Bill C-218

An Act to amend the Criminal Code (medical assistance in dying)

This enactment amends the Criminal Code to provide that a mental disorder is not a grievous and irremediable medical condition for which a person could receive medical assistance in dying.

Criminal Code

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

moved that Bill C-218, An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

Mr. Speaker, I want members to imagine someone's son. He is in his forties and life has worn him down. He lives with a painful illness that leaves him sick, exhausted and often unable to leave the house. On top of that, he struggles with addictions, depression and anxiety, which have taken more from him than anyone can see from the outside. Some days, he can barely hold it together. He relies on his family for a place to live, food and help getting through the week. They are doing their best, and he is doing his best, but the weight of it is crushing.

One day, he finally meets a psychiatrist. He goes, hoping that this might finally be the start of real help. His addictions still have not been treated, and his mental health care has not truly begun. He is vulnerable, scared and hanging on by a thread.

At that appointment, instead of being offered a plan to get him stable, MAID is raised as an option. The assessment moves ahead, and before he ever receives proper support for his mental health or addictions, he is approved. His MAID provider is the one who drives him to the place where his life is ended. This is someone's son who needed help, not a final exit.

Believe it or not, this actually happened here in Canada, and this is where we are headed if we do not act. Unless this Parliament chooses a different path, Canada will allow MAID for people whose only condition is mental illness. That means men and women struggling with depression, trauma or overwhelming psychological pain could be steered toward death by a system that too often cannot offer timely treatment, consistent follow-up or even basic support. This is why I brought forward Bill C-218, the right to recover act. It is simple. It asks Parliament to stop, consider what we have learned and act responsibly before people are irretrievably harmed.

I often think of my grandparents, who immigrated here after World War II with very little. They chose Canada because it was a place where people had endless opportunities to better themselves, where neighbours watched out for each other and communities worked in unison to make a better life for all. They built a Canada where the vulnerable were cared for and the less privileged in society were valued and treated with equal care. Those fundamental values attracted millions of immigrants over the years.

Today, many Canadians fear we are losing those values. Canadians themselves remain some of the most compassionate people anyone will ever meet, but our system is overwhelmed, stretched thin and unable to meet the needs of people who are suffering.

When people fall through the cracks, the easy temptation is to accept that failure is inevitable. When that happens, people facing mental illness can end up alone, waiting months, or sometimes years, for specialized treatment, and when help does not come, they lose hope. That moment of hopelessness should never be treated as an opportunity for the state to end their lives through MAID.

When the House last debated MAID, mental illness was not a part of the core discussion. It was added in a last-minute Senate amendment to Bill C-7. The implications were not fully considered or understood by the House.

Since then, we have learned a lot more. Psychiatrists across Canada, including the chairs of psychiatry at all 17 medical schools, have told us plainly that there is no reliable way to predict when a mental illness is irremediable, which is a requirement in the MAID law. People get worse, but they also get better, and most do. There is no test, scan or clinical tool that can reliably tell us that someone will never recover. All people deserve the opportunity to get better. No one should be encouraged to give up on themselves.

As legislators, we need to listen to what so many medical professionals are telling us, which is how hard it is to distinguish between suicidal ideation and MAID. The feelings behind them, such as hopelessness, loneliness, fear and the belief that one is a burden, are the same. For decades, clinicians have understood that, when someone feels hopeless or sees themselves in a very negative way, it can look like they are thinking clearly, that they are rational, even when their judgment is clouded by despair.

In 2021, most of us did not have the evidence we now have about how MAID assessment functions in the real world or the specific dangers of expanding MAID to mental illness. We now know there is no reliable way to determine when a mental illness is truly irremediable. Suicide prevention experts, including the Canadian Association for Suicide Prevention, warn that how we talk about these issues shapes the choices people make. Suggesting that death is a solution to suffering undermines hope. It puts people at real risk.

The expansion of MAID to mental illness forces Canada into a huge contradiction. On one hand, we invest in suicide prevention. We train professionals to intervene, listen and pull back people from the edge. On the other hand, with the expansion of MAID, we would invite those same vulnerable people to consider state-facilitated death.

We must ask, who receives suicide prevention and who is guided toward MAID? If a person suffering from depression calls a crisis line tonight, do we encourage them to hold on or do we quietly redirect them to an assessor? What principle decides the answer? What medical test? What ethical standard? There is none. That is because the very feelings that drive someone to seek MAID, hopelessness, despair or the belief that they are a burden, are the same signals that every suicide prevention worker is trained to treat as a cry for help.

We would never tell a struggling teenager that their wish to die is rational. We would not tell a grieving spouse that their darkest moment is a reasonable exit point. We would reach out. We would support them. We would insist that their lives still matter. Why should that change simply because despair is given a different label? When someone feels worthless, our duty is not to agree with them. It is to stand with them until the light returns. Canada must decide: Are suicidal citizens people in need of protection or candidates for state-sanctioned death? We cannot pretend that they are both. Besides all this is the fact that we already know the current safeguards are failing.

Let us be absolutely clear about what an expansion of MAID to mental illness would mean. If Canada cannot protect vulnerable people under the current rules, then expanding eligibility to those whose very illness clouds judgment, hope and decision-making will lead directly to preventable deaths. We are already witnessing cases where safeguards fail, where capacity is misjudged and where people are assessed in moments of confusion, exhaustion or pressure. If the system cannot uphold basic protections now, it will not and cannot protect those suffering from severe psychological distress. An expansion would be reckless.

The evidence is already in front of us. A recent article about Ontario's MAID death review committee's findings lays out, in plain and troubling terms, cases that would worry every Canadian. They describe a man who had cancer. I will call him Bill. Earlier in his illness, he had briefly mentioned MAID, as frightened patients tend to do. By the time he was assessed, he was delirious, confused and heavily sedated. His own medical team made it clear that he no longer had the capacity to make major decisions, yet a MAID assessor shook him awake, took the faint motion of lips as consent, withheld sedation, obtained a rushed virtual second opinion and ended his life that same day. Bill was not stable. Bill was not capable. He did not understand what was happening.

In another case, a woman, whom we will call Margaret, wanted palliative care. She said so the day before her death, but she did not qualify for hospice. Her husband, worn down by caregiver exhaustion, arranged for an urgent MAID assessment instead. The day before she had told him she wanted to die with proper palliative support, but the next day two assessments were rushed through. Her final wishes were overshadowed by the strain of a caregiver who could no longer cope.

Another woman, whom we will call Alice, was living with advanced dementia and unable to communicate her wishes in any meaningful way. Her family brought MAID forward twice with minimal documentation, little clarity and no clear expression of consent, yet she was approved.

All of these examples were drawn from the auditor's report. These are stories about real people, who are family members, friends, neighbours and fellow citizens, the people to whom we owe a duty of care. They demonstrate that vulnerable Canadians are already at risk under the current MAID regime. People who are confused, pressured, exhausted or unable to communicate are slipping through the safeguards that were supposed to protect them. If safeguards fail for patients with physical illness, where assessing capacity is clear and verifiable, what will happen when the only condition is a mental illness which, by definition, clouds judgment and hope? To offer death at that moment will place some of the most vulnerable people in this country directly in harm's way.

Today, a person deemed unable to manage their finances must undergo rigorous capacity assessments, interviews, documentation, expert review, collateral information and verification because we recognize the risk of exploitation, yet for MAID, a situation of life or death, a brief conversation can suffice, with no thorough evaluation, and when the safeguards fail, there seem to be few consequences. We now live in a country where we protect bank accounts better than we protect a human life.

We also know of families across Canada that were deeply shaken by how MAID was carried out for a loved one. They describe decisions that felt rushed and were influenced by poverty, loneliness or a lack of access to proper treatment, not by a calm and informed choice. These experiences are warnings from the very people who lived through the consequences.

Canadians are uneasy. Polls show a clear majority do not support MAID for mental illness alone. Provinces are asking Ottawa to reconsider. They are calling for a stop. Quebec, one of the most permissive MAID jurisdictions in the world, has banned it by law.

International human rights experts have raised the alarm, including the UN Committee on the Rights of Persons with Disabilities, which has urged Canada to step back. It warns that our trajectory risks discriminating against people with disabilities and mental illness and recommends repealing this expansion entirely. This is what Bill C-218 would do.

We must remember a crucial truth, which is that recovery from mental illness is not rare, but common. Time and again, people who once felt utterly hopeless have rebuilt their lives once they received proper care and stable support. Every one of us knows someone, whether it was a neighbour, a colleague or a family member, who walked through a very dark season and is now grateful to be alive.

