Bill C-7

An Act to amend the Parliament of Canada Act and to make consequential and related amendments to other Acts

This enactment amends the Parliament of Canada Act and makes consequential and related amendments to other Acts to, among other things,
(a) change the additional annual allowances that are paid to senators who occupy certain positions so that the government’s representatives and the Opposition in the Senate are eligible for the allowances for five positions each and the three other recognized parties or parliamentary groups in the Senate with the greatest number of members are eligible for the allowances for four positions each;
(b) provide that the Leader of the Government in the Senate or Government Representative in the Senate, the Leader of the Opposition in the Senate and the Leader or Facilitator of every other recognized party or parliamentary group in the Senate are to be consulted on the appointment of certain officers and agents of Parliament; and
(c) provide that the Leader of the Government in the Senate or Government Representative in the Senate, the Leader of the Opposition in the Senate and the Leader or Facilitator of every other recognized party or parliamentary group in the Senate may change the membership of the Standing Senate Committee on Internal Economy, Budgets and Administration.

[Arif Virani, Liberal, Minister of Justice]

Thank you very much, Mr. Chair. I'm pleased to be here to speak to Bill C-62, which proposes to delay for three years, until March 17, 2027, the expansion of the eligibility of MAID to persons whose sole underlying medical condition is mental illness. As members will be aware, this bill also requires that a joint parliamentary study be undertaken on the topic, by a mixed committee of Senators and MPs, approximately one year before the new date of expansion.

I will start by expressing my sympathy for anyone experiencing intolerable suffering. I acknowledge that mental illness can cause the same level of suffering as physical illnesses, and that having a mental disorder does not mean that an individual does not have decision-making capacity. Everyone deserves dignity and respect.

As this health committee is aware, the Supreme Court of Canada's decision in the Carter case led to the legalization of medical assistance in dying in Canada. In that decision, the Supreme Court declared the Criminal Code's absolute prohibition at the time on physician-assisted death to be unconstitutional, noting that it should be available to competent adults who clearly consent to the termination of life and who have a grievous and irremediable medical condition. That led to Canada's first MAID law in 2016. Many members were here with me in 2016 when we enacted that law, which restricted eligibility for MAID to persons whose natural death was “reasonably foreseeable”.

A few years later, in the Truchon decision, a trial court in Quebec ruled that the reasonably foreseeable natural death requirement was unconstitutional.

The federal government didn't appeal the decision. Instead it made the general political decision to introduce Bill C-7 to expand eligibility for medical assistance in dying to persons whose death wasn't reasonably foreseeable. When it was introduced, the bill permanently excluded from eligibility for MAID persons whose only underlying health issue was a mental illness.

During consideration of the bill, the Senate introduced an amendment to make that exclusion temporary. The House of Commons supported the amendment, and the bill, as adopted, would automatically have nullified the mental health exclusion two years later.

I want to be clear about something, which is that the government's decision to go forward with those expansions at the time was a matter of social policy. I appreciate, though, that there are those who believe that the charter required us to act in this regard on mental illness, and I want to address this point directly.

MAID is a complex and deeply sensitive topic, and there are important charter-protected interests that arise in this area. On the one hand there is the autonomy and dignity of individuals in making end-of-life decisions. On the other hand, there is the protection of those who are vulnerable and who might be at risk in a permissive regime. In its decision in Carter, the Supreme Court recognized the complexity of legislating in this area and suggested that Parliament's choices on how to balance these competing interests would be given a high degree of deference.

MAID is particularly complex in the context of mental illness. As noted in the various MAID-related charter statements, these inherent complexities are the basis for the mental illness exclusion. Some of the complexities include that the course a mental illness may take is more difficult to predict than that of a physical illness and that many people with a poor prognosis will improve, at least in terms of their suffering, which may alter or impact their wish to die. Moreover, distinguishing routine suicidality and a valid request for MAID becomes particularly challenging when suicidality may be a symptom of the mental illness that led the person to request MAID in the first place.

The MAID mental illness exclusion is not based on harmful assumptions nor stereotypes about mental illness. We recognize, as Minister Holland just said, that the suffering mental illness can cause is on par with the suffering that physical illness can cause. This exclusion is not a denial of this fact. We also accept, as I said at the outset and as I repeat here again, that the decision-making capacity of those who are mentally ill is well established.

As we have said, we do believe the exclusion should be lifted when the health care system is ready to manage the inherent risks and complexities of assessing requests for MAID that are based on mental illness alone. Our provincial and territorial partners agree that more time is needed. Medical experts agree that more time is needed. The lack of consensus on this issue proves that more time is needed.

This bill reflects the caution required to ensure the safety of Canadians and to get this right. As the interests at stake are significant and the consequences, Mr. Chair, are permanent, we must get this right.

Thank you very much.

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

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, my colleague gave us a history lesson.

He said that his party was not able to move forward because there was an election. I would point out to him that Quebec has had two elections in those six years. That did indeed delay the work, as he will agree. However, I do agree with him that Quebec's approach crosses party lines and is far more thorough.

Some people complain about the delay associated with the Carter decision, but that is because this Parliament never took the opportunity to try to change the Criminal Code before there was a court order. It never had the courage to do that, and so we were then stuck with a court order. Mr. Lametti did not stand up solely because the bill did not go far enough. He stood up because it violated patients' constitutional rights. Bill C-7 corrected that.

I would like my colleague to explain what he is advocating when it comes to advance requests for MAID. Does he think that the government, which had a year to introduce legislation, could have included that component in this bill?

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

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

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

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

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

Madam Speaker, the decision to expand MAID in the case of mental illness was not a decision of the courts. It was a political decision made by the Liberals. That is evidenced by the fact that the government's initial legislative response, Bill C-7, expressly excluded MAID for mental illness in response to the Truchon decision, which was not an appellate decision, as the member said, but a lower court decision that, yes, the government should have appealed.

We have heard from experts the fundamental clinical issues, including the difficulty, if not impossibility, of predicting irremediability as part of the reason why there was a one-year delay. It is part of the reason why now the government is kicking the can down the road with a further three-year delay. What evidence can the member cite that the issue is going to be resolved in three short years?

[Ed Fast, Conservative, Abbotsford, BC]

Professor Kaiser, you have in the past stated that the voices of indigenous Canadians have been ignored as the discussion of Bill C-7 has moved forward. Can you comment a little further on the degree to which indigenous communities have or have not been consulted on the expansion of MAID to the mentally ill?

Criminal Code

[Ed Fast, Conservative, Abbotsford, BC]

moved that Bill C-314, an act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

Mr. Speaker, I am pleased to speak to my private member's bill, Bill C-314, the mental health protection act.

In its very essence, this bill is about reaffirming the dignity and worth of each and every human life. It is about recognizing that it is the most vulnerable among us, the disabled and the mentally ill, to whom we owe the greatest duty: to defend and protect their lives and to provide them with every possible opportunity to live life to the fullest.

Medically assisted suicide was legalized in Canada in 2015 by the Supreme Court's Carter decision and later under the Liberal government's Bill C-14. Under this legislation, medical assistance in dying, or MAID, as it is commonly called, was strictly limited to those consenting adults who had an incurable disease that caused enduring, intolerable suffering that could not be alleviated, and where natural death was reasonably foreseeable, which they call the foreseeability test.

At the time, the government and its supportive stakeholders assured Canadians that this was not a slippery slope, where the scope of MAID would continually be expanded to include more and more vulnerable Canadians. However, not surprisingly, in the intervening eight years since the Carter decision, the government has begun to expand Canada's MAID regime to include more and more defenceless Canadians, most particularly those living with disabilities.

In late 2019, a Quebec lower court judge in the Truchon case ruled that the foreseeability test I just mentioned was unconstitutional, requiring Parliament to respond with additional legislation. Sadly, the Liberal government chose not to appeal the Truchon case to the Supreme Court of Canada, presumably because the decision lined up with the Prime Minister's intent to dramatically expand assisted suicide to other vulnerable Canadians. This leaves us with the perverse situation in which the Supreme Court of Canada, the highest court in the country, has never been allowed to opine on whether the reasonable foreseeability test is constitutional.

In any event, the Liberal government responded to Truchon by tabling Bill C-7, which initially eliminated the foreseeability test but expressly excluded mentally ill persons from being caught up in its MAID regime. Here is what the justice minister said at the time:

The fact that there would be risk of ending the life of a person whose symptoms would have improved...is, in part, why we are of the view that it is safest not to permit MAID on the sole basis of mental illness.... There is also ongoing uncertainty and disagreement as to the potential impact on suicide prevention if MAID were made available to this group.

He went on to say:

...there is no consensus among experts on whether and how to proceed with MAID on the basis of mental illness alone. On a question of such importance and with so much uncertainty and expert disagreement, it is incumbent upon us to proceed with caution and prudence.

Those were our justice minister’s views until the unelected Senate suddenly introduced an amendment that expanded MAID to those Canadians whose sole underlying condition is mental illness. Sadly, the justice minister and the government accepted the amendment without protest and, overnight, became zealous proponents of assisted death for the mentally ill. What happened to the caution and prudence the minister was preaching? What about the impact on suicide prevention the minister was so concerned about? What happened to his view that it was safest not to permit MAID on the sole basis of mental illness?

I agree with the Minister of Justice on one thing, which is that, as he has said, this is indeed a complex issue and is deeply personal. It is deeply personal because it involves life, a precious human life.

I would remind the minister and his government that the issue is also profoundly simple; that is, the principle that all life, all human life is precious and worthy of defence and protection, especially for those who do not have the ability to speak for themselves and have no one to speak for them.

