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.

Medical Assistance in Dying

[Luc Thériault, Bloc, Montcalm, QC]

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

[Luc Thériault, Bloc, Montcalm, QC]

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

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

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

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

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

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

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

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

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

The committee report states the following, and I quote:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Message from the Senate

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

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

Business of the House

[Steven MacKinnon, Liberal, Leader of the Government in the House of Commons]

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

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

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

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

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

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

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

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

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

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

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

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

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

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

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

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[The Deputy Speaker, Chris d'Entremont]

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

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

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

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

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

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

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

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

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

[Mike Morrice, Green, Kitchener Centre, ON]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Andréanne Larouche, Bloc, Shefford, QC]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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