These stories matter because they show us what is at stake. Sadly, that is not true in every case, but there is no reliable way to know in advance who will recover and who will not. There is no test, no scan, no certainty. I respectfully suggest that, when someone's judgment is clouded by psychological distress, our duty is to offer treatment, protection and time, not an irreversible decision based on guesswork.

If MAID is expanded, we will be forced into an impossible paradox. A suicidal person calling a crisis line is urged to hold on, yet if they request MAID, that same despair may be treated as justification for death. This is why Bill C-218 is necessary. It would stop the 2027 expansion to mental illness because the evidence cannot support it and the safeguards cannot sustain it. Vulnerable Canadians are already at risk. Expanding eligibility now is reckless. A strong country does not turn its back on those who suffer, but believes in their future and gives them time and care to heal.

I urge every member in the House to support Bill C-218 so Canada would remain a nation that protects the vulnerable, offers treatment before despair and gives every person the chance to recover. Let us take this responsibility seriously. Let us listen to the warnings of those who are assessing the failures in the system. Let us listen to the families who have lived through the consequences of MAID and to those who survived mental illness and rebuilt their lives. Let us remember the kind of country we claim to be, one that protects the vulnerable and gives people the time, care and dignity they need to heal.

[Alana Hirtle, Liberal, Cumberland—Colchester, NS]

Mr. Speaker, my father suffered from four different types of cancer over five years and, indeed, opted for medical assistance in dying, which took place in August 2024. Although sitting with him that day was one of the hardest times of my life, I fully supported his choice to participate in MAID. I also supported the process as it took place and was there throughout it.

I wonder if the member across would share how she voted for the initial legislation on medical assistance in dying.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Mr. Speaker, I was not in the House when the original vote happened.

[Claude DeBellefeuille, Bloc, Beauharnois—Salaberry—Soulanges—Huntingdon, QC]

Mr. Speaker, I am stunned by what I just heard. I agree with the member that there needs to be more mental health services. Obviously it falls under the jurisdiction of the provinces and Quebec to provide the whole range of services needed to support people experiencing mental health issues. However, in her speech, my colleague misled the public somewhat by claiming that the law allows for medical assistance in dying when major mental illness is the sole underlying disorder.

The member knows that in 2027, a joint committee of members and senators will make a decision based on the recommendations of the Department of Health. This comes as no surprise. Everyone knows that the medical community is not ready and will probably not be ready in 2027 to decide on this thorny issue. I think the member has simply found a way to assert her opposition to medical assistance in dying.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Mr. Speaker, it is very clear that Bill C-218 is only about MAID for people with mental health issues solely. I would like to say that no member of the House denies that some Canadians suffer profoundly from mental illness. Their pain is real, and it deserves our deepest compassion, but compassion must be joined with clarity, and the evidence is unmistakable: Even after years of struggle, long-term recovery is possible. That is precisely why the experts tell us that irremediability in mental illness cannot be predicted.

We simply do not have the medical grounds to declare that a life is beyond hope. We have already seen cases where people were approved for MAID not because their condition was truly irremediable but because they lacked housing, treatment or basic support. That is not medicine; that is a system misreading desperation as destiny.

We know individuals who once begged for death, only to recover and to contribute greatly, including my colleague from Elgin—St. Thomas—London South, who openly speaks of a suicide attempt, a long journey back and a life now filled with purpose. When a person is standing on the edge, the role of a responsible nation is to pull them back.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Mr. Speaker, I so appreciate the direction in which my colleague has gone today to protect people with a mental illness only. I can say personally, having served this whole decade on the Standing Committee on Veterans Affairs, that the issue is being abused within our own government and with our veterans, who come for help but are literally receiving suggestions that they consider MAID.

This is outside the scope of what should be happening. People have even been offered funds for their family if they were to choose that. This is inappropriate, and I would ask the member for her perspective on how the government is responding to the needs of people with mental illness.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Mr. Speaker, as I clearly stated in my speech, the government is not doing what it needs to do for the people who are most in need. I do want to also add that one of the most encouraging parts of this journey has been seeing how broad and diverse the support for the bill has really been. Tens of thousands of Canadians have written to us, called, and signed petitions at our office to say very clearly that they do not want mental illness alone to be a basis for MAID but that they want a real right to recover instead. That spans cultures, faiths, professions and backgrounds.

The bill unites people from many backgrounds, right across the country. That is the coalition standing behind Bill C-218.

[Juanita Nathan, Liberal, Pickering—Brooklin, ON]

Mr. Speaker, I appreciate the opportunity to rise today to speak to Bill C-218, which proposes further amendments to Canada's federal legal framework for medical assistance in dying. Specifically, this bill aims to indefinitely exclude those patients whose only health condition is a mental disorder from being eligible for MAID.

This is an issue which is unquestionably complex and can be deeply personal. It continues to challenge parliamentarians, health care providers, experts and people in Canada alike. It is important for us to recognize that medical assistance in dying has been allowed in Canada for close to 10 years now. It is also important to remember that it is the provinces and territories that must put in place the tools and supports that clinicians need to deliver MAID safely and appropriately. Whenever we make changes to the federal legal framework for MAID, we must be cognizant of the impact that those changes have on our partners in the provinces and territories.

As the Supreme Court of Canada recognized in Carter, striking the right balance in this complex area of social policy, where competing social values are at play, is not an easy task. As legislators, we must balance respect for personal autonomy and dignity with our responsibility to those who may be vulnerable.

Today, I will speak to three key elements: first, the objectives of Bill C-218; second, the findings of major expert studies on MAID where mental illness is the sole underlying condition; and third, the federal government's support for provincial and territorial work to improve access to mental health services.

Bill C-218 seeks to make changes restricting eligibility for MAID indefinitely in cases where a mental disorder is the only medical condition involved. There have been concerns expressed by some stakeholders about whether there are sufficient safeguards in place, and whether health care providers have the tools and resources they need to provide MAID safely and appropriately when it comes to mental illness. These concerns are not new, nor are they trivial, and their desire for caution is laudable.

At the same time, we must also recognize that Parliament has debated this question repeatedly over several years. Our legislative framework has evolved in response to court decisions, expert analysis and extensive public engagement. A special joint parliamentary committee has carefully considered the issue at length and provided advice and recommendations on whether to proceed. That committee also reinforced the importance of provincial and territorial health system readiness.

Bill C-218 invites us to consider whether the appropriate balance has been struck with the upcoming lifting of the mental illness exclusion in 2027, or whether another legislative change is necessary at this time. To answer that, it is essential that we understand what the experts have already told us. Significant studies have been completed on the specific question of MAID eligibility where mental illness is the sole underlying condition, including by the Council of Canadian Academies and the expert panel on MAID and mental illness, among others. Taken together, they provide a rich body of evidence.

The Council of Canadian Academies, the CCA, examined Canada's legal and clinical landscape, along with international approaches. The CCA's work highlighted the core clinical challenge: Mental illnesses can be unpredictable in their course and determining irremediability is far more complex than in many physical illnesses. The CCA was not tasked with providing recommendations for or against eligibility, and the members of the working group that dealt with mental illness had a spectrum of views on the matter.

The expert panel on MAID and mental illness, which was mandated by the former Bill C-7, took this analysis further. Its mandate was not to recommend whether eligibility for MAID should be expanded to permit the provision of MAID based on mental illness alone, but rather to recommend protocols, guidance and safeguards for such cases. The panel concluded that the existing Criminal Code safeguards, when supported by the development of MAID practices standards and the implementation of other recommendations, are adequate to allow for safe provision of MAID to people whose sole underlying medical condition is a mental illness.

Both these expert reviews, along with the testimony received through parliamentary committee work, reinforce the same overarching message: MAID in cases involving mental illness requires exceptional caution, but it is not impossible to implement safely. At the same time, clinical readiness, clear standards and comprehensive training are essential.

Following these studies in 2023, a model MAID practice standard was published, and a Canadian-made curriculum was developed. In addition, the federal government is currently supporting the Canadian Psychiatric Association to develop clinical practice guidelines for assessing suicidality and irremediability. Through a federal, provincial and territorial assistant deputy minister-level committee, policy leaders are also considering a range of issues related to MAID, particularly with respect to complex cases, including mental illness.

We have heard from these expert reviews and from a broad range of stakeholders on the importance of provincial and territorial health systems' being ready for the lifting of the exclusion. This includes provincial and territorial efforts to improve access to mental health services and supports across Canada. No one should ever feel that MAID is the only option available to them.