One of the primary functions of government is to protect its citizens, to protect life. In fact, the right to life is expressly enshrined in section 7 of our Charter of Rights. Sadly, the government's Bill C-7 fails to protect the lives of our most vulnerable. It removes the critical safeguards that the original euthanasia legislation included in response to the Carter decision. Removing those safeguards will have irreversible consequences for those who suffer from mental illnesses like depression.

What is equally disturbing is that the Liberal government has also signalled its intention to extend the so-called “treatment option” to minor children. That would arguably make Canada the most expansive, most liberal, assisted suicide jurisdiction in the world. Clearly we are on the slippery slope many of us warned about. Canadians have a right to conclude that the Liberal government has gone too far and too fast in its zeal to implement and expand the scope of assisted death.

My bill will reverse this momentum and repeal the government's decision to extend MAID to the mentally ill. It will put a full stop to the expansion of assisted suicide to mentally disordered persons. Let me be clear. My bill does not in any way reverse the rest of Canada’s MAID regime. Assisted death will remain available for those suffering from irremediable, incurable and intolerable illnesses and diseases. My bill is simply focused on reversing the government’s actions in expanding assisted suicide to include the mentally ill. It would arrest Canada’s slide into normalizing assisted death as an alternative treatment option, something so many of us had predicted would happen.

The evidence from mental health experts is very clear. Contrary to what our justice minister is now saying, there is absolutely no consensus in Canada that the mentally ill should be covered by Canada’s medically assisted death regime. In fact, here is what experts and other stakeholders in the mental health community are saying. John Maher, psychiatrist with Canadian Mental Health Association, states that:

Inducement to suicide while simultaneously denying mental health care to two-thirds of Canadians who urgently need it is an unconscionable failing.

Directly undermining suicide prevention efforts is an insidious and ablest perversion of our mental health care duty.

Drs. Ramona Coelho and Catherine Ferrier, co-founders of Physicians Together with Vulnerable Canadian, penned a statement that was endorsed by over 1,000 physicians. This is part of what it said, “Given that there is no medical evidence to reliably predict which patients with a mental illness will not get better, MAID for mental illness will end the lives of patients who would have recovered…Medicine …would fail in its mission if it were to deliberately end the lives of patients living with mental illness… Legislators must work towards safeguarding the lives of the most vulnerable including those placed at a greater disadvantage because of mental illness.”

Dr. Sonu Gaind, chief of the Department of Psychiatry at Sunnybrook Hospital, Toronto, stated, “The Ministers have provided false reassurances that we can somehow separate people who are suicidal from those who are seeking psychiatric euthanasia. That is simply not true. In my opinion, that is dangerous misinformation coming from our federal Minister of Justice and our federal Minister of Mental Health and Addictions providing a false sense of safety that does not exist.”

Trudo Lemmens, professor and chair in health law at the University of Toronto, said, “I urge Parliament to take very seriously how offering MAID for mental illness deprives disabled persons, particularly those with mental illness, from equal protection against premature death. Persons experiencing mental illness deserve to be protected against premature death by an unreserved focus on ensuring access to all required health care and social support services. Facilitating their death does exactly the opposite.”

Finally, Sephora Tang, psychiatrist and assistant professor in the Department of Psychiatry at University of Ottawa, said, “One cannot prevent suicide while at the same time facilitating it. Placing expectations upon mental health professionals to do both undermines the effective delivery of recovery-oriented mental health care. Canadians deserve to live in a country that is committed to safeguarding the right to life and security of every person. Current MAID legislation fails to achieve this overarching social good.”

Even Canada's justice minister has publicly acknowledged the fact that issues such as irremediability, competency and suicidality are not anywhere close to being resolved to justify such a major policy shift in favour of death. Furthermore, medically assisted death flies in the face of the government’s own promotion of suicide prevention programs, including the recent creation of a national 988 suicide hotline.

It cannot be both ways. It cannot claim, as the Liberal government has, that it wants to prevent suicide deaths on the one hand, when it actively promotes assisted suicide for the mentally ill on the other. Over the last eight years, many of us have expressed our concern and expectation that the Carter decision and BillC-14 would be expanded by future court decisions, and that these decisions would leave more and more vulnerable populations exposed to the reach of medically assisted suicide.

Our concerns were pooh-poohed. We were accused of fearmongering and of misrepresenting the intentions of this Liberal government. Yet, today, the Truchon decision and the travesty of Bill C-7 bear out our concerns. That is why more and more disability groups have set the alarm bells ringing and are vehemently opposing this legislation. They argue that this legislation amounts to a deadly form of discrimination, making it easier for persons with disabilities to die than to live.

We are hearing more and more reports of the poor and homeless approaching food banks to ask for assisted death, not because they are suffering from a grievous illness but because they do not want to go hungry and homeless. The headline in the British magazine The Spectator asked last year, “Why is Canada euthanising the poor?”

The response from some bioethicists appears to be, “Well, why not?” In fact, a new paper by two bioethicists at the University of Toronto makes the case that euthanizing the poor should be socially acceptable. That is indicative of the path on which our country finds itself. It is terrifying.

We also have verified reports of veterans suffering from PTSD who are being counselled by the Liberal government to consider medical assistance in dying rather than being provided with the treatment and supports they need to recover.

These are the vulnerable that the Liberal government promised to protect. Canadians have the right to ask whether this government is exercising the requisite caution and care to avoid unnecessary overreach and ensure that MAID is not abused or misapplied.

Let me conclude. My private member's bill, Bill C-314 gives all of us parliamentarians an opportunity to take a deep breath and reconsider the perilous road we have embarked upon. As I mentioned, my bill simply reverses the expansion of Canada’s assisted death laws to the mentally ill. At the very least, I would ask my colleagues to allow my bill, at second reading, to go to committee where there could be more discussion.

Have we gone too far and too fast with Canada's assisted suicide program? Will we evolve into a culture of death as the preferred option for those who suffer from mental illness or will we choose life?

I implore my colleagues to choose life. I wish them much wisdom as they make that choice.

Foreign Interference and Alleged Intimidation of Member

[Mark Holland, Liberal, Leader of the Government in the House of Commons]

Madam Speaker, I rise to respond to the question of privilege raised Tuesday by the member for Wellington—Halton Hills concerning the alleged foreign intimidation.

Before beginning my remarks, I want to make some things very clear. When a foreign government attacks one of us, it attacks all of us. We must remain united against it.

I want to reiterate what my colleague, the Minister of Public Safety, said on May 2 in the House to the member for Wellington—Halton Hills. We express our solidarity to him and his family and we will continue to work with him and all parliamentarians to make sure he and all parliamentarians get the support they need.

As the Minister of Public Safety has said, since we formed government, we have been vigilant in fighting against foreign interference and ensuring we have in place the people, resources, tools and oversight to defend our institutions, Parliament and Canadians. We will continue to do that work together.

On the specifics of what the member for Wellington—Halton Hills raised, I cannot comment, of course, on an intelligence leak that was the basis of the Globe and Mail's reporting on the alleged allegations by the Chinese government. However, I will raise a few points.

I will use an example of the situation of the question of privilege raised by the member for Louis-Saint-Laurent respecting the alleged premature disclosure of Bill C-7 on medical assistance in dying from a previous session. The member raised his question of privilege the day after the other members had raised other questions of privilege the day earlier. The Speaker at that time ruled that the member did not raise the question of privilege at the earliest opportunity and, therefore, declined to find a prima facie case due to this fact.

The member for Wellington—Halton Hills, in his intervention, stated that he had not raised the matter at the earliest opportunity and stated:

Our authorities refer to the need for questions of privilege to be raised at the earliest opportunity in the House. While the Globe and Mail report was published yesterday morning, this afternoon is the first opportunity I have had to raise this point of privilege. In fact, this afternoon is the first time I have been up in the House since the report was published in The Globe and Mail.

I would like to examine whether, in fact, the member was not able to raise this matter earlier. The day the Globe and Mail story broke, in the morning of May 1, the leader of the Conservative Party was able to ask at least 10 questions in Oral Questions on this matter. During Routine Proceedings on the morning of May 2, the House leader from the Conservative Party requested an emergency debate on the matter respecting foreign intimidation, which had been raised in question period earlier. The leader of the Conservative Party then ostensibly challenged the Speaker on his ruling to not allow the emergency debate to proceed. That afternoon, after the matter was raised repeatedly during question period, the member for Wellington—Halton Hills then finally, at 3:30 p.m., raised his question of privilege.

Given these facts, the statement that the member made that the afternoon of May 2 was the earliest opportunity to raise his question of privilege clearly stretches the limit of credulity. I take all members in this place at their word, but the sequence of events over Monday, May 1, and the morning May 2 raises serious questions about the veracity of the statement that 3:30 p.m. was, indeed, the earliest that this question could have been raised.

Although I cannot refer to the presence or absence of members in the House, I would note that, now that we are in hybrid mode, there is no reason the member could not have raised the matter at the earliest opportunity, which would have been Monday morning, particularly as he stated that this matter is serious and grave.

If a member believes an issue is serious enough to constitute a prima facie case of privilege, he or she has an obligation to raise it at the earliest opportunity. The delay cannot be justified by a member wishing to conduct research to supplant his or her argument with various precedents to support, or to consult legal counsel.

The Speaker has, at his disposal, all relevant procedural precedents and access to procedural authorities to deal with this matter. The precedents are crystal clear. A member must raise the issue at the earliest opportunity. This did not occur in this instance.

The actions that allegedly took place, according to a leaked document as it relates to the member's family abroad, outside of Canada, beyond the jurisdiction of Parliament to deal with.

