It's a complicated situation.
Evidence of meeting #102 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was illness.
A video is available from Parliament.
Evidence of meeting #102 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was illness.
A video is available from Parliament.
9:30 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
Neurodegenerative diseases are physically degenerative diseases where irremediability and developmental stages toward the end, toward decline, are objectively determined. From there, you can't think they're any more complicated than mental disorders over which people are, in a way, torn over remediability. So—
9:30 p.m.
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
On a point of order, Mr. Chair, with the earlier panel—
9:30 p.m.
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
—Mr. Doherty made an objection, which I agreed with at the time. We're not here talking about advanced requests. We're here talking about Bill C-62. It's a piece of legislation with a very specific outcome.
As much as I appreciate Mr. Thériault's passion, it's not on topic.
9:35 p.m.
Liberal
The Chair Liberal Sean Casey
Thanks for the intervention, but we've allowed it all evening. I'm not inclined to change it now. It appears the ministers are ready to speak to it.
Mr. Thériault, please ask your question, then we'll give the minister 30 seconds to reply because your turn to speak is nearly over.
9:35 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
All right. Will there be a bill? Will you look into this so we can have this component that would cover people who are suffering? Are you going to read the Quebec act for inspiration so we can solve this problem once and for all? According to an Ipsos survey, the national approval rate is 85%. That's a real poll.
9:35 p.m.
Liberal
Arif Virani Liberal Parkdale—High Park, ON
We're entirely up to date on the bill that was passed in Quebec.
Mr. Thériault, I can tell you that we've been proceeding cautiously from the very start, in 2016, but always at the national level, for the entire country. The same was true when we responded to the Truchon decision. The same is true when we handle advance request cases. We're going to do it in consideration of Quebec's study and leadership, but we will conduct a study that applies all across Canada.
9:35 p.m.
Liberal
The Chair Liberal Sean Casey
Your time is up, Mr. Thériault. I even allowed you a little extra time.
Mr. MacGregor, go ahead, please. You have six minutes.
9:35 p.m.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
Thank you very much, Mr. Chair.
Thank you, Ministers.
Minister Holland, I'd like to start with you on the subject of the letter that was signed by seven out of 10 provinces and all three territories.
In our first panel, some witnesses were talking about readiness in the system. I am assuming that these ministers would not have signed this letter unless they had confirmed with their deputy ministers or assistant deputy ministers that in fact their system was ready.
You've had in-depth conversations with these members. You've probably had conversations with their deputy ministers. What conditions would have to be in place for you to attach your name to such a letter? You would probably want to consult with your deputy minister to get that kind of assuredness from the health care system that you're overseeing.
9:35 p.m.
Liberal
Mark Holland Liberal Ajax, ON
Do you mean the letter saying that it would be indefinite, as opposed to three years?
9:35 p.m.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
What conditions would have to be in place for you to sign such a letter? Would you want to check with your deputy minister first?
9:35 p.m.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
Okay, that's a good point to put into place.
Also, these ministers were very careful to ask for an indefinite pause. What caused you to choose the three-year delay instead of listening to the ministers who have that oversight of the health care systems?
9:35 p.m.
Liberal
Mark Holland Liberal Ajax, ON
There were detailed conversations with the health ministers. Part of that was about how long it was going to take their systems to get ready.
One concern with some of the ministers, really, was a question of readiness. They acknowledged the equivalency between mental suffering and physical suffering, but a few of them were simply ideologically opposed to the idea of ever proceeding in such a way.
I think that if we were to put it off indefinitely, then we'd see no progress in the system in terms of the adoption of the curriculum or even the belief that we were moving towards that. That would leave people who are in unimaginable suffering.... We're talking about a very small number of people, but these are people who have tried everything and are stuck in unimaginable mental hell. After decades, in many cases, of asking, they are saying, “I want access to MAID”. That is a consideration here.
February 14th, 2024 / 9:35 p.m.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
Thank you.
I am going to take issue with two of your earlier comments.
I do think, actually, that this issue has been punted down the road. It was punted down the road by two years with the Senate amendment. It was further punted down the road by one year of Bill C-39. Now we're looking at a three-year punt.
I also take issue.... I've been on the special joint committee since its inception. I agree with the recommendation that we put forward, but we did not have anywhere near enough of a time frame to study this issue in depth. We had three meetings of three hours each.