The federal government remains committed to supporting provinces and territories to improve access to health care for Canadians, which includes strengthening mental health services. In 2023 the Government of Canada announced the working together to improve health care in Canada plan, a historic investment of close to $200 billion over 10 years to support provincial and territorial health systems to deliver health care to Canadians. This includes an investment of $25 billion through bilateral health agreements with the provinces and territories to support shared priority areas, including improving access to mental health and substance use services.

The federal government has also expanded support for youth mental health initiatives, recognizing that early access to therapy, counselling and culturally safe care can alter the trajectory of a person's entire life. We have also funded indigenous-led mental wellness programs, which acknowledge the need for approaches that are culturally relevant, trauma-informed and community-based, rather than one-size-fits-all solutions. Provinces and territories have taken significant steps to improve access to mental health services in Canada with federal supports over the past 10 years.

Questions related to MAID in the context of mental illness are among the most sensitive we confront as parliamentarians. Our decisions affect people in Canada at their most vulnerable moment, and our work must reflect both humility and resolve. Bill C-218 asks us to confront difficult but deeply important questions.

Deciding whether medical assistance in dying should be available when a mental illness is the sole underlying condition is not a choice that lends itself to simple answers. Reasonable people may come to different conclusions. The Supreme Court of Canada has recognized this complexity, affirming that Parliament is owed a broad margin of deference when navigating challenging social policy issues such as this.

We will have the opportunity to consider next steps further and to study the state of progress during the parliamentary review that will be held in 2026. I look forward to hearing from colleagues as well as from experts, stakeholders and regular people, including those with lived experience with mental illness, as we continue this important debate.

[Claude DeBellefeuille, Bloc, Beauharnois—Salaberry—Soulanges—Huntingdon, QC]

Mr. Speaker, you will not be surprised to learn that the Bloc Québécois will not be supporting Bill C-218. Although we do not support this bill, it is not because we are unconcerned with the issue of medical assistance in dying for people with mental disorders. It is because it is not up to a political party to decide whether to implement a medical assistance in dying procedure for people with mental health issues. This is a societal issue, a societal debate, but also a clinical debate.

The reason it is not yet in effect is that there is no clinical and scientific consensus on how to regulate consent for MAID from a person whose only medical problem is a serious mental health disorder. There is no consensus and that is why Bill C-62, which was passed, excluded people with mental disorders from receiving MAID.

However, the bill provides that in 2027, the joint committee of senators and MPs will be reconvened to assess whether psychiatrists, psychologists and mental health professionals have made progress in their analysis of the future framework for MAID for people with mental health disorders. It is possible that, in 2027, government departments, scientists and psychiatrists will conclude that we are not ready, that it is too difficult to determine the “how” and the “when”, and that it is too difficult to analyze the clinical framework for authorizing or not authorizing medical assistance in dying.

We need to approach this bill with care. This is a societal debate that should not be politicized. We in Quebec have already taken a position on medical assistance in dying. Quebec is one province where this question has been debated at great length. A commission travelled everywhere across the province. A clinical and scientific consensus, as well as consensus in civil society, were reached on medical assistance in dying.

For people whose only illness is a major mental health disorder, medical assistance in dying was also rejected by Quebec for the same reasons it was rejected when Bill C-62 was passed, namely, the absence of a scientific and clinical consensus. We also need to give the experts time to reflect, consult, examine practices and evolve so they can make recommendations to the joint committee in 2027. Once the joint committee receives these recommendations, it will have to decide whether to move forward or put off the decision once again, which is not an easy thing to do. However, what is plain to see is the the seriousness and scientific rigour surrounding the decision to allow or withdraw permission for medical assistance in dying for people with mental health conditions.

I think it is worthwhile for me to read recommendation 1 of the Special Joint Committee on Medical Assistance in Dying, in which all parties and senators participated. They were quite wise, because they recommended the following: That [medical assistance in dying where mental disorder is the sole underlying medical condition] should not be made available in Canada until the Minister of Health and the Minister of Justice are satisfied, based on recommendations from their respective departments and in consultation with their provincial and territorial counterparts and with Indigenous Peoples, that it can be safely and adequately provided; and That one year prior to the date on which it is anticipated that the law will permit [medical assistance in dying where mental disorder is the sole underlying medical condition], pursuant to subparagraph (a), the House of Commons and the Senate re-establish the Special Joint Committee on Medical Assistance in Dying in order to verify the degree of preparedness attained for a safe and adequate application of [medical assistance in dying where mental disorder is the sole underlying medical condition].

My colleague gave several examples. I was surprised to hear her often say the words “depression” and “suicidal”. When I look at what the joint committee discussed and debated, I see that it talked about untreatable mental illnesses, such as schizophrenia. I do not know whether anyone here has ever met a person with schizophrenia who suffers from auditory or visual hallucinations with paranoid thoughts. Their reality may be that they are so medicated that they can no longer enjoy a social life or contact with others. They may be isolated from their family and live in difficult conditions. They likely have to see their psychiatrist regularly and may have tried several types of therapy with no success. This may have been their reality for the past 10 or 20 years. That person lives in a state and conditions that no one here in Parliament would ever want to experience.

We are talking about incurable illnesses that people have to learn to live with and for which they have to be medicated. A person with severe schizophrenia could get all the psychotherapy available, but they are still dealing with an extremely difficult illness. I do not want my words to be misinterpreted. I am not saying that everyone with schizophrenia would want to request medical assistance in dying. I am simply trying to provide some clarification in response to my colleague, who was talking about temporary depression, situational depression or maybe even serious depression. She is right in saying that a person can get through those things with help, psychotherapy, support from local health centres and loved ones. That is true. She is right. Those cases would never constitute a legitimate reason for obtaining medical assistance in dying.

I would also like to point out that there are some very important things in the preamble. Basically, what it calls for is justified, even legitimate: Anyone struggling with mental health issues should have the right to receive the services they need, whether that means consultations, emergency services, support, home care or assistance. In my riding, we have organizations that work in the area of mental health. One that comes to mind is Le Tournant, a transition resource that provides real-time service. A suicidal person can call, and someone can go directly to their home to support them and help them through this distressing time.

My colleague is right to point out that in Quebec, as in other provinces, there is still a lot of room for improvement in this area. Unfortunately, it is not for lack of interest that the provinces are not offering these services, but because they do not have the means to do so. Over the past few years, health services, and particularly social services, have gotten shortchanged because health problems are so significant that social problems have fallen by the wayside a bit. The provinces have to do more with less. A good solution to support people would be to give the provinces the financial resources they need to establish much more intensive services for people struggling with mental health problems. In my riding, there are all kinds of services, including intensive home care services. These services exist, but perhaps not at the same level as the needs require.

My colleague notes in the preamble that this issue falls largely within provincial jurisdiction. I strongly suggest that she join forces with her colleagues to demand that the government do more and provide the provinces with the resources they need to order to implement all the necessary services for people struggling with mental health issues. In the meantime, the Bloc Québécois trusts that the House of Commons will take the time to thoroughly examine the issue of MAID for mental health disorders.

[Andrew Lawton, Conservative, Elgin—St. Thomas—London South, ON]

Mr. Speaker, it is a great honour to rise and speak to Bill C-218.

In less than a week, it will be 15 years since I almost lost my life to suicide. I overdosed. I was in the hospital for seven weeks. For much of it, I was on life support and had to be resuscitated multiple times. Over Christmas, my parents did not know if they would have me as their son, moving forward. It was the culmination of a very dark time in my life that spanned many years, a time in which I felt at multiple times, although not as seriously as I did that horribly dark and sad December day in 2010, that I would be better off dead than alive.

There are many reasons I am so proud to be standing here in this chamber, but one of them is knowing where I have been and where I came from and the fact that there was a time in my life when I never in a million years would have believed that I could ever have the life I have now: a career that I am proud of, an amazing wife whom I love so dearly, these tremendous colleagues and friends I work with every day, and this trust that has been placed in me by the people I represent. None of that would have been possible had I been successful when I attempted to end my life.

I think of my own experience and the experience of many others like me when I reflect on the fact that in just 15 months' time, someone who was in the place I was in 15 years ago will be able to have not only the state's permission but the state's help to end their life by suicide. In March 2027, the criteria for medical assistance in dying are expanding, so someone with only a mental illness, with no physical ailment whatsoever, will be eligible for MAID.