Finally, since these are uncorroborated statements that were allegedly leaked by a member of Canada's security services, it is impossible for the House to confirm the facts in this instance. As the Globe and Mail story stated, the individual would not disclose their identity so as to not breach the Security of Information Act. Allegations that the House cannot corroborate can never serve as a determinative means to establish a prima facie case of privilege.

Moreover, on Monday, May 1, the Prime Minister asked senior officials to consider the matter immediately.

I therefore conclude that this matter was not raised at the earliest opportunity, and uncorroborated allegations should not be seen as meeting the high threshold for a Speaker to find a prima facie case of privilege.

Before I conclude, I would also like to set the record straight about the member for Wellington—Halton Hills' assertion that the government did not tell him about the Chinese government's alleged actions.

The Minister of Public Safety and the Prime Minister became aware of the matter following the story that appeared in The Globe and Mail on May 1. On May 2, security officials also briefed the member on all the information that could be provided.

Additionally, the member has received briefings from CSIS on a number of occasions regarding the fact that his work makes him a target of foreign governments. Unfortunately, we live in a time when many foreign governments are targeting democratically elected members of the House. Going forward, we have made it clear to CSIS that, in cases of threats to an MP or their family, regardless of a level of concern, the MP should be briefed quickly and thoroughly.

This is not a partisan issue. We must all work together to defend our institutions, the communities and, most importantly, the parliamentarians who serve on behalf of their communities to protect our democracy.

Criminal Code

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

Madam Speaker, when we were looking at Bill C-14 two Parliaments ago, there was a statutory requirement for a review. The government went ahead and introduced Bill C-7 before we ever did that review. It accepted the Senate amendment to its bill before it established the special joint committee, of which I was a member, both in the previous Parliament and in this one. We struggled with many of the issues the member highlighted in his speech. Two of the themes we were grappling with as a committee were respect for individual autonomy versus protection of the vulnerable.

I share the member's concerns with this. How, in his mind, do we try to rectify those two concepts, so that we are respecting a person's autonomy to make decisions that are in their own interest but also making sure that we as a society are protecting the most vulnerable?

[Rob Moore, Conservative, Fundy Royal, NB]

Madam Speaker, the minister seems to be of the opinion that, if we just let people warm up to the idea, it will somehow become a good idea.

What I am saying is that this is not something that should be offered to Canadians this year, next year or the year after that. Offering medical assistance in dying to someone who is suffering with mental illness is not the right move forward. The member is quite right in saying there are rules within Bill C-7 that certainly do not contemplate this massive expansion, rules that apply to someone who is near death or has a reasonable foreseeability of death. Those rules are not made to apply to someone who is suffering with mental illness.

I would argue that all of us in this place should agree to do better and to fight, hand in hand, for those who are suffering with mental illness.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Madam Speaker, given the circumstances that, if we do not pass this bill, the provisions that were included in Bill C-7 will automatically come into force, I assume the member will be voting for Bill C-39.

What steps would he and his party want to see taken before March 2024 to ensure that adequate mental health supports are provided to all Canadians?

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

Madam Speaker, I believe that we are doing something very positive when we take the time to reflect on what has been brought into place through Bill C-7 and MAID and adequately address the ever-growing concerns of this legislation being abused or overextended to those dealing with mental illness alone.

We need to take this time, pass this bill and make sure that in the time it allots us, we put in place the safeguards that Canadians are demanding. These safeguards will make sure that veterans who are vulnerable and people with mental illness are protected and that those who are passing through a temporary season in life do not make a decision with such finality. We need to make sure we put the safeguards in place.

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

Mr. Speaker, it is an honour to stand to give my thoughts on Bill C-39. For those who are watching the debate today, this is the bill to amend the Criminal Code to delay, until March 17 of next year, the repeal of the exclusion from eligibility for receiving medical assistance in dying in circumstances where the sole underlying medical condition is a mental illness.

It has to be stated very clearly, because of the timeline with which we are dealing, that if this bill is not passed, the original sunset clause that was put in place by the old Bill C-7 will come into effect on March 17, which is just over a month away. It is for that reason that I will support the bill and will work with all parties to get the bill passed quickly.

Today's conversation has to happen within the context of the mental health crisis in Canada. We know and have heard, and this is not just from members of Parliament, from many advocates and stakeholders that there is an extreme lack of funding and resources. Clearly, there absolutely must be parity between physical and mental health in funding.

The Minister of Mental Health and Addictions has stated in the House that Canadians should have access to timely evidence-based, culturally appropriate and trauma-informed mental health and substance use services to support their well-being. With that I agree wholeheartedly, but words are not enough. We need to see the requisite resources and funding to follow through those words.

We know that beyond the Canada mental health transfer many advocates have long been calling for legislation to enshrine in law parity between mental and physical health. I am very glad today that I am giving my speech beside the hon. member for Courtenay—Alberni, who is our mental health and addictions critic and who has himself tabled Motion No. 67, which calls on the government to develop that legislation and to urgently fulfill its promise to establish that Canada mental health transfer.

In my own riding of Cowichan—Malahat—Langford, many of my fellow citizens are going through extreme struggles with the opioid crisis. They are dealing with trauma. They are dealing with underlying mental health challenges that are simply not being addressed. That is an extreme gap and the cause of an extreme amount of shame for a country as wealthy as Canada to be still having these conversations about the resources that need to be brought to bear in communities like mine.

I have been a member in the House since 2015, so this is now my third Parliament. I have been here for the entirety of the legislative journey of medical assistance in dying. I can remember Bill C-14 and the sometimes difficult debates we had in the House. That legislation was in response to the Carter decision in the Supreme Court, which basically said that to deny people this right was contrary to our charter. It therefore gave the government a timeline to address it with the appropriate legislation.

What is not often talked about with Bill C-14 is that there was a legislative requirement in that act when it received royal assent. There was a five-year statutory review of medical assistance in dying. Unfortunately, that never occurred before the government went ahead in the previous Parliament and introduced Bill C-7, which established a second track for people whose death was not reasonably foreseeable.

The context of today's speech and C-39 is the fact that we have a story here of the government in several instances putting the cart before the horse. It not only introduced Bill C-7 before a statutory review occurred, which was a requirement of Bill C-14, but it then went ahead and accepted a Senate amendment to the bill that ran contrary to its own charter statement. It did that pretty massive expansion to the law without establishing a special joint committee that was a requirement of Bill C-7.

I am intimately familiar with what this process has been because I have not only been a member of the House since 2015, I have not only participated in debate on Bill C-14 and on Bill C-7, but I have also been a member of the special joint committee, both in the previous Parliament and in this Parliament.

The message all along has been that this kind of a review should have occurred before we were dealing with a timeline crunch. It became quite obvious during the special joint committee that too many Canadians, too many professionals in our country had apprehension about mental disorders as the sole underlying medical condition for being able to access medical assistance in dying as early as next month. Hence, we have Bill C-39.

I want to go back to the original charter statement that the government released as a part of Bill C-7. That includes a number of important statements as to why the government felt, originally, that mental disorders should be excluded from accessing MAID. It did say in that charter statement that the exclusion was not based on the assumption that individuals who suffered from mental illness lacked decision-making capacity. It also said that the exclusion was also not based on a failure to appreciate the severity of the suffering that mental illness could produce. Rather, it was based on the inherent risks and complexity that the availability of MAID would present to those individuals.

First, that charter statement identified that the evidence suggested that screening for decision-making capacity was particularly difficult. It could be subject to a high degree of error. Second, the statement identified that mental illness was generally less predictable than physical illness with respect to the course that the illness may take over time. Finally, it highlighted the experience that a few of the countries that permitted MAID, namely Belgium, the Netherlands and Luxembourg, for the sole underlying medical condition of mental illness had and some of the concerns relating to the increasing number of these cases and the wide range of mental illnesses in respect to which MAID could be provided.

Again, it really highlighted the fact that precaution was the necessary mode that was required before we embarked on this path. However, the government in its wisdom decided to accept a late stage Senate amendment to the bill after the House, full of its duly elected members, had given a final vote on Bill C-7. As a member at that time, I could not bring myself to accept that Senate amendment. Therefore, I ended up voting against the final version of Bill C-7 because of that.

It also needs to be said, when we are going over the history, that the special joint committee that was a requirement of Bill C-7 got a very late start. It was first brought into being just before the summer recess in 2021. We only had a few meetings before the summer of 2021 and we had the unnecessary election, launched solely at the request of the Prime Minister, in August of that year. This completely wiped out anything that was happening during the 43rd Parliament. That Parliament ceased to exist, and all of the committees that were a part of it did as well.

The new Parliament, the 44th, reconvened later that year, but it was not until around April or May of 2022 that serious discussions started coming together and we could actually get the special joint committee reformed. Again, we have to put that in the context of the impending deadline of March 17, 2023.

An incredible amount of time was wasted, not only from an unnecessary election but also from the delays of getting that committee up and running. We had to twice request an extension of our mandate from both houses of Parliament because the timelines we had been given were completely unrealistic, not only in hearing from as wide a range as possible of witnesses but also in producing a report that would reflect the gravity of the subject matter with which we were entrusted. That has to be highlighted in the debate today on Bill C-39.

I also think it is important because there have been a few narratives around this legislation. It is important to go back to understand what the Criminal Code actually says, and also to put that in the context of the definition of irremediability.

It is important that, in order to be eligible for medical assistance in dying, a person has to meet all of the following criteria: they have to make sure that they are in fact eligible for health services in the province they reside in, they have to be at least 18 years of age and capable of making decisions with respect to their own health, they have to have a grievous and irremediable medical condition, and they have to have made a voluntary request. All these conditions must be satisfied. A person must also give informed consent to receive medical assistance in dying, after having been informed of the means available to relieve their suffering, including palliative care.