How can you say that this is not punting it down the road? How can you say that the special joint committee had adequate time when in fact we did not?
9:35 p.m.
Liberal
Mark Holland Liberal Ajax, ON
This, of course, was the second time the joint committee had been sitting. The joint committee, in its previous iteration, had spent an extraordinary amount of time on the subject. It was round two, if you will, for the special joint committee. We're very appreciative of their work. They did extensive work in the first round and that wasn't very long ago.
The second point was that there seemed to be a uniformity of opinion within that joint committee that more time was needed. I don't know how much time you need to study.... Once you reach a conclusion that says you need additional time, to keep studying to say you need more time doesn't make a huge amount of sense to me.
In terms of punting down the road, you can use whatever nomenclature you want. The point here is that we have to make sure the system is ready. Given the opportunity, I can talk about all the things that were done over that one-year period and why we thought they would be sufficient, but the underlying reality is that it was insufficient and we needed more time. I wish I had clairvoyance and could have known that, but I lacked it.
9:40 p.m.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
Thank you.
I'd like to turn to Minister Virani, if I could.
You were mentioning, to paraphrase the Supreme Court, that they were going to give a high degree of deference to Parliament when legislating in this area because of how sensitive it was. When Bill C-7 was first introduced, I thought there was a very reasonable charter statement issued that explained the government's initial reasons for excluding this. Then at the eleventh hour, a very consequential Senate amendment was accepted. I think that really is the root of all the problems we're finding ourselves in today.
Do you, as a minister, now have regret about that decision?
I truly believe that this decision was putting the cart before the horse—and I'm speaking as a member of the special joint committee. We have been playing a game of catch-up ever since. The law was changed in advance of the important consultation and in advance of those committee hearings. As a result, we have had to constantly shift the timeline.
Again, why didn't the government exercise that high degree of deference, as you put it, that the Supreme Court gave you the room to exercise in the first place?
9:40 p.m.
Liberal
Arif Virani Liberal Parkdale—High Park, ON
I think there are two issues there, Mr. MacGregor. One is what deference is accorded by the Supreme Court, and then the other is your criticism of our response circa 2019-21 vis-à-vis mental illness.
Do I regret that decision? Not at all, because I think what the Senate prompted was an active discussion about mental illness and the evolution of this law and its potential expansion. The development of the MAID curriculum, the model standard and things like the oversight mechanisms that are under development are all by-products of that function. I think that's proper vis-à-vis showing equivalence between mental suffering and physical suffering and not perpetuating negative stereotypes such as that mental suffering does not deserve the same level of treatment or to be addressed, and also not perpetuating pejorative assumptions about the decision-making capacity of people who are mentally ill.
On the deference piece, Mr. MacGregor, what I would say to you is that the court has said that there's a certain amount of deference owed as part of the dialogue between the courts and Parliament. There's extra deference shown in the matter of complex social policy, and then they highlighted in the Carter decision that, when it comes to MAID, that deference is directly applicable.
What they're saying there is that they're going to allow a margin of manoeuvrability for Parliament to try to get this right when we're balancing delicate interests. I'll say to you what I said at the outset. When you have issues around the unpredictability of the course of one's mental illness and when you have the possibility of suicidal ideation being a symptom of someone's condition, while I firmly believe you can distinguish between suicidal ideation and a well considered, well-thought-out request for MAID, you have to make sure that difference and that distinction can be made. You also have to ensure that all of the health care practitioners, MAID providers and assessors have the ability to do so.
When only 40 people have had that education, I think that's not enough.
9:40 p.m.
Liberal
9:40 p.m.
Conservative
Michael Cooper Conservative St. Albert—Edmonton, AB
Thank you, Mr. Chair.
Minister Holland, you have repeatedly claimed this evening that the only persons who would be captured by this expansion of MAID for mental illness are persons who have been suffering with an irremediable, irreversible mental health condition for a prolonged period—decades—and have sought all treatment options. That is false, and you know it to be false.
Minister, on what basis can you peddle such a false claim?
9:40 p.m.
Liberal
Mark Holland Liberal Ajax, ON
I would hope that anybody who is in a mental health crisis would come forward and would seek mental health services, and of course under the regime that we're contemplating here today, that would mean that somebody would get help. They would not have access to the regime. What I'm saying, sir, is that for the people I'm speaking to, these are very real cases with individuals who are trapped—
9:40 p.m.
Conservative