and treatment. He was told there was a backlog, and the wait was taking longer than it should have. With worsening health complications, he applied for MAID and it went through. As members can imagine, the family was devastated by their experience.

There was also Corporal Christine Gauthier, a veteran and Paralympian, who called Veterans Affairs Canada to get a ramp installed. She was also asked to consider MAID. How did we get to the point where a veteran who served our country was told to consider ending her life instead of receiving the help she was seeking, something as simple as adding a ramp, for her own personal mobility? This is not the only time such a thing happened.

When something like that happens, it creates a situation that makes it more difficult for people to trust government services. When someone has these experiences or hears about them, it erodes their trust. Actually, it destroys their trust. During a personal crisis or a moment of weakness, they cannot help but worry that they will die because they simply spoke with the wrong person at the wrong time. That is a serious problem, and we should be working to fix it instead of making things worse.

We are heading down the wrong path, because the government's approach to this issue sends people a message of despair: that they should give up because their life is not worth living. With respect to that point, I hope everyone here will take heart in the story of Tyler Dunlop from Orillia, Ontario. At 37 years old, he had been homeless for years. He felt suicidal and planned to apply for MAID, but then he received some help in his life. Over time, he had a major shift in his thinking and experienced a spiritual transformation. After changing his mind to no longer seek assisted suicide, he released a new book, called Therefore Choose Life: My Journey from Hopelessness to Hope. We should all be glad that he is still here with us and can tell his story.

I want to share some of what he says in his book. He writes, “Though I had resigned myself to the fact that I'd be dead soon, my conscience—what has been called the voice of God—began to trouble me, the more I thought about MAID.” He goes on, “Around this time, much to my chagrin, I learned that the Liberal Party decided to postpone for one year the expansion of medically assisted death to Canadians with mental illness, so, like it or not, my appointment with death would have to wait.”

If not for the previous postponement, then, there is a good chance that Tyler would not be alive today. What if he had died so young, instead of simply receiving the help he needed and the compassion he was looking for? He has found a renewed sense of purpose and a new life through his Christian faith, thankfully escaping being yet another victim to a culture of death in which some people are considered more worthy of life than others. Now, he is able to share his story and his conviction that government can never replace God as the moral authority over right and wrong.

This is an encouraging story of survival, but there are more people out there who need our support. According to Statistics Canada, 4,500 Canadians die by suicide each year. That is 12 per day. That means 4,000 people struggling with mental disorders. What message will we send to those people who are at risk?

Then, there is the ongoing epidemic of addiction and substance abuse, which can officially be considered mental disorders. Will we allow assisted suicide to expand to the point that addiction makes somebody eligible? Where will it end? Life is precious and something that must be defended, especially when it is vulnerable Canadians who think that the only way out of the situation that they are in is death.

However, we are losing sight of that. The Liberals and their ideological allies blatantly ignored alarm after alarm raised by witnesses and community members at the Special Joint Committee on Medical Assistance in Dying, which is why Conservatives on the committee had to publish their dissenting reports. Despite attempts by the expert panel, which the government selected, to block key stakeholders or ignore committee testimony, we are working as hard as we can to represent these voices. Expert after expert and story after story have raised alarms, but the Liberals remain committed to their agenda, no matter what.

Canadians cannot trust them to fix what they have broken, but they can count on Conservatives to continue bringing hope and provide real help for those who are suffering. That is what our country needs right now. Our country needs hope.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Mr. Speaker, I listened to the member and I wonder, if he were to apply the same principles that he talks about with regard to Bill C-62 to MAID as a whole, whether he would actually support the legislation with that particular amendment, even if it were taken out. Would he apply those same principles that he was talking about to the MAID legislation as a whole?

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Mr. Speaker, there are a few important points that we need to talk about first.

First of all, the Liberals did not actually complete the mandatory review that the original legislation had. If that review had happened properly, I would be willing to bet that we would not be where we are today.

The next point I want to make is that a couple of years ago the government promised $4.5 billion or maybe $6 billion for mental health. I do not remember the exact amount. I stand to be corrected, but as far as I am aware, so far, it is zero dollars. The government talks about making sure there are supports there for people with mental health, but the only support I am aware of right now is the 988 hotline that my Conservative colleague has been able to get in place.

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

Mr. Speaker, what the parliamentary secretary fails to acknowledge is the many ways in which the government's policies on euthanasia have been a profound failure.