Now we get to the definition of a grievous and irremediable medical condition as outlined in the Criminal Code. A person has to meet the following criteria for that definition: it has to be a serious and incurable illness, disease or disability; they have to be in an advanced state of irreversible decline in capability; and that illness, disease or disability, or that state of decline, has to be causing them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions that they consider acceptable.

Those are the definitions in the Criminal Code, so despite the narratives we hear out there, those conditions must be met or the person administering MAID will have committed a crime. They will be in violation of the Criminal Code of Canada and will get the appropriate punishment as a result.

One of the difficulties is the fact that the term “irremediable” is not a medical or scientific term. It is a term that finds its definition within the Criminal Code. If we go to scientific or medical literature, it is a difficult term to define, and that, I think, is why we are seeing a lot of the apprehension around accessing MAID for mental disorders where the sole underlying medical condition is a mental disorder.

Some witnesses who appeared before our committee expressed the opinion that this should not be permitted, because there cannot be any certainty with respect to the incurability of a mental disorder. However, other witnesses told us that certainty is not required and that there are ways to consider irremediability, for example by looking at the years of treatment that people have had and whether any responses of the patient have actually been positive.

We also have to understand that the respect for personal autonomy in all of this is paramount, and it is has to be a treatment that is acceptable to the individual receiving it. They not only have to express informed consent, but it has to be something acceptable to them as a person.

I now want to talk a little about the special joint committee, which I have had the honour of being a member of, as I previously mentioned.

I think it is important to underline that our committee has struggled with the question of how to balance individual autonomy with protections for the vulnerable. We were tasked with looking at five themes through the passage of Bill C-7 and the motion that guided our work from both the House of Commons and the Senate: how we institute protections for persons with disabilities; the state of palliative care in Canada; advance requests; mature minors; and, of course, the subject of today, mental disorders as a sole underlying medical condition and their eligibility with respect to applying for medical assistance in dying.

Our final report is due to be tabled in the House this Friday, February 17. We wrapped up our committee meetings last week and finally approved a draft report. That draft report, as I speak, is going to translation services so that it can be ready for tabling here in the House, and so we will be able to meet the deadline that was given to us.

Before we did that work, we had others who did some important work ahead of us. We had the expert panel that was established. They also wrestled with major concerns, such as incurability, irreversibility, capacity and suicidality, and of course the intersection between structural vulnerability, mental disorder and medical assistance in dying.

That panel report, an important precursor to our work as a special joint committee, did state that assessors in medical assistance in dying should be able to establish incurability and irreversibility with reference to treatment attempts made; the impacts of those treatments; and the severity of the illness, disease or disability. The incurability of a mental disorder cannot be established in the absence of extensive attempts at interventions with therapeutic aims.

This means that someone who has not had access to adequate care would not be eligible for MAID. Therefore, MAID could never be used as a substitute for good psychiatric care. I think that is an important thing we have to realize. There will be safeguards in place, not only with the Criminal Code, but also, we hope, with the standards of practice.

For patients who are considering this, we want to make sure that there has been a long track record of attempts to deal with their illnesses. At the same time, we have heard very clearly that there are many Canadians and many professionals who feel that additional time is needed to make sure we get this right.

One of the witnesses before our special joint committee was the chair of the Government of Quebec's Select Committee on the Evolution of the Act respecting end-of-life care. She explained that Quebec had decided that MAID for mental disorders as a sole underlying medical condition should not be permitted at this time because of the challenges of determining irremediability, as well as the lack of social consensus. Another level of government, this time the Province of Quebec, is also underlining the concerns that many members of Parliament are expressing here today.

I mentioned the final report that will be tabled in the House, but our committee did release an interim report. That interim report was specifically on this subject matter. I will read from our conclusion. It states:

We must have standards of practice, clear guidelines, adequate training for practitioners, comprehensive patient assessments and meaningful oversight in place for the case of [medical assistance in dying for mental disorders as the sole underlying medical condition]. This task will require the efforts and collaboration of regulators, professional associations, institutional committees and all levels of governments and these actors need to be engaged and supported in this important work.

Although some work is already underway to implement the recommendations of the Expert panel, there is concern that more remains to be done to ensure that all necessary steps have been taken to be ready by the March 2023 deadline...

Again, in our interim report, our special joint committee was already, at that time, expressing concern with the upcoming deadline, and I think it is a smart move that we are moving ahead with Bill C-39. If we back that up with the testimony we heard at committee, we had a number of different witnesses who clearly expressed that they had troubles with this deadline and that those standards of practice were not yet ready.

It needs to be underlined again that, if Bill C-39 is not passed, the original sunset clause of March 17 will come into effect. My vote for this bill is occurring because of that very fact. This is aside from the broader conversation we need to have about medical assistance in dying in general. It is support for a bill that is going to extend the deadline by one year so we can make sure that we get these standards of practice right, so we have the necessary time to engage with the broader community.

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

Mr. Speaker, I rise to speak on Bill C-39, a legislation that imposes a new arbitrary deadline of March 2024 in place of the Liberal government's arbitrary deadline of March 2023 whereby persons with a sole underlying mental health disorder would be eligible for MAID.

I support Bill C-39 only because it is better than the alternative, namely that in one short month from now, on March 17, MAID would be available to persons with a sole underlying mental health disorder. This would be an absolute disaster and certainly result in vulnerable persons prematurely ending their lives, when otherwise, they could have gone on to recover and lead healthy and happy lives.

Rather than imposing a new arbitrary deadline that is not grounded on science and evidence, what the Liberal government should be doing is abandoning this radical, reckless and dangerous expansion of MAID altogether. This is why I wholeheartedly support Bill C-314, which was introduced last Friday by my friend and colleague, the member for Abbotsford, and would do exactly that.

One would expect that before deciding to expand MAID in cases of mental illness, a responsible government would take the time to study the issue thoroughly and consult widely with experts. After all, we are talking about life and death. We are talking about a significant expansion that would impact a vulnerable group of Canadians.

However, the Liberal government is not responsible, and that is not what happened. This is why the government finds itself in the mess it is in today with this rushed, 11th-hour legislation to delay the expansion.

Instead, the Minister of Justice accepted a radical Senate amendment to Bill C-7, which established an arbitrary sunset clause. That set in motion this expansion of MAID in cases of mental illness, effective in March of 2023. To provide some context, Bill C-7 was a response to the Truchon decision; its purpose was to remove a critical safeguard, namely that death be reasonably foreseeable before someone is eligible for MAID. It was a terrible piece of legislation that the government should have appealed but did not.

As bad as the bill was, when it was studied at the justice committee, of which I was a member at the time, nowhere in the bill was there any mention of expanding MAID in cases of mental illness. The justice committee did not hear evidence on that point. Indeed, when the minister came to committee, he said that there were inherent risks and complexities with expanding MAID in cases of mental illness, and therefore, it would be inappropriate to do so.

The bill went over to the Senate, and all of a sudden, the minister unilaterally accepted the amendment. Then what did the Liberals do? After little more than a day of debate, they shut down debate on a bill that had drastically changed in scope and rammed through the legislation for this expansion of MAID in cases of mental illness.

There was no meaningful study and absolutely no consultation with experts, including psychiatrists; persons struggling with mental illness; or these person's advocates. There was nothing. In short, the justice minister made the decision to go ahead with this significant expansion and then said the issue would be studied later. Hence, there was the establishment of an expert panel that was appointed after the government had already made the decision to go ahead. One would think that if an expert panel were going to be appointed, it would be appointed before deciding. However, that is not what happened with the justice minister and Liberal government.

We saw a special joint committee established after the fact. Talk about getting it backward, putting blind ideology and hubris ahead of science and evidence, and showing a total disregard for the concerns and lives of Canadians struggling with mental illness. Had the Minister of Justice and the Liberal government done their homework at the outset, they would have learned very quickly that this expansion of MAID cannot be implemented safely.

I serve as a co-vice-chair on the Special Joint Committee on Medical Assistance in Dying. As early as the spring, the committee heard from multiple witnesses, including representatives of the mental health community, and most importantly with respect to some of the clinical issues, leading psychiatrists. The body of evidence showing that this cannot proceed safely was overwhelming. One of the key reasons cited for this was that in the case of mental illness, it is difficult, if not impossible, to predict irremediability. In other words, in the case of mental illness, it is difficult or impossible to determine whether someone can recover and become healthy. This is a serious problem.

Let us look at some of the evidence that was available to the minister in the spring. Dr. John Maher, a clinical psychiatrist and medical ethicist who appeared before the committee, said, “Psychiatrists don't know and can't know who will get better and live decades of good life. Brain diseases are not liver diseases.”

Dr. Brian Mishara, a clinical psychiatrist and professor at the Université du Québec à Montréal, told the committee, “I'm a scientist. The latest Cochrane Review of research on the ability to find some indicator of the future course of a mental illness, either treated or untreated, concluded that we have no specific scientific ways of doing this.”

Even the government's expert panel conceded the difficulty in predicting irremediability. At page 9 of the expert panel report, the panel observed, “The evolution of many mental disorders, like some other chronic conditions, is difficult to predict for a given individual. There is limited knowledge about the long-term prognosis for many conditions, and it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient.” The government's own expert panel said that it is difficult, if not impossible, to predict irremediability.

If one cannot predict irremediability, persons who could go on to lead healthy and happy lives may have their lives prematurely ended. This is a problem that the government cannot avoid and that has not been resolved. Let me remind this House that, under the law, one must have an irremediable condition in order to be eligible for MAID. However, here we have leading experts and psychiatrists, including the government's expert panel, saying that it is difficult, if not impossible, to predict irremediability.