This is a profound expansion and a fundamental inversion of the message that we have spent so much money and so much airtime and so much effort and energy telling Canadians for years, through countless campaigns aimed at ending the stigma surrounding suicide; through more programming, funding and resources to support people with mental illness; and through campaigns telling people that they are better off alive, that they do have a future. They are efforts that we all extend in our own lives to those around us to give messages of hope to those who need it. To put a fine point on this, and to make it personal, because it is personal, if the laws that are coming into force in 15 months had been there 15 years ago, I would probably be dead right now. I say that with full gratitude that I am not.

I did not want to extend a cry for help. I actually had access to resources and treatment. I had a support system. I had a family who loved me. I had these privileges that so many others who struggle with mental illness did not have. Even with all of those available to me, I felt like there was no future. The proverbial light at the end of the tunnel did not exist. I did not want to get better. It was not that I had not tried; I had not tried enough, clearly. However, I felt like I had done my time. I felt like I had put in enough effort to try to get better and when I did not, I had made my decision that I was going to end it. It was not impulsive; it was quite rational, actually. I decided it weeks out. Believe it or not, as silly as it sounds, I had it on my calendar, and I scheduled the day because I had appointments and meetings before it that I did not want to miss, as though that makes any sense at all, as though it would matter if I missed a meeting, given that I was planning on not sticking around.

This is how, when a person is struggling with mental illness, as I was so very seriously, it plays tricks on them. By design, a mental illness is a distortion of the person's ability to see clearly and think clearly about what they are in the midst of. It clouds their judgment. If I had ever gone to a health care worker and said, “I am planning to end my life,” they would have not just a moral but a legal obligation to stop me. They would have legal authority to detain me, because that is how sacrosanct it is that people have a right to recover, that they have a right to live and that medical practitioners must do no harm and protect them from harming themselves. We have a duty to help people.

I talk about my own story, and I have heard so many others like it. After my colleague from Cloverdale—Langley City introduced her bill, I launched the “I got better” campaign, in which I shared my testimony and invited Canadians to share their own. I would like to share some of those in the House today.

A lawyer from here in Ottawa said that they wondered if they would have used MAID if it had been available when they were in their darkest days, or if they would use it in the dark days yet to come.

A man reached out and said he struggles with personal family issues and mental illness. He has very bad days. He has tried attempting suicide before, and he is worried that he will not be stopped in the future if he has more of those dark days and MAID is available to him.

On a more positive note, a woman who was in an abusive relationship for 22 years and wanted to die said, “If MAID had been around then, I would not be here now, and I am damn happy it was not.” I will ask members to pardon the unparliamentary language. She continued, saying, “I am happy now. I have had a fantastic career caring for seniors. I have grandbabies and kids I love. I have a wonderful husband now who means the world to me.”

Another woman said she wanted to end her life many times, but looking back, she is so happy she has a life now where she is happier than she ever was before.

I will share one more about a woman who described two years of agony, with damage to her liver, hospitalizations, dozens of failed medications and a compilation of diagnoses without any real clarity, but she was given a second chance. She had been labelled as chronically unstable and told she had a poor prognosis, was unable to thrive independently and would likely revolve through the system for the rest of her life. She had attempted suicide several times.

There was one doctor who would not give up on her. As she said, “Recovery takes one person, not one pill. It takes one person who believes in you and forces uncomfortable treatment onto you for the sake of the future life that's awaiting you.” That woman went to university, became a social worker to help others, is happily married and, more importantly, is happy.

None of these stories could ever be guaranteed if we were to do what the government is doing in 15 months, which is to license giving up on people at their most vulnerable moments, at their darkest and lowest points.

Of those who die by suicide, 90% are people who have diagnosable mental illness. Physicians have testified before Parliament and its committees that suicide is often contemplated and planned over a long period of time by people who would very easily, as I am confident I would have, go to a doctor to make a rational, logical case that they have tried all of the treatments and they believe that they are better off dead than alive. There was a consensus among psychiatric experts who have testified and spoken about this elsewhere that there is no clear way to separate suicidal ideation as a symptom from a request for a health care practitioner to help in ending one's life.

Dr. John Maher testified before Parliament that 7% of those who attempt suicide die by suicide. That means that 93% of people who, at one or multiple points, want to end their life eventually get over that. The success rate of MAID is 100%. By design, this is a policy that will give up on people.

There are very few things in this chamber that we can say are genuinely life-and-death issues. This is one of them. A few weeks ago we saw that, in 2024, MAID accounted for 5.1% of the deaths in Canada. That is a 1,520% increase over 2016 when it became legal. We are seeing a massive expansion to people who, in the vast majority of cases, will get better. About 50% to 60% of people with mental illness will actually recover with no treatment, and that number is even higher for people who do have treatment available.

I would not be here today had I been successful. I would not be here today had I not gotten over the darkest, worst feelings of my life, which anyone could encounter. That is something I believe needs to be understood by those who believe this is an abstract question of legal theory and legal rights. These are real people. There are faces to this. If Bill C-218 does not pass, people will die. We have a right and a duty to stand up for those who need it. I will be proudly supporting this bill, and I thank my colleague so much for introducing it.

[Aslam Rana, Liberal, Hamilton Centre, ON]

Mr. Speaker, medical assistance in dying is a complex and deeply personal issue. It touches patients living with unbearable suffering, their family and friends, and the health care professionals who care for them.

Today, as we begin consideration of Bill C-218, I want to speak to how we got here, what the bill proposes and some of the questions I have concerning this bill.

Let me begin by briefly reviewing the path Parliament has taken over the last decade. Understanding the evolution of the law helps us understand the importance of moving carefully when changes are proposed.

First, in 2015, in the Carter decision, the Supreme Court of Canada struck down the blanket prohibition on physician-assisted dying because it violated section 7 of the charter. The court suspended its ruling so Parliament could craft a new framework, one that balanced individual autonomy and dignity with the sanctity of life and the need to protect vulnerable people. It also recognized that Parliament is owed a high degree of deference given the complexity of the issue and the competing societal values involved.

Second, in December 2015, the Special Joint Committee on Physician-Assisted Dying, which was made up of MPs and senators, was tasked with making recommendations on the legal framework to respond to the Carter decision. That committee heard from 61 witnesses, received 132 briefs and published its recommendations in February 2016.

Third, also in 2016, Parliament passed Bill C-14, which legalized the provision of MAID. It did so by creating a MAID framework in the Criminal Code made up of eligibility criteria to determine who can obtain MAID, procedural safeguards to ensure MAID is provided safely and exemptions to criminal offences such as murder for practitioners who provide MAID in accordance with these requirements. Eligibility for MAID was originally restricted to competent adults whose natural death was reasonably foreseeable.

Fourth, in 2021, Parliament adopted Bill C-7, which expanded eligibility for MAID to those whose natural death is not reasonably foreseeable. It also added additional safeguards to address the increased complexity of providing MAID in those situations. At the same time, Parliament temporarily excluded for two years the eligibility of MAID for individuals whose only health condition was mental illness. Importantly, this was not due to stigma or stereotyping about mental illness, but because experts made it clear that unique considerations, including how to assess whether a mental illness is irremediable, required further study and that further health care system preparation was needed.

Bill C-7 also required Parliament to establish the new Special Joint Committee on Medical Assistance in Dying, which heard from more than 150 witnesses, received hundreds of written briefs and submitted three reports. In addition, the bill called for the ministers of justice and health to initiate an independent expert review to recommend protocols, guidance and safeguards for MAID for mental illness, which they did.

Fifth, in 2023, Parliament adopted Bill C-39, which extended the temporary exclusion of mental illness by one year to allow time for federal, provincial and territorial governments, in collaboration with professional bodies, to prepare standards and training and to consider any recommendations from the special joint committee.

Most recently, in early 2024, the special joint committee and several provincial and territorial ministers of health called for more time for provincial and territorial health systems to prepare for the lifting of the exclusion. Parliament passed Bill C-62, which extended the temporary exclusion to March 2027.

At the same time, Parliament also mandated that further review be undertaken by a special joint committee of Parliament, which is to begin by February 28, 2026. The committee is expected to provide a further assessment by Parliament on the readiness of provincial and territorial health systems for the expansion of MAID eligibility to those whose only underlying condition is mental illness. I look forward to its findings and recommendations.

We must also remember that when we speak of medical assistance in dying, we are speaking of a health service that doctors and nurse practitioners deliver as a part of end-of-life care. Changes to the legal framework for MAID would have significant repercussions for provincial and territorial health systems, and changes should be informed by the experience of the people responsible for health care in Canada.

