Health Committee on Feb. 14th, 2024

[The Chair, Liberal, Sean Casey]

I call this meeting to order.

Welcome to meeting number 102 of the House of Commons Standing Committee on Health. Happy Valentine's Day, everyone. This is a wonderful way to spend Valentine's evening. I am feeling the love here already.

Today's meeting is taking place in a hybrid format, pursuant to the Standing Orders.

To the folks who are participating virtually, you have interpretation available to you. You have the choice on the bottom of your screen of floor, English or French. Please don't take any screenshots or photos of your screen during the meeting.

In accordance with the routine motion, I am informing the committee that all remote participants, except one, have completed the required connection tests in advance of the meeting. We will test Ms. Long, if necessary, when we get to her.

The subject matter of this meeting is Bill C-62. Pursuant to the order of reference of Tuesday, February 13, 2024, the committee is commencing its study of an act to amend An Act to amend the Criminal Code, regarding medical assistance in dying, no. 2.

I'd like to welcome our first panel of witnesses.

Appearing as individuals, we have Dr. Pierre Gagnon, psychiatrist, by video conference, and Dr. K. Sonu Gaind, professor of psychiatry at the faculty of medicine at the University of Toronto, who is here with us in person.

Dr. Georges L'Espérance, president of the Association québécoise pour le droit de mourir dans la dignité, will also be testifying by video conference.

Dying With Dignity Canada is also with us virtually, represented by CEO Helen Long.

Thank you all for taking the time to appear today. As it was explained, you will each have five minutes for your opening statements.

Dr. Gagnon, we will start with you.

You have five minutes to give your presentation.

[Dr. Pierre Gagnon, Psychiatrist, As an Individual]

Good evening, honourable members. I appreciate the opportunity to share some thoughts on this bill.

The first thing I can confirm, as a Quebec psychiatrist, is that certain documents or rumours have been circulating. It has been said that the Quebec psychiatric community is largely in favour of this expansion, which is not true, or that implementing the practice of euthanasia for patients with psychiatric disorders would not generate problems or controversy, which is not true either.

I would like to share a few points with you this evening, which can be boiled down to the following. We should start off by recognizing that suicidal ideation is one of the main and intrinsic symptoms associated with most serious psychiatric disorders. Furthermore, it is clinically impossible, even for the most gifted psychiatrists, to differentiate suicidal ideation from what would be considered a genuine request for euthanasia or medical assistance in dying by interviewing and assessing a patient.

The other thing is that all diseases are different. You can't apply the same criteria in every case. Psychiatric disorders are long-term disorders which seriously affect the will to live. The will to live and die ebbs and flows; this has been shown in a number of studies. Against all odds, patients eventually adapt and want to live. The principle of non-discrimination or equality for persons with psychiatric disorders is to provide treatment tailored to the patient's individual condition, not to provide the same treatment to all persons for all illnesses. In our opinion, the principle of equality means that we should offer treatments tailored to the individual's situation.

With psychiatric disorders, there is always a degree of uncertainty in terms of prognosis, which means that the notion of irremedialness not present. As a result, this criterion for medical assistance in dying is not met.

Similarly, having patients refuse treatment comes with the territory when we are dealing with mental disorders. There is no other field that requires practitioners to obtain court-ordered treatment as frequently as we do in order to treat patients against their will, because they lose all perspective about their condition. It is therefore inconceivable that we should let the patient decide that a doctor should end his or her life, when science proves day after day that these people can be helped, that their condition can be improved and that they can even find a way back to a fulfilling life.

In addition, the relationship between the patient and mental heathcare professionals, as well as the attitude of healthcare professionals, can play a particularly important role. The duty of psychiatrists and other healthcare professionals is always to try to instill hope, which is very valuable therapeutically.

I would also like to point out that when people argue passionately in favour of medical assistance in dying or euthanasia for people primarily suffering from mental disorders, they often give as an example rare or very serious psychiatric disorders that have resisted all treatment. In fact, studies published on cohorts of patients who had undergone euthanasia in countries such as Belgium and the Netherlands show, on the contrary, that much more common and treatable disorders were present in patients who received euthanasia.

In fact, a study published in JAMA Psychiatry showed that in 55% of cases, depressive disorders were the main psychiatric diagnosis. The majority of patients who had undergone euthanasia had a personality disorder or were lonely and socially isolated; 70% of those people were women, whereas suicide is more prevalent in men.

Another study of Belgian patients with mental disorders requesting euthanasia showed that there had been an idiosyncratic and excessive expansion of the concept of intolerable suffering.

This study revealed that psychiatrists had accepted that a significant component of intolerable suffering that made a person eligible for euthanasia could be due to social, economic and even existential factors, such as the loss of a loved one, friend or pet, financial problems or the feeling of being a burden to society.

As a result, it is the most vulnerable people, not those with severe and untreatable mental disorders, who are usually given euthanasia.

I'll leave it there. I look forward to your questions.

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you very much, Dr. Gagnon.

Dr. Gaind, welcome to the committee. You have the floor for the next five minutes.