According to the psychiatrists who appeared before the special joint committee, what that means is that medical assessments in cases of mental illness for MAID are going to be decided on the basis of “hunches and guesswork that could be wildly inaccurate.” Those are the words of Dr. Mark Sinyor, a professor of psychiatry at the University of Toronto, who appeared before the special joint committee. These words were echoed by other psychiatrists who appeared before our committee.

The expert panel did not use such language, but it essentially conceded the point in its report because it was unable to come up with any objective standard by which to measure whether a patient's condition in the case of mental illness is irremediable. Instead, the expert panel ridiculously and recklessly said that it was going to wash its hands clean of this and that it was going to give a big green light and say it can all be done on a case-by-case basis. There would be no objective standard whatsoever; all would be guesswork and subjective assessment.

At the special joint committee on the issue of predicting irremediability in the context of mental illness, Dr. Mark Sinyor said that physicians undertaking a patient assessment “could be making an error 2% of the time or 95% of the time.” A 95% error rate is the risk on a matter of life and death, on a procedure that is irreversible and results in the termination of someone's life. For persons who are struggling with mental illness, this is the government's solution. The minister just stood in this place and said, “Damn the evidence. Damn the facts. We are going full steam ahead”.

I cannot think of a more reckless approach than the one the Liberal government has taken on an issue of profound importance to so many Canadians. It is not just the issue of irremediability, although given that this cannot be resolved, it should be the end of the matter. In addition, psychiatrists and other experts at the special joint committee emphasized that in the case of mental illness, it is very difficult to distinguish between a request motivated by suicidality versus one made rationally. In fact, suicidality is a symptom of mental illness, and indeed, 90% of persons who end their lives by suicide have a diagnosable mental disorder.

To illustrate how radical the government is, I note that when the Ontario Medical Association surveyed Ontario psychiatrists in 2021, 91% said they opposed the expansion of MAID for mental illness under Bill C-7. About 2% expressed support. Some 91% were against, 2% were in support and the reset were undecided. This speaks to how reckless, how radical, how extreme and how out of touch the government is on the question of expanding MAID in the case of mental illness.

In the face of the overwhelming evidence that we heard at committee, we issued an interim dissenting report calling on the Liberals to put a halt to this radical and reckless expansion. The minister ignored our interim dissenting report. He ignored the experts. He ignored the evidence. It appears he is so blinded by ideology that it is impossible for him to see what is in plain sight: This cannot be done safely.

In December, when it was evident that the minister was not listening, the Association of Chairs of Psychiatry in Canada, which includes the heads of psychiatry at all 17 medical schools, said to put a halt to this expansion. However, the minister still was not prepared to act. Indeed, it was not until the day after Parliament rose for Christmas that he had a late afternoon press conference where he made some vague commitment to introducing legislation in which there would be some type of extension. Then, with only 17 sitting days left before the expiration of the sunset clause, the minister finally saw fit to introduce this bill. I think this very clearly illustrates the shambolic approach with which the government has handled this issue.

We now have legislation, but what does this legislation do? As I noted at the outset of my speech, it provides for a new arbitrary deadline, even though issues of irremediability, suicidality and capacity to consent have remained unresolved for the past two years. There is absolutely no evidence that those issues are going to be resolved a year from now.

What we have is nothing more than an arbitrary deadline, and a year from now, we are going to find ourselves in exactly the same place. Let us be clear. When we speak about suicidality, irremediability and capacity to consent, these are not issues to be brushed under the rug. These are serious legal and political issues that are fundamental to determining whether this can go forward.

In closing, whether this expansion takes place a month from now or a year from now, it will be an absolute disaster and will result in persons struggling with mental illness having their lives wrongfully terminated. It is time for the government to get its head out of the sand, stop being blinded by extreme ideology, follow the science, follow the evidence and scrap this ill-conceived expansion.

[Rob Moore, Conservative, Fundy Royal, NB]

Mr. Speaker, today we are seeing an admission of a process that was far too rushed. Just two years ago, the Minister of Justice appeared at a justice committee one morning and said that there was not a consensus on how to move forward with expanding medical assistance in dying to those whose sole underlying condition is mental illness. However, later that day, after the Senate had amended the legislation to include mental illness, the minister suddenly said in the House that he was confident there was a consensus. The minister's own charter analysis of Bill C-7 said that those whose underlying condition is mental illness needed to be protected.

Therefore, we see evidence now that 70% of Canadians are opposed to this expansion. We know that many Liberal members are voicing their concerns. Will the minister consider delaying this expansion indefinitely, so that those who are suffering with mental illness, such as our veterans with PTSD, are protected?

[David Lametti, Liberal, LaSalle—Émard—Verdun, QC]

Thank you, Mr. Moore. That's an important question. You and I have both been through the committee process on Bill C-7. I appreciate the work that we've all done on that.

Let me say, first of all, that if someone is suffering from a mental disorder, there is help. People should reach out for help. That is critically important to underline at the outset.

The current MAID regime contains balances within it. Those reports are troubling to me. It is up to the medical profession to ensure that those standards are met. It's up to the medical profession to underline that MAID is about individual choice for people who qualify under the criteria that are there. That's something that needs to be underlined, because it seems that in some of the reports that has been downplayed.

I underscore that when those criteria are not met, and the regime has not been followed, there's a criminal act there. Then it's up to the police to investigate.

A great deal of work has been done on mental illness since I made that statement in 2021. The expert committee has come up with a report and a set of guidelines. A great deal of work has been done at the federal and provincial levels to ensure that for the vast minority of cases—and I underscore “minority of cases”—where, according to those guidelines that are being developed through the expert committee, someone might be eligible for MAID solely with the condition of mental disorder, those safeguards will be in place.

I understand the concerns, and I understand that the concerns would change. I'm committed to continue to work with all of you to improve those standards as we move forward, to improve the communication of those standards so that we have clarity, and to work with provinces to ensure that they have the appropriate supports in place to make these provisions operational.

[Rob Moore, Conservative, Fundy Royal, NB]

Thank you Mr. Chair, and thank you, Minister, for being here today, as well as your officials.

I have a few questions.

We're seeing...kind of ripped from the headlines as of late. You were here before at this committee on Bill C-7, discussing medical assistance in dying. As you know, the bill that you had brought forward before was amended by the Senate to include those suffering with mental illness. As of March 17, 2023, those individuals will be eligible for MAID.

The amendment for that, quite frankly, surprised us at this committee—I think on all sides—because this was considered under Bill C-7. When you, yourself, spoke in the House in February 2021, you said that you “do not believe that we are fully prepared to safely proceed with the provision of MAID on the ground of mental illness alone”.

Now, we see in the headlines multiple instances—very disturbing ones—of individuals who have served our country, the Canadian Armed Forces veterans, being offered medical assistance in dying when they reach out for help, perhaps with post-traumatic stress disorder or some other challenge they're facing. Canadians are shocked and alarmed by this.

My question for you, Minister, is the following. We know that the RCMP is getting involved in this. Clearly, under our current system, vulnerable Canadians are not being sufficiently protected when it comes to medical assistance in dying. In light of this looming deadline of March 17, 2023, when MAID will be further expanded, are you willing to put the brakes on that expansion until we get some guidelines in place that clearly protect vulnerable Canadians—not only members of the Canadian Armed Forces and veterans, but all vulnerable Canadians suffering with mental illness?

[Professor Isabel Grant, Professor, Allard School of Law, University of British Columbia, As an Individual]

Thank you very much.

While I'm grateful for the opportunity to speak to you today, I do so with a profound sense of despair over what is happening with track two MAID. No matter how many people tell you that Bill C-7 is dangerous and no matter how many people die because they can't afford to live, it feels like a runaway train careening towards a human rights disaster. Ableism is so deeply embedded in our political and social structures that we don't see it as ableism but rather as a form of common sense.

The Supreme Court of Canada describes discrimination against people with disabilities as being premised on a distorted view that disability is a flaw that needs to be fixed or eradicated. It is precisely this ableist view of disability that fuelled Bill C-7 and is now killing disabled Canadians.

This ableism, sadly, has also permeated these hearings. Imagine that you are disabled. Perhaps you live in a one-room apartment. Perhaps you need diapers to deal with your incontinence. You've been listening to these hearings and heard your legislators talk about whether it would be better to be dead than to be like you. Far from feeling that your autonomy has been enhanced, you feel demoralized and depressed. You tell your doctor you are struggling, but she just reminds you that you are now eligible for MAID. Is it any wonder that so many disabled Canadians feel devalued and afraid?

If you take only one thing from my words today, it is this: There is only one safeguard that will protect people with disabilities from wrongful deaths, and that is reasonable foreseeability of natural death. That is the only safeguard that can prevent people from dying because they are too poor, too isolated or too exhausted from fighting for their survival to continue living. Death is the great equalizer. Everyone dies, and this is the only safeguard that removes making value judgments about the worth of disabled lives from the equation.

It is impossible to separate the suffering caused by disability from the suffering caused by the social, economic and political accompaniments of disability. If I cannot access smoke-free housing, is that my multiple chemical sensitivities or is that the inadequacy of social housing? If I can't afford an apartment with an elevator, is that my disability or my poverty? If I am facing institutionalization at 40 because the government won't provide me with home care to ensure I can get to the bathroom at night, is that my disability or is that the abject failure of the state to provide the basic necessities of life?

These situations have led to the deaths by MAID of real people who did not want to die. This is a system that would not provide Sathya Kovac with home care but gave her death by a house call. She wrote her own obituary before her death, saying, “It was not a genetic disease that took me out, it was a system.”