This brings me to the private member's bill, Bill C-218. At its core, the bill proposes two notable changes: number one, to replace the term “mental illness” with “mental disorder”; and number two, to change the structure of the exclusion provision. At first glance these may seem like technical adjustments, but the first change in particular could have significant consequences for eligibility for MAID and how the law is interpreted.

The term “mental disorder” is used in the clinical world, but it covers a far broader range of conditions than “mental illness” is intended to capture. “Mental illness” refers mainly to conditions that fall within the domain of psychiatry; the term does not include neurocognitive or neurodevelopmental disorders, such as Parkinson's disease, which is typically treated by other medical specialists. Under Bill C-218, however, this condition would now be captured by the exclusion, because it falls under the broader category of mental disorder.

Currently, individuals whose sole underlying medical condition is a neurocognitive disorder are eligible for MAID. This leads me to an important question: Why broaden the exclusion to include conditions like Parkinson's disease that are currently eligible for MAID? If this was not the intent of the bill, then further clarity is needed.

My second concern relates to the proposed change in Bill C-218 of the definition of “grievous and irremediable medical condition”. The Criminal Code's definition of this term includes three components: “a serious and incurable illness, disease or disability”, “an advanced state of irreversible decline in capability”, and “enduring physical or psychological suffering” that is due to the person's medical situation.

Currently a mental illness is not considered to be an illness, disease or disability, for the purpose of MAID eligibility. This means that a mental illness cannot meet the first requirement of a grievous and irremediable condition. Bill C-218 proposes something different; it states, “a mental disorder is not a grievous and irremediable medical condition.” The question is, why? What problem does it aim to solve that the current exclusion does not already address? Could this change be perceived as saying that a mental illness cannot result in enduring suffering?

When it comes to MAID, caution is essential; that is why the government has repeatedly committed to ensuring that provincial and territorial health systems are ready before any expansion would take effect. That includes training assessors and providers, developing and implementing clinical guidelines and supports, and strengthening oversight systems for MAID.

Bill C-218 raises important questions, but before we move forward, we must ensure that its effects are clearly understood and aligned with the careful work Parliament has been doing for nearly a decade. The way Canada approaches MAID speaks to some of our most deeply held values: respect for personal autonomy and dignity, compassion for those who suffer, and a firm commitment to protecting vulnerable people. We owe it to Canadians—

[The Deputy Speaker, Tom Kmiec]

The time provided for the consideration of Private Members' Business has now expired, and the order is dropped to the bottom of the order of precedence on the Order Paper.

It being 2:30 p.m., the House stands adjourned until Monday at 11 a.m. pursuant to Standing Order 24(1).

(The House adjourned at 2:30 p.m.)

The House resumed from December 5, 2025, consideration of the motion that An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, we are debating Bill C‑218, which seeks to specifically exclude patients with a mental disorder from being able to request an assessment of their condition to determine whether or not they are eligible for medical assistance in dying. Some of these patients have had a mental disorder for decades, 20 or 30 years. They have tried everything, all available treatments, have been treated for decades without significant improvement in their condition and have endured stigma and discrimination their entire lives. These are people whose decision-making capacity is established according to the rules, people for whom psychiatry can only offer a life indefinitely housed in palliative care with no cure. These people's suffering has become intolerable, but Bill C‑218 tells them to try again for their own good, because their only option is repeated treatment. They are told to suffer so that, maybe one day, they will be cured.

In June 2022, the Special Joint Committee on Medical Assistance in Dying recommended that MAID be expanded to include mental disorders. The only two reservations it had were about how prepared clinics were to ensure safe and appropriate implementation, as well as the very short time frame leading up to the March 2023 deadline. Those reservations can be found in the conclusion of the June 2022 interim report of the Special Joint Committee on Medical Assistance in Dying.

However, in its latest report in 2026, the Special Joint Committee did a complete 180° and questioned the merits of expansion, despite proof that such a position is discriminatory; despite proof that the groundwork had been laid, according to the Canadian Association of MAiD Assessors and Providers, the psychiatric associations of Canada and Quebec, the Department of Health and the Department of Justice; and despite the establishment of practice standards by the task group that the Liberal government funded to define the practice standards and required training for assessors and providers.

I find it troubling to stand here before legislators who support a blanket, definitive exclusion from MAID for patients with mental disorders, even though the exclusion is discriminatory and unconstitutional, yet who lack the courage to refer the matter to the Supreme Court to spare suffering patients from having to bear that burden. It speaks to ideological rigidness, unfortunate partisan politics and a flagrant lack of compassion. It is unbearable to hear constant claims that issues with accessing care and structural vulnerabilities supposedly lead patients to choose MAID over treatment, despite evidence to the contrary and without proposing a substantial increase in health transfers.

In terms of structural vulnerabilities, Health Canada data, annual reports on MAID in Canada, and a scientific study by James Downar and Kieran Quinn, entitled “Is Structural Marginalization Driving Medical Assistance in Dying (MAiD) in Canada?”, have concluded that structural vulnerabilities do not play a significant role in MAID requests.

When it comes to MAID, it was not the House but the Supreme Court that did the work. Back in 2015, it forced the House of Commons to amend the Criminal Code to respond to requests from patients whose constitutional rights were being violated. The Bloc Québécois believes that the Carter decision and the Baudouin ruling justify opening up MAID to people with a mental disorder whose chronic suffering has become intolerable.

On what grounds should the government undermine or restrict the right to self-determination of a person with a mental disorder, as long as their decision-making capacity is not affected? On what grounds should chronic suffering that has become intolerable be considered reasonable? On what grounds would discrimination be reasonable?

The role of the state is not to claim it knows better than a person facing unbearable suffering what is right for them in a matter as personal as their own death. The role of the state is to ensure that the conditions are in place for that person to make a free and informed choice.

The right to self-determination, free and informed consent, informed decision making and the exercise of a patient's decision-making capacity, when this has been established in accordance with best practices, all run counter to the medical paternalism that still seems all too present in psychiatry.

We must ask ourselves the following: On what grounds should certain patients with a mental disorder whose suffering has become intolerable and has been established as chronic, and whose medical records demonstrate beyond any shadow of a doubt that all available treatments have been administered without resulting in a permanent improvement or significant relief from intolerable suffering, be discriminated against or forced to continue suffering?

Some psychiatrists argue that it is impossible to determine that a mental disorder is irreversible. They question whether a psychiatrist can establish a prognosis or even diagnosis of incurability. However, all of these issues are clearly explained in the expert panel's report, which proposes guidelines and precautions to be taken for the safe and appropriate provision of medical assistance in dying for people with mental disorders. I urge everyone to consult it.

Madam Speaker, the members opposite are really bothering me because they are laughing and talking. If they do not want to listen to me, they are free to go outside. I ask that you intervene and stop the clock.

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

I would remind hon. members that it is important to remain silent and listen when a member has the floor.

The hon. member may resume his speech. He has three minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, a few psychiatrists use anecdotal, unsubstantiated claims to assert that every mental illness is treatable or curable, but they also say that psychiatry is wrong about both prognoses and diagnoses. Those psychiatrists cannot explain why we should rely on anecdotal, unsubstantiated accounts involving patients whom they say would have met the MAID eligibility criteria and safeguards set out in the expert panel report when those psychiatrists have no experience with MAID, either as assessors or providers, and when they are are effectively opposed to track 2 or MAID in general.

The report by the expert panel that proposed the conditions under which MAID could be expanded to mental disorders is clear. Just because a patient makes a request does not mean they will be eligible. During her testimony, Stefanie Green explained that the following individuals are ineligible: a person in a suicidal crisis; a person who has recently been admitted for treatment and diagnosed; a person whose request is based on structural vulnerabilities; and a person who refuses, without justification, all treatments that could improve their condition. A person is also ineligible if accessible and effective treatments are available or if the assessors are unable to determine eligibility based on all or part of the criteria.

Evidence of de facto accessibility, linked to a level of preparedness for the safe and appropriate provision of medical assistance in dying for people with mental disorders, was demonstrated in the recent study by the Special Joint Committee on Medical Assistance in Dying. Those who oppose MAID must do so for other reasons.

The Bloc Québécois opposes Bill C-218 and proposes that the dispute over whether the exclusion of patients constitutes discrimination be clarified by the Supreme Court.

In the meantime, we ask that the sunset clause not be removed prematurely and indefinitely. The final recommendation is that recommendation 16 of the expert panel report, which calls for establishing prospective monitoring at the conclusion of the assessment process, be implemented as an additional clinical safeguard.