In fact, it has been repeatedly called out, not only by those who are concerned about the impact on those struggling with mental health challenges, but also by those within the disability community, which has been nearly unanimous in their criticism of the government's approach. The disability community has identified how the approach the government is taking is undermining the services that they wish to access, and it is in fact devaluing the lives and contributions of people living with disabilities. The Liberal government and the parliamentary secretary need to acknowledge that.

I want to ask the member a question. There were some very specific constructive proposals around this in the last Conservative election platform, things such as how a doctor should not be bringing up and proposing MAID to someone who has not asked for it. At a minimum, if there is going to be a conversation about euthanasia, it should be initiated by the patient. It should not be something a doctor, someone in the health care system or someone who works for a government department, such as veterans affairs, is suggesting to them.

Does the member agree that one reasonable reform would be to say that it should be the patient bringing up the conversation, if it is a conversation they want to have, not somebody else bringing it up and suggesting death to them?

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Mr. Speaker, absolutely, if the euthanasia framework is going to be in place, to me, that is the only way that it should be in place. The patient needs to be the one who is initiating the conversation.

The fact that multiple government departments are on record as asking people or offering people medical assistance in dying is absolutely absurd. That speaks to all kinds of levels of failure from the Liberal government. There are people who cannot find a home who are looking for medical assistance in dying. Veterans have been offered medical assistance in dying. For somebody who could not receive health care to treat cancer, and it is not like cancer is some rare disease in this country, but this person could not receive treatment for cancer, and he chose MAID instead, even though he did not necessarily want it but because he was unable to get treatment that should normally be readily available for him.

That is ridiculous. The number of failures by the Liberal government is absolutely ridiculous.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, some Conservatives seem to think the Criminal Code no longer exists. We have had these debates before. When someone nefarious is working in the health care system, they simply need to be fired and reported to the police. That can happen. The provisions are there.

I therefore invite my colleagues who know of cases like this, which are always very specific cases, to report these people to the police. Are we going to generalize to such an extent that we are going to prevent any suffering person from asserting their right to self-determination and deciding what is good for them when it comes to something as intimate as their own death?

It is odd that Conservatives are libertarians when it comes to economics, yet when it comes to moral issues, they think the government needs to be in charge.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Mr. Speaker, I would certainly hope that anybody who is found to be pushing MAID on somebody when they do not actually want it would be charged. They should be charged because that is absolutely ridiculous.

I do not have any faith that that would actually happen. I think there are so many ways that people can get around that, or just say that they were simply initiating a conversation, that it was just a kind of a comment or that they thought they had consent from them to be able to talk about it. There are so many vagaries that could be introduced for people who are offered that.

At the end of the day, it comes down to this main point: The government exists, in part, to protect Canadians. It should be offering hope, not death.

[Marie-Hélène Gaudreau, Bloc, Laurentides—Labelle, QC]

Mr. Speaker, I am going to try to recover from that. It is a good thing I wrote down a few words, because I have a lot to say tonight. My goal is for those who do not want to listen to me to leave the chamber. They can listen to my speech again tomorrow morning when they are feeling good and ready to hear about the beauty of life and something that is part of life.

I will start with this. As we have said many times this evening, Quebec is ahead of the curve when it comes to these matters. It has been 10 years since the Quebec National Assembly passed medical assistance in dying, based on the work of the Select Committee on Dying with Dignity.

Dignity is about respect for the individual. Dignity is the foundation of the issue we are talking about. Neither partisanship nor any creation dictates who we are. We are talking about human dignity.

I hope that my colleague who just left and who had another point of view on the issue will have the opportunity to listen to the interpretation of my speech. This is a very sensitive issue. It is a social issue with serious consequences. That is why it is important. That is why the work that my colleague did and that the entire special joint committee did is important. They realized that there was a little something missing to ensure that there are no flaws in the process concerning the choice of our lives. We are talking about dying, but it is our life. Who can make decisions about our life?

It is vital to understand that society as it is today is moving forward much more quickly than legislators are. That is a fact, so we have to have the courage to act. We took an extra year. What concerns me is that we cannot know where we will be in three years. Can we get a guarantee on that promise? When my constituents talk to me about promises, they say that they will believe it when they see it. People are suffering now. We need to act now.

I am addressing all of my colleagues. Let us get this straight.

I am sorry to bother my colleagues, but what I am saying is very important. It is late and we are all going to bed soon. I am sorry, but this issue affects me deeply.

[An hon. member]

It is a matter of respect.

[Marie‑Hélène Gaudreau]

Yes, Mr. Speaker, it is a matter of dignity and respect.