The Supreme Court of Canada has held in the death penalty context that one wrongful death is too many. I ask you how many wrongful deaths are too many for track two MAID? To those who say that MAID is just another form of health care, remember that it is legislated as an exemption to murder and aiding suicide, and that is the only reason Parliament has any jurisdiction. The Criminal Code makes explicit that ending a life is so serious that we don't allow people to consent to their own deaths. The MAID regime makes an exception to that, but only for disabled Canadians. Only their lives are not worth saving. How can you not see that this is discriminatory?

It is irresponsible to delegate the definition of murder and aiding suicide to doctors and ask us to trust a health care system that is strapped for resources and near the breaking point. When we look at Canada's record of eugenics, from residential schools to warehousing of the mentally ill and the sterilization of indigenous and disabled women and girls, we see that doctors were deeply implicated in all of these.

This government has focused not on eradicating the suffering of people with disabilities but rather on eradicating the sufferers. I urge this committee to take meaningful steps to prevent the impending human rights catastrophe that will be MAID for mental illness and to put an end to track two MAID.

Thank you.

[Marie-Françoise Mégie, senator, Quebec (Rougemont), ISG]

Thank you to all the witnesses for being with us today.

Ms. Carr, during the Senate review of Bill C‑7, we heard witnesses from the disability community. They said many among you think that they are vulnerable. From their point of view, putting this label on them means stigmatizing them. They have the right, like anyone else, to give their consent or to request medical assistance in dying.

What is the state's role in terms of drawing a line between protecting persons with a disability who may be vulnerable, and the necessity of respecting the individual choices they might make? How do we avoid infantilizing them? They were the ones to use that term. By saying that they are vulnerable, we are trying to infantilize them.

What do you think?

[Gabrielle Peters, Co-Founder, Disability Filibuster]

My name is Alex Cosh . I'm acting on behalf of Gabrielle Peters as her echo today.

Good morning, I'm joining you very early in the day from the unceded territories of the Squamish, Musqueam and Tsleil-Waututh nations.

Modern western ableism, and particularly scientific ableism, serve as historical and ongoing links between colonialism and MAID. Modern western ableism forms the basis and provides the rhetorical and pseudoscientific framework for constructing hierarchies, defining other and establishing lesser, as well as delineating arbitrary lines between “deserving” and “undeserving”. Within your ableist system, track two MAID extends the coercive but seemingly arm’s-length power of the state to provide a designated class of citizens with premature death at the hands of the state.

I'm speaking to you today as the co-founder of the Disability Filibuster, a national grassroots initiative started by Catherine Frazee and myself on the eve of the passing of Bill C-7 and the creation of its second track for MAID.

Disability Filibuster was in part a response to disabled people being marginalized from the discussion and decision-making around Bill C-7 and our frustration that our collective anger was cordoned off and isolated, much like our lives.

Disability Filibuster was the only space created for the only people targeted by the expansion of MAID to voice their views. The media locked down and was dominated by the endless public relations work of those lobbying for its expansion.

Concerns about the social contagion of covering the ending of one's life were tossed aside. The line between editorializing was blurred to the point of romanticizing and lionizing those who made the choice not to continue to be a “burden on those around them” and to “end things on their own terms”. You could hear Frank Sinatra singing between the lines.

No mention was made of the previously publicly articulated and enthusiastic supports for involuntary euthanasia of disabled people during the time of Tracy Latimer's murder in reshaping the narrative to make these same people the champions of autonomy. The political sphere was dominated by the disproportionate representation of politicians enthusiastic for expanding MAID and all for being seen in a favourable light by its well-connected and well-heeled proponents. A foundation sharing the same name and lineage as the Prime Minister played more than a minor role in propelling supports to the forefront.

Disabled people are a large minority, but we are still the minority, a minority that is disproportionately poor, racialized and not noted for its strong political value and influence, as is evidenced by our policy absence in political platforms and campaigns during elections. We didn't have a chance. There was no place for disabled people in the discourse around the policy that specifically and solely affects disabled people and no one else.

Even today, the only place for us in media coverage is as human interest stories about those among us who have resigned ourselves to applying for MAID after tiring of seeking non-existent supports and unable to gulp down the prospect of a future of subsistence-level poverty inflicted and normalized as a component of our broader dehumanization and oppression. In order to be allowed a presence, you have to agree to die.

So removed, uninterested and ill-informed are our politicians and media about our lives and the discussions that we have that we've found ourselves regularly characterized as right-wing religious fanatics. This characterization is so laughably incorrect that I struggle to express the absurdity of it.

Over the course of two years, Disability Filibuster has hosted approximately 80 hours of Zooms. These included panels, readings, arts, casual conversations and live processing of our grief and exhausted rage. A great deal of knowledge was shared.

However, the truth is that I didn't come here today under the illusion that I can alter minds or inform those who have consistently, persistently and wilfully chosen to do the least possible to inform themselves about the lives of disabled people, particularly those living in poverty and on the extreme margins of society—your society.

I came to put it in on the record: Canada's expansion of MAID to disabled people whose deaths are not reasonably foreseeable reifies and builds on the existing dehumanization of disabled people in Canada, breathes new life into the goals of never-dismantled eugenics and is based on the ableism that formed this country's foundation, and as such, represents a serious threat.

The material and social conditions and absence of positive liberty facing disabled people in Canada are fundamentally different from those of non-disabled people. The very different social contract offered to disabled people has yet to provide us with a guarantee of freedom to live in the community, to not be forced into institutions should our needs exceed those deemed appropriately human, the denial of our equal right to travel, and the provision of infrastructure that would make us intended participants—not unintended participants—in society.

I didn't come here with illusions. I came here to remind you that history changes and that one day our roles will be reversed and you will be the ones answering questions.

[Ellen Cohen, National Coordinator Advocate, National Mental Health Inclusion Network, As an Individual]

Thank you, Madam Chair.

Good morning. I hope everyone is well.

My name is Ellen Cohen, and I'm here today as an independent witness willing to share my expertise that is built from my professional and personal experiences.

For over 30 years, I have worked in the mental health consumer sector. I'm a person with mental health challenges and two chronic health conditions, and a family member. I need you to know that there is a lot on the line for me today, and I'm nervous. This is so much larger than all of us. The recommendations that you make to the government can make a big difference for people I support, persons with disabilities and people with mental health conditions living in Canada.

Who is not touched by mental illness? Mental illness affects everyone. People with disabilities make up 22% of the population, and that represents 6.2 million people living in Canada. Among youth aged 15-24 with disabilities, 60% claim to have mental health-related disabilities. All too often, some professionals do not understand that people with intellectual, physical and sensory disabilities can also have mental health conditions that are not related to any disability they may have.

I know that some of the problems where MAID is a major concern for our communities include poverty and lack of food security, safe housing, access to health care, mental health care and addiction services. There is also systemic discrimination—to mention a few.

I was invited onto the panel representing mental health from a disability perspective, which I did. The disability community is diverse, and I know that mental health consumer survivors are divided on the issue of MAID. Despite what was said by Dr. Gupta in her testimony to the members of this committee, I came onto the expert panel with an open mind. As a member of the panel, I was responsible to voice my opinion and to make recommendations for safeguards where mental illness was the sole underlying medical condition in applying for MAID.

Since the beginning of the process, there were challenges, including the composition of the expert panel. It was made up of seven doctors, five or six of whom provided assessments, one palliative care family doctor working with marginalized people, two doctors from the indigenous community, a psychiatric ethicist, two lawyers, two community members from the mental health community, and myself, a member of the disability/mental health community.

From the beginning of the panel, those who were assessors talked about the difficulties they were experiencing with [Technical difficulty—Editor] patients in general. They shared about the complications and difficulties of assessment. Those difficulties were not clear to me, nor were they transparent. The assessors also shared about the amount of time needed for each assessment and talked about the fair compensation for the work that is expected of MAID assessors. There was no space made for meaningful discussions on seriously complicated issues concerning decision-making, consent and capacity, accountability, monitoring, privilege, vulnerability. That just did not happen in the context of people suffering with mental health disorders.

When the discussion of mental illness came up, the discussion was shut down, or we moved on. When suggestions were brought forward, panel members were discouraged due to time constraints. When I did suggest something, I was shamed by the only other peer on the panel, stating that having specific safeguards for those suffering from mental disorders was discrimination.

Under Bill C-7, I believe there's a big difference between people requesting MAID for incurable and disabling conditions and those who are requesting MAID for mental illness as the sole medical condition. I ask you this: Is this a lack of resources or bureaucracy? I believe the outcome of the panel was a foregone conclusion. It became clear that some of the expert panellists had very little appetite to make any attempt at recommendations regarding the addition of legislative safeguards for any amendments to Bill C-7 with regard to mental health disability.

After reading the Quebec decision and giving it some thought, it became obvious to me that there were too many unanswered questions and issues in determining and assessing requests for track two patients without adding to it the request from people with mental illness, which will be available come March 2023, so I left the panel.

Through this whole process, there was limited discussion about mental illness as the sole mental condition for requiring MAID. The process was rushed. Seven months from our first meeting was not enough time to decide about life and death. It was not enough time to consult with the community that Bill C-7 is endangering. I would like to point out that this parliamentary process is also being rushed.

Thank you for allowing me to share my story.

Government Business No. 16—Proceedings on Bill C‑11

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Madam Speaker, the member has mixed in the Emergencies Act with this. The Emergencies Act did not suspend the Charter of Rights. This is another falsehood that is being peddled by the opposition.