[Michael Cooper, Conservative, St. Albert—Sturgeon River, AB]

Madam Speaker, I rise in strong support of Bill C-218, the right to recover act, introduced by my friend, the member for Cloverdale—Langley City. The title of the bill fully reflects the substance of the bill. It is the right to recover: to give persons struggling with mental health challenges hope and help, instead of state-sanctioned, state-administered death, by putting an indefinite pause on the Liberal government's ill-thought-out expansion of MAID where mental illness is the sole underlying condition.

I commend the member for Cloverdale—Langley City for bringing forward the bill, because it is absolutely needed. We need legislation to be passed by Parliament. Otherwise, this ill-thought-out expansion will take effect in March 2027.

I have to say that it should never have been this way. It should never have come to this. The planned expansion is a master class in how not to do policy and how not to legislate.

Back in 2021, the then Liberal justice minister David Lametti, at the eleventh hour, accepted a radical Senate amendment, which he initially opposed, that set the train in motion for the expansion of MAID for mental illness, effective March 2023. There was no meaningful study, no meaningful consultation and no meaningful debate. The Liberals simply rammed it through. This was on a question of life and death concerning among the most vulnerable persons in Canadian society. It could not be more reckless than that.

Here we are, more than five years later, and the planned expansion has been nothing short of a mess. It has been completely shambolic, including the fact that the government has been all but forced to introduce two emergency bills to delay implementation because it did not do its homework at the outset.

Had the Liberals done their homework, they would have heard loud and clear what experts, including leading psychiatrists, have been saying, and that is that MAID for mental illness is a really bad idea, that it cannot be implemented safely for a multitude of reasons, not least of which include two unresolved clinical issues.

The first of those issues is that it is difficult, if not impossible, to predict irremediability. In other words, it is difficult, if not impossible, to predict whether someone suffering from a mental illness will get better. Indeed, many mental illnesses are remediable, and they are very difficult to predict in terms of a prognosis.

As Dr. Karin Neufeld, who is one of Canada's most renowned psychiatrists and is none other than the chair of the Association of Chairs of Psychiatry in Canada, put it in her brief to the Special Joint Committee on MAID, which is studying this very issue, “Psychiatric disorders lack reliable biomarkers, follow non-linear trajectories, and frequently improve after years of severe impairment.” Accordingly, Dr. Neufeld concluded that psychiatrists are poor predictors of long-term outcomes. Simply put, modern psychiatry lacks the tools to predict irremediability in individual cases of mental illness. It is so uncertain in terms of predicting irremediability, that studies show that psychiatrists get it right less than 50% of the time.

As Dr. Sonu Gaind, who is the past chair of the Canadian Psychiatric Association, told the special joint committee, one would be better off flipping a coin to predict irremediability. This is on a matter, again, involving life and death. What that means is that if this expansion were to go forward in March 2027, or at all, tens of thousands of Canadians who could get better, recover and lead productive lives will have their lives prematurely ended.

This prospect is untenable, and it is unconscionable. The uncertainty around predicting irremediability not only renders MAID for mental illness a completely reckless and dangerous policy, but also makes it impossible to administer in compliance with the law. This is because a prerequisite to qualifying for MAID is that an individual must have a grievous and irremediable condition. Given that it is difficult, if not impossible, to accurately predict irremediability in cases of mental illness, the legal basis for MAID cannot be satisfied, full stop. Therefore, we have not only a clinical issue, but also a major legal impediment to this expansion going forward.

The second major clinical issue identified is that it is difficult to distinguish, in cases of mental illness, a rational request for aid versus one motivated by suicidal ideation. This is because, in many cases, suicidal ideation, suicidal thoughts, are a symptom of the illness, and that is underscored by the fact that, in more than 90% of suicide deaths in Canada, mental illness is a factor. What that means is, if this were to go forward, long-standing suicide prevention efforts would be undermined. The mental health law would be upended, because given that suicidal ideation is often a symptom of mental illness, it begs the very practical question of which requests for MAID would merit intervention and suicide prevention versus the granting of MAID.

Given these unresolved clinical issues and other issues, and the clear opposition from the vast majority of psychiatrists, including the 17 chairs of psychiatry representing all 17 medical schools in Canada, who penned a letter to the Minister of Justice saying to put an indefinite pause on this, the Liberals twice, as I alluded to, introduced emergency legislation to kick the can down the road. They kicked the can down the road yet again with a new date of implementation, that being March 2027. Guess what. Nothing has changed. The same clinical issues remain unresolved, and there is no evidence that they will be or can be resolved in the foreseeable future, if ever.

This is why the special joint committee on MAID, which wrapped up its work in June, of which I was a member, of which the member for Cloverdale—Langley City was a member, recommended that the government stop kicking the can down the road and simply put an indefinite pause on this ill-thought-out expansion. I would note that the recommendation was a unanimous recommendation from Conservative and Liberal MPs on the committee.

The government likes to claim it makes decisions based upon evidence, that it make decisions based upon the facts. Well, if that is so, then to follow the evidence, there is only one, objectively speaking, reasonable course of action for the government to take, which is to admit it got it wrong in 2021 and to reverse course by putting an indefinite pause on this expansion. Bill C-218, the right to recover act, provides a clear path forward to do just that.

Let us pass Bill C-218.

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

Madam Speaker, I have a few thoughts I would like to share with the House on the legislation and what it is that the member is actually proposing. With what the previous speaker just mentioned, it is important for us to recognize that the government took action because of a superior court decision that was made in the province of Quebec.

Both the member and I have actually been around since the creation of the MAID legislation, so we are very—

[Some hon. members]

Oh, oh!

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

May I interrupt the hon. member?

While members were speaking on that side of the House, we had calm. Can we continue to have calm and let the member make his speech?

The hon. parliamentary secretary.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, I think it is really important that we put into perspective why we are where we are today. This is not something for which a political party made the decision. The member who just spoke, as well as the members opposite who were around, back in 2015, like myself, just need to reflect back to that time and what was taking place. For example, the Supreme Court of Canada put it on the political agenda, so there was a need for the House of Commons to respond to it. It was the Carter v. Canada case, which obligated all of us at that time to deal with the issue.

The government worked collaboratively and there was a high sense of co-operation on the issue. After all, what could be more personal than having to deal with the issue of medical assistance in dying, and having to make difficult decisions as to when to say no to a medical treatment, or to have a medical treatment that would ultimately lead to the death of an individual? It is very much a personal decision. I think that we need to amplify that. Those personal decisions are best made by the individual working with the experts they have access to, and having those heartfelt discussions with family members and often close friends.

I think we often underestimate the important contributions and understanding that health care providers, in particular, and others provide while dealing with the difficult issue of death. For those who are dealing with it on a more frequent basis, if they go to hospice care facilities or personal care facilities, they will often find those health care professionals and others in situations where they have to deal with death on a regular basis. As we all know, it is a part of life. If we then factor in the difficult complications that come to the table with individuals who have a desire to seek MAID, there have been a great deal of arguments brought forward. The decision was made in February or maybe March 2015, but the Supreme Court started hearing about it in 2014.

The passion was very real. We got to see some of that passion. If members recall, we had a special committee of the House. I believe it might have even been a joint committee that included members of the Senate. Whether members were on the committee or not, there was a great deal of discussion that took place between committee members and other members of different caucuses. I can recall members inside the chamber delivering speeches on MAID, even talking to some of the individuals who were involved in the lobby rooms. We would often see tears while listening to their personal stories. All one needs to do is to review Hansard during the second reading. Even back then, I spent a lot of my time on the floor of the House here.

However, I can say that the committee that studied it after second reading, and even prior to second reading, was deeply engaged. It went on at great length, for hours and hours, with personal stories of witnesses who appeared before it. It was not an easy decision. Sitting back, what I witnessed was some members of the Conservative Party advocating one way and others advocating another way, as it was with the Liberal Party and other entities within the House, because it was based on sharing our free thoughts, having a free vote and so forth.

It was difficult, but ultimately a vast majority of members of Parliament voted in favour of Canada's having MAID legislation. That is something that was not done lightly or taken lightly, and I think we need to emphasize that in this debate. It was very thorough, and ultimately, members from all political entities ended up voting in favour of Canada's having MAID legislation.

A number of years after that, as I alluded to at the very beginning and as the previous speaker was making reference to, was the issue of mental illness and whether it should or should not be part of MAID. Once again that was put on the table, brought to the House of Commons, because of a decision from a superior court.

[Some hon. members]

Oh, oh!

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

Can we allow the hon. member to finish his speech?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, the issue of MAID came before the House again because of a superior court decision in Quebec. That we can say.