The role of the government is not to claim to know better than an individual what is good for that individual concerning something as personal as their own death. We are talking about people enduring intolerable suffering, sometimes for decades. I am not talking about a headache. Who are we to know what is good for them? If we could agree on that at least, we could probably make a lot of progress. Maybe partisanship would be set aside for once.

Dying is part of life. The only thing a human being knows when they are born is that they are going to die. Am I telling my colleagues anything new? The answer is no.

Having the right to choose for oneself, based on one's values and level of suffering, is that possible in a free country, or in any case a very free Quebec? It is essential. In Quebec, we have a consensus. Quebec society is ready. Quebeckers have been looking at this for decades.

Just because other provinces want to intervene on this issue does not mean we have to infringe on the rights of people who are ceaselessly crying out to us for help.

My father said, “I can't live in this coffin any longer”. He had ALS. I think MPs are familiar with this disease, as one of the members suffered from it a few years ago. “My body can't take it anymore. I want to live, but I can't stand the suffering anymore.” That is the crux of the issue. There are still certain pieces missing, particularly when it comes to expertise. There are still pieces missing when it comes to ensuring there is no bias when the choice is made.

In 2015, when my father requested MAID, he was not eligible. ALS is a death sentence, but no one knows when the disease will progress to the terminal stage. His death was a long, drawn-out process.

My father always said that human beings must be respected throughout their journey. How does it feel to see someone suffer? We want to help and support them, but when we know there is no way out, no treatment, no hope, what do we do? Some will say that these people must continue to suffer and simply wait for death to come. My father used to say that he was living in his coffin. My father's illness changed my life because I witnessed it for 20 years.

I agree that we need to address the process. What is left to do? We need a few more meetings. That is what we have been hearing for the past few days. I invite members of the House to reach out to someone who has experienced this process first-hand with a loved one. That is what I went through with my father. Above all, we must avoid talking drivel. I often hear remarks that I will not repeat. Who are they to say such unbelievable things?

I will conclude my speech with the following. When people are suffering unbearably, when science does not allow them to have any hope, they must have a choice. It is a matter of solidarity, humanity, altruism and compassion. That is why, this evening, in light of everything I have just said, I move the following amendment:

That the motion be amended by deleting all the words after the word “That” and substituting the following: “the House decline to give second reading to Bill C-62, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2, as no clause addresses the call for the Government of Canada, adopted unanimously by the Quebec National Assembly, to amend the Criminal Code to align with the Quebec legislation on end-of-life care by allowing advance consent requests.”.

[The Deputy Speaker, Chris d'Entremont]

The amendment is in order.

Questions and comments.

The member for Louis-Hébert.

[Joël Lightbound, Liberal, Louis-Hébert, QC]

Mr. Speaker, I sincerely want to thank my colleague for her speech. I believe that this is an issue where the debates are particularly instructive for members. We have been dealing with these matters in the House of Commons since 2016 and my position has changed over time, including on advance requests.

I think I still need to study the issue, but I understand that this can be useful in some cases. I have met people who could have used this. I have heard some very touching stories, even from people close to me, about people who could use this. However, on the subject of mental illness, my position has also crystallized. Many psychiatrists have told me that this track was not necessarily desirable, that it was far too difficult to gauge the irremediability of a mental illness.

My colleague mentioned the consensus in Quebec. Yes, there is one on advance requests. However, as far as mental illness as a sole reason for opening the door to medical assistance in dying goes, the National Assembly of Quebec did vote in Bill 11, in June 2023, as my colleague mentioned. It excludes mental illness because there is in fact no consensus within the medical community. Some members of that community shared their deep concerns with me about opening up MAID for this.

I would like my colleague's thoughts on that.

[Marie-Hélène Gaudreau, Bloc, Laurentides—Labelle, QC]

Mr. Speaker, as for that vote, I want my colleague to know that it came out to 57%. Also, the member should be careful when talking about provisions that exclude mental disorders. It is time to get educated. Tomorrow morning, I am going to talk about advance requests.

Let us imagine that I have been diagnosed with Alzheimer's disease and I choose not to put my loved ones through that. The day I am no longer able to recognize my children or I act a certain way because I do not recognize myself and have no awareness of my situation, a whole host of specialists will come on the scene. I experienced that with my father, who, incidentally, had no dementia whatsoever. Falling through all those safety nets means far more exclusion than acceptance.

When it comes to mental health, again, what we might need to do is dig a little deeper and ensure we have all the tools to reassure people. They need to know that this is not a slippery slope to culling the herd, as some people are saying.