I do not think one should take charter statements lightly. The member has essentially impugned the professional integrity of the lawyers at the Department of Justice, who are not just parroting government lines; they analyze a bill based on their own professional expertise and knowledge and they produce a charter statement that they feel is accurate. I do not think we should take charter statements lightly.

In terms of Bill C-7, the government was responding to court decisions. I think they are a very credible form of input.

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

Madam Speaker, I wanted to ask the hon. member a fairly specific question about the content of his speech. He spoke about charter statements and the importance the government attaches to charter statements. We have seen multiple cases in which the government has table-dropped amendments to its own legislation and it has not offered a revised charter statement to line up with that change in policy.

We saw that in another case with Bill C-7, where the government changed its policy in response to a Senate amendment but did not offer a revised charter statement. On the previous version of this bill, Bill C-10, we saw the government adopting changes from government members in committee without revised charter statements. This is a government that, through the Emergencies Act, has suspended the charter and then we have had contradictory stories told by the minister.

I am very suspicious of the stated commitment to the charter. It seems increasingly like these charter statements are then subsequently ignored through amendments and not updated. It suggests that this is just an effort by the government to whitewash an attack on human rights.

Most specifically, why does the government not have a practice of offering updated charter statements when bills are amended as a result of the amendments government members have put forward when they come out of committee?

[Luc Thériault, Bloc, Montcalm, QC]

I'm talking about the report the minister commissioned from the expert panel that was to look into whether or not to include in Bill C‑7 the sunset clause designating March 17, 2023, about when mental health disorders are the only medical conditions claimed.

That's okay, I will move on to another question.

Mr. Carnevale, you talked about additional safeguards for mature minors. You also stated that mature minors should not be granted medical assistance in dying if they are suffering from mental health disorders. I did understand what you said.

In your opinion, what should the additional safeguards be?

[Dr. Derryck Smith]

That's a very interesting question as well. I have to tell you that, when people ask me what I do for a living, I tell them I'm a medical doctor first and a psychiatrist second. The seat of all psychiatric illness is the human brain, which the last time I looked was part of the body and part of the human experience. Our personality, as we describe it, lies in the frontal lobes of our brain, so I'm very much opposed to this dichotomy between physical illness and mental illness. These are all disorders of the human body—and, in this case, mostly the human brain.

I don't have a problem sorting out whether people should or shouldn't. We have pretty clear criteria that are put down in the legislation. We have new criteria in Bill C-7. Assessment could involve a skilled clinician who knows what they're up to in psychiatry and a second assessor, and maybe even talking to the family doctor and to the patient's family. These assessments take literally hours and involve a wide variety of people—the patient, the doctor, a couple of assessors and the patient's family.

I can remember one assessment I did, in which I spent three hours talking to each of the children of a man who was seeking MAID. I want to make sure of what everybody's opinion is. In the end it's up to the individual person, but we want to listen to what other people have to say when approaching that decision.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Madam Chair.

I would like to take the opportunity to ask a legal specialist who is here today something that I was asked in the past 24 hours and that I could not answer on the spot.

Mr. Roberge, in its report, Quebec and its special commission on the evolution of the end-of-life care act chose not to proceed and not recommend that the bill tabled this morning open the door to mental illness as the sole medical issue.

If we were to follow this recommendation and bill C‑7 and its sunset clause were indeed adopted, what effect would that have on coordination or consistency?

Do you think Quebec would then have to abide by that decision? Would it have some autonomy, leeway? We are well aware that the regulatory frameworks are not necessarily in the Criminal Code.

In your opinion, what would happen from a legal point of view?

[Pierre Deschamps, Lawyer and Ethicist, As an Individual]

Good evening, everyone.

Thank you for inviting me to testify.

This evening I will be discussing advance requests for medical assistance in dying.

Advance requests for medical assistance in dying make it possible for capable persons to consent in advance to the provision of medical assistance in dying where they are in a state of life or health incompatible with their values, such as a state of advanced dementia preventing them from recognizing family members or from performing their activities of everyday life. Such requests are now made as part of a relaxing of the rules governing access to medical assistance in dying, as may be seen in the way Canadian legislation has evolved on the matter.

I would like to draw your attention to a few historical facts.

Bill C‑14 made it possible for persons to agree to have a physician or nurse practitioner inflict death on them with their consent, provided they gave their consent at the time the medical assistance in dying was administered. This constituted an exception to, or a derogation from, the rule stated in section 14 of the Criminal Code that prohibits a third party from inflicting death on a person even where that person has given consent. This development was accompanied by the legislator's introduction of safeguards that restricted or limited the circumstances in which medical assistance in dying may be provided based on the eligibility criteria developed at that time.

Bill C‑7 added an exception to that rule by permitting persons to receive medical assistance in dying even if, at the time it is administered, those persons are unable to consent to it, provided they have signed a prior written agreement with a physician waiving the requirement to consent to medical assistance in dying at the time it is provided. Here again, the legislator established safeguards to protect the person who is to receive medical assistance in dying.

It is now being proposed that persons who do not yet have a grievous and irremediable medical condition, but who anticipate having such a condition, should, if in a given situation such as a state of advanced dementia preventing them from recognizing family members or performing their activities of everyday life, be allowed to receive medical assistance in dying in circumstances in which — and I want to emphasize this — they, although conscious, are unable to consent to the provision of medical assistance in dying.

By legislating on this matter, Canada would be joining a very small number of countries that have accepted that a person may receive medical assistance in dying by means of an advance request. I am referring to the Netherlands and Belgium, which have very different statutes on this issue.

In the Netherlands, advance requests for medical assistance in dying are authorized, but, between 2017 and 2019, there were only two or three cases per year of persons suffering from advanced dementia who received euthanasia in accordance with their advance medical directives.

In Belgium, an advance euthanasia directive takes effect only if a person is irreversibly unconscious at the time of euthanasia. In other words, that person must be in an irreversible coma. From 2016 to 2020, between 22 and 33 persons per year received euthanasia in accordance with their advance medical directives.

Unlike Belgium, Canada is currently considering the possibility of providing medical assistance in dying to a person who has made an advance request, not where that individual is in an irreversible coma, which presupposes a total loss of consciousness, but where a person with a grievous and irremediable medical condition such as advanced dementia is still conscious, even if only minimally so, but incapable of giving free and informed consent to the provision of medical assistance in dying.

In such circumstances, Parliament would be asked to validate or sanction under criminal law the possibility for a person who makes an advance request for medical assistance in dying to receive such assistance if the conditions that individual has established as activation triggers of his declaration are met.

While the drafting of an advance request for medical assistance in dying entails its own difficulties, particularly with regard to the identification of factors that may determine when it should take effect, activation of the declaration presents challenges in many areas: the medical condition required for consideration to be given to providing such assistance; the provision of medical assistance in dying to an incapable or more or less unconscious person; the severity of the person's cognitive losses; the family members who would be called upon to commence the assessment process leading to the provision of medical assistance in dying; and the medical and other assessments required to determine whether the person has reached a point where his or her previously expressed wishes must be considered.

Here the challenge for legislators is to design robust safeguards that will protect persons who have made advance requests for medical assistance in dying — such requests are generally made many years before the condition that may potentially give rise to their activation appears — from abuses such as medical assistance in dying that is provided too early or in haste under pressure from family members or medical staff who sympathize with the state of mental deterioration of the person, who will thus be put in a highly vulnerable position.

In addition to Parliament's intervention in criminal law, there can be no doubt that provincial statutes, as in Quebec's case, will be required to determine the circumstances in which an advance request for medical assistance in dying may be activated when a person is considered incapable of giving consent yet is still conscious, even if minimally so.

Motion That Debate Be Not Further Adjourned

[David Lametti, Liberal, LaSalle—Émard—Verdun, QC]

Madam Speaker, the hon. member indeed reminds me that Conservatives, whether inside or outside the House, seem to have fallen in love with blocking and blockades.

We are here because we have many other pieces of legislation, including a budget. There is not just Bill C-8, which, as we have mentioned, has had 12 days of debate and obstruction and concurrence motions and everything else that the Conservatives can throw up in order to delay it, but also Bill C-7, which we have not debated yet, and Bill C-9, which we have not debated yet. There is Bill C-18 and there is Bill C-19.

There are all kinds of things that we have yet to debate, as well as the budget, and that is because the official opposition simply wants to run out the clock; delay, delay, delay; and use every tactic at its disposal to throw this government off its agenda. Canadians do not want that. They want us to work together.

[Jay Potter]

When Bill C-7 was passed, the safeguards related to a death that was not reasonably foreseeable included a safeguard that required the person to be offered consultations with various professionals, including disability support services. That was part of, as I understand it, responding to concerns that were expressed by the disability community. There is obviously much more that can be said on this issue.

The committee could look to members of that community and to disability rights organizations to provide evidence to inform its considerations.

[Abby Hoffman]

That is correct at the present time, and that is absolutely something we need to fix. Bill C-7 directed the Minister of Health to develop regulations that would ensure that we would collect that kind of data. That is what we are doing.

Protection of Freedom of Conscience Act

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Madam Speaker, one of the most common threads we heard throughout the testimony from experts on Bill C-7 was that there was a need for national conscience rights.

The committee heard from patients rights groups, lawyers, disabilities rights experts, medical ethicists, indigenous leaders, imams, rabbis and priests, as well as individuals who provided testimony of their own personal experiences, which are very different than the one that the member spoke to.

I have also received emails from physicians from across the country who are deeply concerned about their ability to continue practising as a result of, and from those who have experienced, intimidation and coercion to participate in the provision of MAID.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

moved that Bill C-230, An Act to amend the Criminal Code (intimidation of health care professionals), be read the second time and referred to a committee.