[Dr. K. Sonu Gaind, Professor of Psychiatry, Faculty of Medicine, University of Toronto, As an Individual]

Thank you, Mr. Chair.

My name is Sonu Gaind. I'm a psychiatrist, professor and governor at the University of Toronto, the chief of psychiatry at Sunnybrook, a past president of the Canadian and Ontario psychiatric associations and now the president of the new Society of Canadian Psychiatry. I'm not a conscientious objector and was the physician chair of my previous hospital's MAID team. My roles inform my expertise, but I'm here as an individual. I'm not representing any group.

I want to first express appreciation for the decision to pause the planned expansion of MAID for mental illness. In all honesty, this was the only responsible choice to make because there remain three critical unresolved issues.

First, MAID is for irremediable medical conditions—ones that can be predicted to not improve. Worldwide evidence shows we cannot predict irremediability in cases of mental illness—meaning that the primary safeguard underpinning MAID is already bypassed—with evidence showing such predictions are wrong over half the time. Second, scientific evidence shows we cannot distinguish suicidality caused by mental illness from motivations leading to psychiatric MAID requests. Overlapping characteristics suggest there may be no distinction to make.

Combining these inconvenient truths with the fact that those with mental illness have higher rates of social suffering, like homelessness and poverty, means that MAID assessors would be wrong most of the time when predicting irremediability. They would wrongly believe they are filtering out suicidality and would instead be providing death this March to marginalized, suicidal Canadians struggling with social distress who could have improved.

People talk of false hope. This would be assessors colluding with the patient's mental illness symptoms and providing false despair. They would be wrongly reinforcing that the situation is hopeless to the most marginalized who could have gotten better. That would be the ultimate discrimination.

How did we get here—twice being at the brink of providing MAID for mental illness and twice saying we are not ready? I think it's because those entrusted to provide evidence as experts have pushed ideology instead.

Senator Kutcher's sunset clause in 2021 never asked if we could responsibly provide MAID for mental illness, but set an agenda predetermining that we would. The CAMAP mental illness module claims to train assessors to weed out suicidality from psychiatric MAID requests, yet it does nothing of the sort and there is no evidence that we can actually do that.

The expert panel tasked with providing safeguards refused to recommend any additional legislative safeguards, despite Canada lacking a due care requirement before providing death by MAID. One-sixth of that panel resigned, yet the panel chair doubled down on pushing expansion, testifying that she is not concerned by the two-to-one gender gap of more women than men getting psychiatric MAID where it is allowed. It's remarkable.

Now, the dissenting senators, unhappy with the pause to expand, aim to convince the Senate to disregard Bill C-62's call to pause, with Senator Kutcher saying they need to “protect against the tyranny of the majority”. Wow.

While citing their historical medical credentials and claiming they are addressing medical and procedural issues of the report, the dissenting senators neglect to provide any evidence to address the key medical issues of the inability to predict irremediability, the inability to filter suicidality and the risks to the marginalized when providing MAID for mental illness.

We're an outlier among peer nations in not even having a national suicide prevention strategy, and these dissenting senators are pushing easier death for mental illness. With any due respect to the dissenting senators, zealotry should not trump reality.

I'm confident that this committee, and I hope the rest of the Senate, will not follow the dissenting senators in their march against evidence.

I must point out the impact that expansionist activism has already had. After Bill C-7's expansion of MAID for any disability in 2021, MAID deaths shot up by 30% to over 13,000 Canadians in 2022, and 2023 will no doubt be higher. Of these tens of thousands of Canadians, over one-third cite that feeling like they are a burden is a suffering that leads them to MAID. Nearly one-fifth cite loneliness, and for over half it was a loss of dignity.

The debate about providing earlier, easier death has sucked all the oxygen out of the room. What are we now providing death for?

As I wrote in the Toronto Star recently, I hope this focuses us on the real issues of our fellow Canadians' suffering and propels us somewhere better than pushing death to solve life suffering. “If we're serious about addressing these issues,” to quote that piece, “Canada has a chance to be a forerunner in the world by, instead of striving to be number one globally in assisted suicide, establishing the world's first portfolio for a Minister for Living with Dignity.”

Thank you again for your thoughtful review of this issue.

I'm happy to answer any questions.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Gaind.

We'll now go to Dr. L'Espérance from the Association québécoise pour le droit de mourir dans la dignité.

Welcome to the committee.

The floor is yours.

[Dr. Georges L'Espérance, President, Association québécoise pour le droit de mourir dans la dignité]

Thank you, Mr. Chair and members of the Standing Committee on Health.

The Association québécoise pour le droit de mourir dans la dignité is grateful for the invitation.

I'm a retired neurosurgeon, an active MAID provider and president of the association.

With respect to Bill C‑62, I will focus on a few main points on the new delay in accessing medical assistance in dying for people with mental illness, and then speak about advance requests for cognitive neurodegenerative diseases.

Excluding mental health disorders will only lead to legal challenges, which are cumbersome and unacceptable to affected patients. This is a political decision that goes against the interests of the few patients who could have been assessed, as is their right.