[An hon. member]

Oh, oh!

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, they can call it what they want. It is still a superior court in Quebec.

Moving forward, the issue has been brought to the House, and a decision has been made. There is a sunset clause within the legislation that does need to be addressed.

On the issue of mental illness, ever since I have been a parliamentarian, I can remember Dr. Gulzar Cheema, one of my colleagues in the Manitoba legislature, arguing and articulating on why it was so important that we have not only a department of health but also a department of mental health, because we need much more to recognize mental health as part of our health system. There are severe files within mental health that I believe, if this legislation were to pass, would never, ever get any consideration, and I do not believe that would be appropriate.

Given the very importance of the issue of mental health, let us have more discussions. I would like more provinces to establish departments of mental health, but at the end of the day, I do not necessarily believe the exclusion is the way to go.

[Jeremy Patzer, Conservative, Swift Current—Grasslands—Kindersley, SK]

Madam Speaker, it is always an honour to rise in this place on behalf of the great people of southwest and west central Saskatchewan.

Canadians sent us here to deal with many problems affecting them personally and impacting the country as a whole. There is no doubt that what we are debating right now is a very serious issue facing our society. I first want to thank my colleague the member for Cloverdale—Langley City for her leadership in bringing forward the right to recover act, Bill C-218. She has already brought hope to so many people and approached such a difficult topic with the compassion and the urgency that it deserves.

Not only has the member for Elgin—St. Thomas—London South seconded the bill, but along the way he has done a lot of work advocating for it. He had the courage to share his own personal story of battling years of severe depression and surviving suicide attempts. While telling his full story, which includes a challenging process of recovery, he shone a light on a struggle facing thousands of Canadians and their loved ones.

To give us more perspective, here are some of the latest numbers from the federal public health website. Each year in Canada, there are 4,750 deaths by suicide and 20,000 hospitalizations caused by self-harm. There are 100,000 reported suicide attempts, along with 250,000 people who make suicide plans and 840,000 people with serious thoughts of suicide. That means every single day there are 250 Canadians who make reported suicide attempts, 700 who make suicide plans and 2,300 who have serious suicidal thoughts. Let us allow all of that to sink in for a minute.

We often talk about having better awareness about mental health, but we also need to build on that by actively meeting people's needs and providing real protection for those who are vulnerable. With this bill, both of these MPs have moved us forward in that important goal.

At the moment, we are in a situation where the current law would allow access to MAID for people who have a desire to die solely on the basis of their mental illness. If we think about it for a second, we can start to imagine how that creates an opening in the medical system where it becomes easier for a suicidal person to end their life. In other words, it is pretty clear that we are really talking about assisted suicide.

As Canadians learn that this is happening, they are increasingly against the idea, but currently, if nothing changes, the Criminal Code would allow eligibility for assisted suicide on the basis of mental illness alone starting next spring. As disturbing as it is to think about, it is not too far in the future. However, Bill C-218 provides a simple solution. By a short amendment to the Criminal Code, it would stop the expansion of MAID for mental illness before it takes effect.

Just recently, the Special Joint Committee on Medical Assistance in Dying studied this exact issue and came to the same conclusion. Based on the consistent testimony of witnesses and experts, the committee's report officially recommended an amendment to the Criminal Code to exclude mental illness as the sole underlying medical condition for MAID. This recommendation reflects a consensus across party lines, and now that we have Bill C-218 in front of us, it just makes sense for us to proceed with it to achieve the final result we would like to see.

Earlier this year, I had the chance to work with the special joint committee as it carried out the study. That happened because I ended up filling in for one of the regular members, the member for Cariboo—Prince George—Omineca, who was supposed to be on that committee but had to spend some time away to recover from surgery he had on his knee.

I want to make a special mention of something here. It made perfect sense for him to participate in the study because he has been one of Canada's strongest advocates for mental health. He has worked tirelessly for years to make the 988 suicide prevention hotline a reality. After his motion passed unanimously in the House, it still took a few years before it finally launched, thanks in large part to his persistent efforts with introducing legislation, setting timelines and helping to keep up the pressure on the government to get the job done.

It needed so much time and effort to accomplish, even though it was a project that already had broad support across parties. It was worth doing because we know that 988 has made a real difference and has been saving people's lives.

We all support suicide prevention. We have a good idea of how important it is to be prepared so that we can respond with compassion and provide resources to people who are suicidal. On the other side of the equation, we also need to be extremely cautious of sending the wrong signals or messages, which could push a vulnerable group of people in a worse direction.

We had a representative from 988 appear as a witness in this study on assisted suicide for mental illness. She provided data to us based on her team's experience:

...on frontline signals from 988, up to 7% of interactions on the service refer to MAID. Critically, among those who reference MAID, 74% endorsed thoughts of suicide in the past two days, compared with 48% among other contacts. In short, interactions with our national suicide crisis line that reference MAID are associated with substantially higher suicidal ideation. That's not a theoretical concern; it's a real, measurable, elevated risk among people who mentioned MAID to Canada's suicide prevention service.

The same witness also went on to say:

My recommendation is straightforward. Do not expand MAID to cases where the sole underlying condition is a mental disorder. This recommendation aligns with the position of the International Association for Suicide Prevention that the overlap between MAID requests and suicide makes distinguishing between them impossible. MAID for mental illness will undermine suicide prevention by positioning MAID as a viable alternative to treatment.

This was one of the key concerns raised during the committee study. As this witness said, which was a point echoed by others, it is impossible to distinguish a desire for death inspired by mental illness from being suicidal.

Dr. Sandip Singh Gandham expressed, “I worry that in some cases, we may not be responding to an autonomous, enduring request for assisted dying, but rather to the voice of the illness itself.”

We also heard the story of Donna Duncan in B.C. Her daughter, Alicia, appeared as a witness and has been raising the alarm on her mother's case, which is directly related to the issue before us today. Donna was approved for and died by MAID in British Columbia in 2021, only hours after being released from a psychiatric unit and following a suicide attempt.

Donna was clearly suicidal and facing a mental health crisis, and all her blood tests came back normal. She had no terminal condition. She should not have been a candidate for MAID, yet the system deemed her eligible for track 1 MAID because, under the influence of a mental disorder, she was starving herself. In this case, the existing safeguards failed despite the family's best efforts and despite Donna's own admission that she did not want to die. She just felt deprived of proper care.

If a mistake was made in this case or any others, what is the remedy supposed to be? Death is irreversible. As the Duncan family found out, the only person authorized to access Donna's MAID assessment records is Donna herself, and Donna has died. Neither her family nor even the police can access the records, and neither the regulators nor the B.C Privacy Commissioner is prepared to override that. Realistically, then, how is anyone supposed to investigate whether the law was followed?

There are also concerns about new conflicts with providing patient care in the relationship that therapists have with clients. Are Canadian care providers there to fight relentlessly for every last person who can be helped or are they there to process people according to their requests and wishes, even if they could eventually recover in the future from their mental illness?

Dr. Jitender Sareen put his finger on this when he said, “This goes to the core psychiatric practice, which is grounded in assessing and treating hopelessness and preventing suicide.”

Is the psychiatrist there to help prevent suicide or enable it? What does it do to a psychiatrist's ability to do the former if the patient knows all the time that all they have to do to have their life ended is refuse to co-operate on therapeutic help that might work?

In that context, if MAID is available as an option, it becomes a factor on its own, which can undermine the effectiveness of therapy. Along with the general problem of recognizing suicidality for what it is, medical and psychiatric professionals also share deep concerns with the idea of irremediability and predicting patient outcomes while considering all the complexity of treatments for mental illnesses.

Dr. Karin Neufeld testified about a middle-aged patient of hers who had been suffering from a major depressive illness since childhood. He was seeking a referral for MAID and would have qualified, but after undergoing treatment with this particular therapist, he has now recovered the will to live. We have heard about similar cases as well.

Across Canada, people struggling with a mental illness are contemplating MAID not because they want to die, but because they are not getting proper support. They come from all walks of life. In this area, we heard about particular concerns related to indigenous communities and people with disabilities.

Our approach to allowing assisted suicide for mental illness is something that medical professionals, psychiatrists, advocacy groups and the United Nations have called on us to rethink. Parliament has itself pushed the deadline back multiple times and our special committee has now recommended indefinitely suspending it. We should listen to Canadians and listen to the committee and finally reverse this expansion. Let us pass Bill C-218.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Madam Speaker, it is my honour and privilege to rise today to speak to Bill C-218, a bill that would repeal the coming into force of MAID for mental illness as the sole underlying cause for concern.