Mr. Speaker, it is a privilege to rise today to begin the debate on my private member's bill, Bill C-230, the protection of freedom of conscience act. This bill revives my private member's bill, which died on the Order Paper, from the last Parliament, with some slight modifications.

I would be remiss if I did not once again acknowledge that this bill is built on the hard work and determination of former members of Parliament. The first bill proposed to address this issue was introduced by the late Mark Warawa in 2016. His bill did not proceed because of the government's introduction of Bill C-14. After Bill C-14 was passed into law, my former colleague David Anderson introduced his private member's bill, Bill C-418, during the 42nd Parliament. However, that bill also died on the Order Paper when the general election was called in 2019.

I would like to thank all those who have been championing this issue for many years and their willingness to work with me. Experts throughout Canada have provided information and advice, while thousands of grassroots Canadians voiced their support for protecting our fundamental freedoms. I would also like to thank the Library of Parliament for its timely, diligent and expert research, which helped inform this proposed legislation.

For the purposes of this debate, I think it is important to understand conscience. There are numerous definitions of conscience, but they are consistent in defining it as an individual’s inner sense of knowing the difference between what is right and wrong and allowing that knowledge to guide their behaviour. The Canadian Charter of Rights and Freedoms, under the heading of “Fundamental Freedoms”, in subsection 2(a) states that everyone has the fundamental freedom of conscience. In this way, Bill C-230 is straightforward. It seeks to add two new offences to the Criminal Code of Canada. I will read the summary so members will know what they are:

This enactment amends the Criminal Code to make it an offence to intimidate a medical practitioner, nurse practitioner, pharmacist or other health care professional for the purpose of compelling them to take part, directly or indirectly, in the provision of medical assistance in dying.

It also makes it an offence to dismiss from employment or to refuse to employ a medical practitioner, nurse practitioner, pharmacist or other health care professional for the reason only that they refuse to take part, directly or indirectly, in the provision of medical assistance in dying.

This bill is a response to calls from disability rights groups, first nations, the Ontario Medical Association, legal experts and many medical and mental health professionals to protect conscience rights. It ensures that medical professionals who choose not to take part in or refer a patient for assisted suicide or medical assistance in dying will never be forced or coerced to violate their freedoms as stated in the charter.

Previous Parliaments have passed laws that created the unintended consequence of doctors and medical professionals being forced to participate in providing a patient's death, regardless of whether they believe it is in their best interest. Bill C-14 and Bill C-7 created a federal standard for medical assistance in dying and assisted suicide but not for conscience protections.

By way of background, sections 241.1 to 241.4 of the Criminal Code of Canada deal with the provision of medical assistance in dying. These sections are in part VIII of the code. It deals with offences against the person and reputation, which include offences such as homicide, kidnapping, assault and many more. Subsection 241(1) of the Criminal Code still makes it a criminal offence to counsel or aid in a suicide. It reads:

Everyone is guilty of an indictable offence and liable to imprisonment for a term of not more than 14 years who, whether suicide ensues or not,

(a) counsels a person to die by suicide or abets a person in dying by suicide; or

(b) aids a person to die by suicide.

When creating the exemption allowing for MAID, the government had to create an exemption to this prohibition on counselling or aiding in suicide. This then leads to the untenable claim that the Criminal Code already protects the conscience rights of medical professionals.

Some claim that the clarification clause, section 241.2 (9) of the Criminal Code, somehow protects conscience rights. It states:

For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.

While I understand why some would want to think it protects conscience rights, I believe they are sadly mistaken. While I appreciate and support this inclusion in the Criminal Code, it only addresses one side of the coin. This clause only confirms that the Criminal Code is not the source of compulsion to participate in medical assistance in dying.

For the Criminal Code to have any teeth on this issue, it should articulate that it is an offence to compel someone to provide, or assist in providing, medical assistance in dying against their will. Compelling someone to participate in MAID can and does happen, which is why I have brought forward this legislation and why it needs to pass.

Regarding jurisdictional questions about this bill, as I mentioned earlier, this bill proposes that two new offences be added to the Criminal Code of Canada to address intimidation, dismissal from employment or refusal to employ a medical professional. This is similar to section 425 of the Criminal Code, which addresses the same actions taken by an employer to compel employees with respect to belonging to or organizing a union. I would suggest that if it is appropriate to have section 425 in the Criminal Code, it is reasonable to include the amendments I am proposing.

I would also submit that it is inaccurate to argue that conscience rights legislation somehow interferes with the role of the provinces while, at the same time, believing that the legalization of medical assistance in dying does not. Ensuring that conscience rights are protected is the responsibility of Parliament and of the Government of Canada, which is why I introduced this bill and why it should be passed.

Additionally, provinces can introduce their own conscience rights legislation for medical professionals. For example, Manitoba has passed simple and clear legislation in this regard, and I would encourage all provincial legislatures and parliaments to follow Manitoba’s example.

While the text of this bill focuses on the conscience rights of medical professionals, this legislation also serves to protect the right of patients to receive a second opinion. What do I mean by this? If all doctors are forced to propose MAID as a treatment option to their patients, this one-size-fits-all approach would give Canadian patients less choice, not more.

Additionally, individuals who object to MAID would be deterred from entering the medical profession altogether. Patients would no longer be able to seek a second opinion for their end-of-life care. In this way, conscience rights for medical professionals not only protect medical professionals and their patients, but they also protect our health care system.

Without conscience rights, doctors are constrained to provide, or refer their patients to receive, medical assistance in dying, regardless of whether it is their professional opinion that it is in the best interest of the patient. This concern for the patient’s best interest does not mean that a medical professional objects to medical assistance in dying in all cases, just that in his or her opinion it is not an option that should have to be offered in every case. This became especially pertinent to the medical community with the passage of Bill C-7.

To highlight the impact of the removal of the safeguard that death be reasonably foreseeable, I would like to quote from a recent column published online in Policy Options magazine which states the following:

Many injuries and physical illnesses are indeed accompanied by temporary depression and suicidal thinking. For example, research demonstrates increased risk of suicide for two years after a spinal cord injury. This suicidality overwhelmingly ends with adaptation and recovery support. Offering death to anyone during a period of transient increased suicidality is, in our view, unethical and violates the standard of medical care by which physicians must abide.

The fact that the newly expanded law may facilitate death in those circumstances of increased suicidal thinking is, in and of itself, problematic.

Some have tried to frame conscience rights as the rights of the patient versus the rights of the doctor. Nothing could be further from the truth.

Health care is fundamentally about the doctor-patient relationship. For example, take the psychiatrist who supports MAID in certain circumstances, but in a certain case has spent 15 years counselling a patient who suffers from bouts of depression and suicidality. For 15 years, they have built understanding and trust. What would happen if that patient, suffering from a bout of suicidality, should demand assisted suicide? Under current law, that psychiatrist would be forced to refer that patient to someone else so he or she could die. They must do this, despite knowing that the suicidal thoughts are temporary and that otherwise the patient is joyful and loves his or her life. Ending that patient's life would be wrong, but the psychiatrist’s hands are tied. This should not be what passes for medical care in Canada.

Some might claim that there are safeguards in place to prevent such tragedies, but I would ask them if they are absolutely sure. With the passage of Bill C-7, many safeguards for medical professionals were removed. We are talking about ending a human life. There is no room for uncertainty when a life hangs in the balance.

Additionally, should the first line of safeguards not be the expertise of the medical professionals who know their patients best? If those medical professionals do not believe death is the answer, should we not at least consider if they are right? However, this then leads to the concern some raise that protecting the conscience rights of medical professionals will block access to those who truly want it. I would suggest this is both misleading and nothing but baseless fearmongering. Medical assistance in dying and assisted suicide are readily available throughout all of Canada. There are information phone lines, hospitals staffed with willing medical professionals, even email addresses to help set up appointments. In a word, MAID has become the status quo. It is available.

The Canadian Medical Association also stated clearly that conscience protections would not affect access because there were more than enough physicians willing to offer MAID. Therefore, common sense should tell us that the charter rights of medical professionals are breached when they are forced to either offer or refer assisted suicide or medical assistance in dying. Surely, we have the capacity to both ensure access to MAID while still protecting the fundamental charter right to freedom of conscience.

Finally, some have suggested that medical professionals should leave their morality at the door. I do not believe we want this to happen. For example, we would all want and expect doctors to be bound by their morals if they were offered a bribe to move someone up on a waiting list. If we hold our medical professionals to a higher standard, we cannot then tell them to ignore their personal moral standards. Further, while discussing the issue of conscience rights with a doctor, she told me that, in the absence of conscience protection, the group with the most to lose are the patients, and they are the ones we are trying to help. This bill protects the doctor-patient relationship by ensuring that doctors and other medical professionals are always able to recommend and provide the care they believe is best for their patients. Patients need this bill to pass. Canada’s medical professionals need this bill to pass.

Over the past two years, we have seen just how important our health care system is and how critical the medical professionals who work in that system are to Canadians and our way of life. We need to create a work environment for medical professionals that protects them, supports them, and encourages them to continue in the critical work they do.

In closing, I encourage all members to support passage of the protection of freedom of conscience act.

Medical Assistance in Dying

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

Mr. Speaker, the next petition I am tabling is in respect to Bill C-7, which was passed in the last Parliament, particularly the government's decision to support a Senate amendment that would allow euthanasia or assisted suicide for those who have been—

Parliament of Canada Act

[Mark Holland, Liberal, Leader of the Government in the House of Commons]

moved for leave to introduce Bill C-7, An Act to amend the Parliament of Canada Act and to make consequential and related amendments to other Acts.

(Motions deemed adopted, bill read the first time and printed)