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

Mr. Speaker, there have been a lot of presumptive comments made in the House about what the people think or want. I do think it is important to just say, at the outset, that every poll that has been done, that I have ever seen, shows that a substantial majority of people in this country do not support the expansion of euthanasia to include those for whom mental health is the sole underlying condition.

I do want to ask the member about advance directives. I think there is a lot of misinformation and confusion around the issue of advance directives. The idea of advance directives implies that I could know how my future self would feel under the conditions of a particular disease or challenge. Garnett Genuis today, at age 37, could know for sure what a future version of himself would want, in terms of life or death, if he were to experience dementia, Alzheimer's or something like that.

The reality is I have no idea what that future person would want in that situation. The idea that a present person could bind a future self under different circumstances to die in a particular situation is a radical denial of autonomy. It makes my present self the dictator over my future self. A position of autonomy emphasizes the legitimacy of consent in the moment, but not the denial of autonomy in which a prior version of self binds the future self.

[Marie-Hélène Gaudreau, Bloc, Laurentides—Labelle, QC]

Mr. Speaker, when members talk, they should at least have a basic knowledge of the medical context, of what is happening on the ground. Unfortunately, it is pretty clear that we do not all have the same basic knowledge. I therefore cannot answer my colleague. Does he even know what an advance request is?

I hear them talking about euthanasia. We are not talking about the same thing. We need to be on the same planet to have a dialogue. I think we need to look at this in committee. At the same time, given that Quebec is ready, we need to be allowed to do as we see fit.

All the Conservatives have to do is mind their own business. When they form government 10 years from now, they will say no. As for us, we will be free.

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Mr. Speaker, we are here today because without immediate intervention by Parliament, the expansion of medical assistance in dying to individuals whose sole underlying medical condition is a mental disorder will come into force on March 17. That is only a few weeks away, at a time when this country is experiencing a mental health crisis, the isolation of seniors, toxic drugs poisoning people in communities across Canada, inadequate OAS increases and still, unfortunately, and hard to imagine, no Canada disability benefit in place for people living with disabilities who are also living in poverty. The necessary safety social nets are missing, yet we are having a debate about an extension to medical assistance in dying.

Why is the fact that the social safety net not in place so important? People in Canada deserve the dignity to live healthy lives and to live lives where they are not in poverty.

I want to talk about the Canada disability benefit because the budget is coming. The next budget is coming very soon, and it is the expectation of the NDP and the expectation of Canadians that the Liberal government will live up to its commitment, its promise made in 2015, that there would be a Canada disability benefit. Too many people in the disability community are waiting for this disability benefit to lift them out of poverty. When I say too many, even one is too many.

I am encouraging the Liberal government, which I know is listening closely to this debate, to actually do something and to get the Canada disability benefit into the pockets of the people who need it in this country so that we can start to have serious conversations about how to advance medical assistance in dying. We certainly cannot do it in the middle of a mental health crisis, while our communities are being poisoned by toxic drugs and while people living in poverty with a disability have no social safety net and no reliable income.

I also think it is a disgrace, at this point in time, that the Liberal government is not considering the impacts of these clawbacks on persons with disabilities and anyone who is living on the poverty line, who are relying on social benefits, which they are entitled to, from the federal government, which are being rolled back. I think specifically about CERB at this point in time. We know that many Canadians, in good faith, applied for the CERB and got the CERB. We now have a federal government that has decided it is a good idea to start targeting people already living in poverty to get their CERB back.

They know these people are living in poverty. They know the incomes of these people and they continue to go after them. At the same time, they are giving free rides to corporate CEOs who are taking home millions of dollars a year in salaries and bonuses, and not looking at the way they took wage subsidies and gave them away to their shareholders and in their own bonus packages.

I think about Air Canada specifically. The government decided to give it a bailout during the pandemic. Air Canada said that the government could have it back because the government is not allowing it to give it to its executives as bonuses. These are the choices that the federal government is making. It is giving CEOs and large corporations the regular free ride while targeting people living in poverty.

Today, I was reading the report from the federal housing advocate. Human rights are being violated right now. We are talking about the expansion of MAID for mental illness as the sole condition, and I put a big blame on the Conservatives here because I have been sitting in a number of studies in HUMA, on housing. We know that the Conservatives walked away and lost 800,000 units of affordable housing in this country.