Canada is becoming a parable. It is becoming an example of what not to do for the world. The United Kingdom recently had a discussion about introducing euthanasia or MAID to the country. It looked at Canada and said, “That is not what we want to do”, and it actually rejected it.

I remember back in 2016-17 making arguments in the discussion about introducing MAID into Canada and calling it a slippery slope. I can say that I was wrong when I said it was a slippery slope. It turns out that it was a cliff. We had no idea that we were going to fall off this cliff. One-fifth of people who die in Canada die because of MAID. This is a major cause for concern.

We can look to other jurisdictions that are very similar to Canada. California has demographics similar to Canada's, has similar political understandings and has a similar population, yet in the same time frame, we saw that 13,000 people in Canada used the MAID program and only 300 people used the assisted suicide program in California. Something is seriously wrong with our system.

When MAID was brought into Canada, there were two criteria for it. Someone had to have a reasonably foreseeable death, something that we argued against. We said that was nebulous; we did not know what that meant. Most people's death is reasonably foreseeable. We will all die. That was one criterion for MAID, along with the fact that a condition had to be grievous and irremediable.

That was then challenged in the courts. I recall that we had just passed the MAID regime through Parliament. Parliament had spoken as to what the law ought to be in Canada. Just a couple of years later, it was challenged by two people from Quebec, and it was overturned at the first level of court in Quebec.

David Lametti, the justice minister at the time, refused to defend the work of Parliament. His personal opinions on MAID and the direction it should go were well known, but as the justice minister of Canada, it was his responsibility to defend what Parliament had put in place, and he refused to or was negligent and did not do that. He did not challenge the lower court decision in Quebec.

Therefore, that decision stood, and that then placed an arbitrary deadline upon Parliament to come up with a solution. That is how we got the so-called track 2 MAID, and along with that came the idea, which they put in in 2026 and then extended out to 2027, that MAID for mental illness should become a thing here in Canada.

There has been a committee study since then that looked at this. I tried to answer this question: Is Canada ready for MAID for mental illness? We heard over and over from people who said that if somebody is suicidal and wants to die, we cannot determine who will get better and who will not get better. There is no test for this. That is reason it was extended for one more year, because they said we had to continue to work on it.

Here we are, about a year out from that, and there is still no test today. When somebody calls the suicide prevention hotline, there is no test to say that someone is going to come around, that we can put them into treatment, they will recover and have a desire to live again and we should put them into a suicide prevention program.

There is no test for people to say they will send one person to the suicide prevention program and another person will be offered MAID. There is no test to say one person is going to recover and another person is not. We just do not know. The default should be that people having suicidal ideations will get better. We will give them treatment, support them and try to remove the things in their lives causing the suicidal ideation.

I would point Canadians to the work by my colleague, the member for Elgin—St. Thomas—London South, and the many speeches he has given on this, saying that, if this had been the law several years ago, he would not be here today because he would have availed himself of it. Today, he is a member of Parliament and a high-functioning individual. He is laughing at that. It is a true story. I thank him for being vulnerable with us, sharing these stories over and over again, telling this story and being a champion for Bill C-218.

Bill C-218 would make it so that we have suicide prevention in this country and only suicide prevention in this country. It is not for the Government of Canada to set up a program where some people get suicide prevention treatment and some people do not get suicide prevention treatment. That is not a country any of us want to live in, where we say suicide prevention is good for one person but not good for another person. We heard over and over again at committee that there is no test to determine the difference.

With that, I look forward to voting on this bill. I will be voting for it. I am very hopeful this bill will pass and we will once again restore suicide prevention in this country.

[Andrew Lawton, Conservative, Elgin—St. Thomas—London South, ON]

Madam Speaker, this is a bill that is very personal. It is an issue that is very personal. Through the course of the work of the Special Joint Committee on Medical Assistance in Dying, we heard from a number of experts who have worked with patients going through challenges, much like those I went through 15, 16 years ago, people who felt that they were better off dead than alive. These are people who deserve support. These are people who deserve treatment. These are people who should be welcomed into wanting to live, not assisted with end of life.

The bill from my colleague from Cloverdale—Langley City, who so eloquently called it the right to recover act, is a bill that would do exactly what the title says. It would offer people a right to recover. It would offer hope. It would offer light to people in the darkest moments of their lives. I was so honoured, with my story, to be able to be a champion for this, even before my colleague introduced her bill. I was equally honoured to be named to the Special Joint Committee on Medical Assistance in Dying, at which we were able to tackle—

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

I have just been informed that the hon. member has already spoken to this bill and it is not appropriate that he speaks to it again. My apologies.

I would invite the hon. member for Cloverdale—Langley City to rise for her right of reply.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Madam Speaker, I will begin by grounding the end of this debate in remembering young Kiano Vafaeian who lost his life to MAID. He was 26 years old, and he had lived with type 1 diabetes since he was four. After a serious car accident as a teenager, he also struggled with his mental health, and later he lost vision in one eye.

In 2022, when he was just 23 years old, Kiano sought MAID in Ontario. His mother, Margaret, fought desperately to keep her son alive, and she succeeded for a time, but Kiano had become obsessed with getting MAID. He continued to request it from Ontario Health until they told him straight out that he would never qualify in Ontario, but shockingly, they suggested other jurisdictions he could contact in his quest to end his life. Sadly, he found a willing doctor in B.C., where he received MAID on December 30, 2025, from the now infamous Dr. Ellen Wiebe. He was 26 years old.

When I heard Kiano's story, I could not stop thinking about my own little brother Johan. In 2023, he was diagnosed with terminal brain cancer. He knew he was dying, but he wanted to live. However, the medical staff at the Abbotsford hospital seemed to want to end his life. While lying on a bed in the hallway on the oncology ward, he was asked not once, not twice, not three, four or five times but six separate times if he wanted MAID. They were relentless. They pressed him, saying that they did not think they would be able to control his pain, scaring him out of his wits, but he still had a will to live.

I am very proud of my little brother for standing up for his life, for having the courage and the commitment to make a statement that his life was still worth living, even if it was for only another eight or ten months. He had time to mend fences, make friends with the people at the hospice and say goodbye to his family.

This is why Bill C-218 is necessary, because not everyone will have the will and the ability to fight the way my brother fought. Not everyone will have the strength to say no six times. When someone is sick, frightened, depressed or unable to see any hope for tomorrow, surely the responsibility of our medical system is not to reinforce the despair but to protect them while they are vulnerable and help them find their way back to hope.

This is particularly true when we are talking about mental illness. For years, Conservatives have warned that expanding MAID to people suffering solely from mental illness crosses a line we should not cross. We were told that the safeguards would be enough. We were told that the system could be made ready. However, the implementation has been delayed again and again, while the fundamental question remains unanswered: How can we declare that a person's mental illness is irremediable when we cannot reliably know that they will never recover? However, we do know one thing with absolute certainty: Once that life is ended, there is no tomorrow.

When we first debated the bill, members told us to wait for the special joint committee to do its work. Well, it has. The committee heard the evidence and recommended that people whose sole underlying condition is mental illness be indefinitely excluded from MAID eligibility. Parliament asked for that review. We now have its answer.

If the concern with Bill C-218 is the wording and the use of the term “mental disorder” instead of “mental illness”, then let us fix the wording at committee. We are prepared to work with the government at committee to make the technical changes. A bill should not be defeated at second reading over one word when there is agreement on the principle. Time is of the essence. The scheduled expansion is coming in March. Let us work together and send the bill to committee.

The measure of a compassionate society is not how efficiently it helps people die. It is whether in the moment when someone can no longer see the value of their own life, the rest of us are prepared to see it for them. Our answer to suffering should be care. Our answer to despair should be hope. When someone believes there is no possibility of recovery, Canada should never be the one to agree with them. That is why I am asking my colleagues to vote for Bill C-218. Give Canadians the time, the care and the hope that they need. Give them the right to recover.

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

The question is on the motion.

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

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, we request a recorded vote, please.

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

Pursuant to Standing Order 93, the division stands deferred until Wednesday, October 7, at the expiry of the time provided for Oral Questions.

The House resumed from September 23 consideration of the motion that Bill C-218, An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

[The Speaker, Francis Scarpaleggia]

The House will now proceed to the taking of the deferred recorded division on the motion at second reading stage of Bill C-218 under Private Members' Business.

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

Vote #177

[The Speaker, Francis Scarpaleggia]

I declare the motion defeated.

I wish to inform the House that, because of the deferred recorded divisions, Government Orders will be extended by 43 minutes.