Conservatives are the instigators of the problem that is manifesting on the ground right now that the Liberals did not fix when they came into power. The housing advocate said that Canadians' human rights are being violated because they do not have access to housing. It is despicable. If our country cannot use our natural resources to make sure that people are not living in tents outside the airport in Vancouver, that is totally unacceptable. I blame both the Conservatives and the Liberals because they know what has been happening, that it has been happening for decades and they have done nothing about it.

The housing advocate told the government that a national encampment response plan needs to be in place by August 31. I am sorry to say that, based on the speed at which the Liberal government moves, that is highly unlikely. I hope it takes up the challenge from the federal housing advocate, because no one should have to live in an encampment without access to clean water, waste removal and garbage pickup. We would think the federal government could at least support cities with respect to garbage pickup so people have access to clean spaces when they are forced into a tent encampment. I would ask the Prime Minister and any of the Liberal MPs to walk down Wellington Street, the ByWard Market or Sparks Street. They walk by these people every single day and do nothing.

We know that the health ministers across the country are concerned about this bill before us today. We also know the Liberal government is playing snail mail on pharmacare, the pharmacare that can help people with their mental health and help people take their medication properly so they can be healthy. The Liberal government has decided that is something that is going to snail along. Again, the deadline is very short on that.

We are talking about these social safety net pieces the Liberal government is moving at a snail's pace on, and the Conservatives are to blame for the conditions of the housing market and housing for people in this country right now. I want to highlight that Conservatives also voted against every single social program and initiative that came out in the fall economic statement and the budget. They say that they care about people; meanwhile, they are voting against everything that would help people, including food. They have decided they do not want to support a national school food program. How do we expect to have debates that matter to people in Canada when we cannot make sure that kids are fed and people live in homes? That is what the Liberals and Conservatives have done.

I want to read something that I received from a mental health worker in my riding who reached out to me. She said, “I implore the government to reconsider this expansion...and to engage in a meaningful dialogue with mental health professionals to safeguard the well-being of...Canadians, especially the most vulnerable”.

I implore the Liberal government, and the Conservatives who continue to try to stall social programs and initiatives the NDP is working to advance in this House, to take this seriously. We know that, as we stand here in this House today having this debate, we have a toxic drug supply in this country that people are reaching out to because they do not have the medications they can afford as there is not a national pharmacare program in this country.

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

Mr. Speaker, I agree with the member that many Canadians are struggling right now. I would challenge her to reconsider her participation in the confidence and supply agreement with the government as a result. Maybe we will have to agree to disagree on whether more federal spending on federal bureaucracy, sticking its nose into provincial jurisdiction, is actually going to improve the lives of, for instance, kids who are hungry in schools.

I want to ask the member about the bill before us, Bill C-62, and the situation around euthanasia and facilitated suicide in Canada. Because of the challenges we are seeing, with people facing pressure and people being offered or having euthanasia pushed on them, in our last election platform, Conservatives proposed that we would protect the right of patients to choose to receive care in a MAID-free environment. That is, by protecting the conscience rights of physicians and health care institutions, we would preserve the right of patients to choose to be in a hospice or a health care facility where they know they would be offered life-affirming care.

There are many Canadians, I think, who want that. They do not appreciate being in a situation where government bureaucrats, health care officials or bureaucrats in other departments are pushing, promoting or encouraging them to choose a path they do not want to take.

Does the NDP support our proposal to protect the right of patients to choose to receive care in euthanasia-free or MAID-free spaces?

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Mr. Speaker, as the member of Parliament for Port Moody—Coquitlam, Anmore and Belcarra, I can tell colleagues that, every day, when I come to this House, I work for the residents of my community. Just last week, there was an announcement of $25 million from the housing accelerator fund that came into my riding. I worked on that in conjunction with the HUMA committee and as a part of the confidence and supply agreement. It would not have happened if the NDP were not working and forcing the government.

What the Conservatives did was to have a peaceful protester physically assaulted, roughed up, when the Leader of the Opposition, the leader of the Conservative Party, came to my riding. It was totally unacceptable for their leader to come to my riding and physically have their people manhandle someone.

I did not appreciate it and—

[Damien Kurek, Conservative, Battle River—Crowfoot, AB]

Mr. Speaker, I rise on a point of order. That is an outrageous accusation. I would urge you, Mr. Speaker, to ensure that we maintain the respect and decorum that should be accorded this place. For the member to make accusations as she just did not only demeans the Leader of the Opposition but also discourages members in this place from being able to—

[The Deputy Speaker, Chris d'Entremont]

I appreciate the help, but that is descending into debate. I would also suggest to people here this evening to stick to the bill at hand, Bill C-62, which we are counting down to really quickly.

Questions and comments, the hon. member for Louis-Hébert.

[Joël Lightbound, Liberal, Louis-Hébert, QC]

Mr. Speaker, I apologize to the parliamentary secretary. He is used to this, but I think he can make room for others.

I fully agree with my colleague on many things. We need more mental health resources and more access to care. There are several socio-economic factors that can exacerbate mental illness.

As far as today's bill is concerned, I would like us to look at things from another angle. Let us look at the genesis of what brought us to include mental illness as grounds to request medical assistance in dying. It came from a Senate amendment that, in my opinion, should not have been accepted by the government. I do not want to make any assumptions, but we are hearing rumours that senators might try to block what could be the will of the House to delay this for three years, as Bill C‑62 seeks to do.

What is my colleague's opinion about the role the Senate should play with respect to the House, whose members are duly elected to make decisions?

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Mr. Speaker, what we need to do here is to start thinking about the future and start reacting to what needs to be done now. We have a very small window to save people from this expansion.

We need to get social programs in place before we do any more expansions on this type of program.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, it is being said that we must move quickly to adopt Bill C-62 to save people. I am all in favour of implementing social programs to save people, but does the member have a different point of view from the Conservatives right now? If we invest in social programs, will people all of a sudden get relief after 30 years of suffering and inadequate treatment?

The accessibility of frontline services is another debate. How can we shut down debate today by claiming that, if ever we move forward with expanding MAID eligibility to people with mental disorders, then that would be an affront to people's integrity, when the fact is that MAID is voluntary? What is more, there are people who are going to examine the request and, if a person is suicidal or receiving care for the first time, then they will not have access to medical assistance in dying.

I am trying hard to make people understand that just because a person makes a request does not mean that they will be eligible. When the member says things like that, how does she think that her point of view differs from what we have been hearing from the Conservatives today?

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Mr. Speaker, I will just go back to the comment from one of my residents who said that they are imploring “the government to reconsider this expansion...and to engage in a meaningful dialogue with the mental health professionals to safeguard the well-being of...Canadians, especially the most vulnerable”.

[The Deputy Speaker, Chris d'Entremont]

There being no further members rising for debate, pursuant to order made earlier today, it is my duty to interrupt the proceedings and put forthwith every question necessary to dispose of the second reading stage of the bill now before the House.

The question is on the amendment.

If a member participating in person wishes that the amendment be carried or carried on division, or if a member of a recognized party participating in person wishes to request a recorded division, I would invite them to rise and indicate it to the Chair.

[Richard Bragdon, Conservative, Tobique—Mactaquac, NB]

Mr. Speaker, we request a recorded division.

[The Deputy Speaker, Chris d'Entremont]

Pursuant to order made earlier today, the division stands deferred until Wednesday, February 14, at the expiry of the time provided for Oral Questions.

It being 10:09 p.m., pursuant to an order made earlier today, the House stands adjourned until tomorrow at 2 p.m. pursuant to Standing Order 24(1).

(The House adjourned at 10:09 p.m.)

The House resumed from February 13 consideration of the motion that Bill C‑62, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2, be read the second time and referred to a committee, and of the amendment.

[The Speaker, Greg Fergus]

It being 3:23 p.m., pursuant to order made on Tuesday, February 13, the House will now proceed to the taking of the deferred recorded division on the amendment of the member for Laurentides—Labelle.

Call in the members.

[The Assistant Deputy Speaker, Carol Hughes]

The question is as follows. Shall I dispense?

[Some hon. members]

No.

[The Assistant Deputy Speaker, Carol Hughes]

[Chair read text of amendment to House]

(The House divided on the amendment, which was negatived on the following division:)

Vote #640

[The Assistant Deputy Speaker, Carol Hughes]

I declare the amendment defeated.

The next question is on the main motion.

If a member participating in person wishes that the motion be carried or carried on division, or if a member of a recognized party participating in person wishes to request a recorded division, I would invite them to rise and indicate it to the Chair.

[Ruby Sahota, Liberal, Brampton North, ON]

Madam Speaker, we request a recorded division.

(The House divided on the motion, which was agreed to on the following division:)

Vote #641

[The Assistant Deputy Speaker, Carol Hughes]

I declare the motion carried.

Pursuant to order made on Tuesday, February 13, Bill C‑62, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2, is deemed referred to a committee of the whole, deemed considered in committee of the whole, deemed reported without amendment and deemed concurred in at report stage.

(Bill read the second time, deemed referred to a committee of the whole, deemed reported without amendment and deemed concurred in at report stage)