And yet expanding medical assistance in dying to those affected would make it possible to comply with the Supreme Court of Canada's decision of February 6, 2015, as noted by the Senate in 2021. Judges have never unanimously ruled out mental disorders. This exclusion forces patients, who have already been leading broken lives for decades, to go back to the courts request that their constitutional right be upheld by the government.

To give you some context, let me remind you of paragraph 252 of Superior Court of Quebec Justice Baudouin's decision, handed down on September 11, 2019, which reads as follows:

[252] Vulnerability should not be understood or assessed on the basis of a person’s belonging to a defined group, but rather on a case-by-case basis, at least for the purposes of an analysis under section 7 of the Charter.

This bill means an additional three years of suffering for people with mental disorders on top of the three years that have already passed since March 2021.

Further delays continue to stigmatize people with mental disorders, even though the federally mandated pan-Canadian expert panel on MAID and mental illness released its report in May 2022 and very clearly laid out its recommendations.

On the issue of advance requests for cognitive neurodegenerative diseases, the federal Minister of Health, Mark Holland, has stated that he has no plans to act on advance requests in the near future. However, in Quebec, this right has been enshrined in law since June 2023, and the Criminal Code must be amended so that patients who want to exercise their right can be assessed by providers who will not have to fear criminal prosecution. Our association urges the federal government to take concrete action on this issue.

While Ottawa dillydallies, patients are suffering. Every year, there are 14 new cases per 1,000 people aged 65 and over, and 70 new Alzheimer's cases per 1,000 people aged 90 and over. More than 15 people are impacted every hour of every day by neurocognitive disorders. By 2030, Canada could have nearly one million people living with neurocognitive disorders.

To delay the expansion of medical assistance in dying for advance requests is to dash the hopes of many citizens. Those who are struggling with the terrible loss of their personality are forced to shorten their lives while they are capable of making a decision so as not to find themselves locked in indignity.

In its February 2023 report, the Special Joint Committee on Medical Assistance in Dying already recommended that you move forward by approving advance requests.

The majority of Canadians are in favour of this measure.

Quebec developed its law on advance requests for medical assistance in dying after an in‑depth consultation process that reflects the specific values and concerns of our province, which are in keeping with those of more than 80% of Canadians.

We ask you to consider any approach that would enable Quebec to follow through with its humanist legislation as of this spring, and thus meet the expectations of thousands of Quebeckers. By allowing advance requests, you have the opportunity to demonstrate your commitment to participatory democracy, Quebec institutions and respect for individual end-of-life rights, in addition to showing humanity and compassion.

It is important to note that eligibility for medical assistance in dying brings serenity and peace of mind, and enables people with disabilities to live fully in the present without the anguish of seeing long road ahead, paved with suffering and loss of dignity from a disease that inevitably leads to death.

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. L'Espérance.

Next, representing Dying with Dignity Canada, is Helen Long, the CEO.

Ms. Long, thank you so much for being with us. I know that you didn't have very much notice, but I also know you're very well steeped in the topic.

Welcome to the committee. You have the floor for the next five minutes.

[Helen Long, Chief Executive Officer, Dying with Dignity Canada]

Thank you very much for having me.

Good evening, members of the committee.

I appreciate this opportunity to testify on a matter of profound concern to the people across the country who are afflicted with severe, treatment-resistant mental disorders. I'm drawing upon a submission we made to the special joint committee in November 2023.

This is an issue that concerns us deeply at Dying with Dignity Canada because it speaks to the rights of persons who have both historically and presently been deprived of section 7 and 15 charter rights to make autonomous and lawful decisions concerning their end-of-life choices simply because their illness is psychiatric in nature and not physical.

The bill before you would extend the denial of access to MAID assessment for those whose sole underlying condition is a mental disorder for a further three years, until March 2027.

Given that Bill C-7, which brought in the right to a MAID assessment for those whose death was not imminently foreseeable, passed in 2021 with a sunset clause excluding that access for those with a mental disorder for two years, which was extended for a further year, means that persons in this category will have been denied for six years the same set of MAID entitlements as those with a physical illness.

It is outrageous to suggest that the development of a regime for MAID MDSUMC needs six years. It is especially egregious given that all of the metrics the government set for readiness in its last delay have been met. We have a nationally accredited curriculum and willing, competent assessment providers. We have practice standards against which regulators of physicians and nurse practitioners can oversee that conduct.

No new metrics are set in Bill C-62. What more is left to do? We need to look to those who are doing the work of providing MAID assessments and provisions; the regulatory bodies charged with the oversight of clinicians' conduct; the 127 physicians and nurse practitioners across this country who have confirmed in writing that the MAID system, MAID assessors and providers and psychiatrists who wish to be involved in MAID MDSUMC and who have testified that they are ready; the regulatory authorities; and, most importantly, patients with severe, treatment-refractory conditions who are ready for MAID MDSUMC.

No new metrics have been established for this delay. Adequate safeguards are in place, including the requirement for a minimum 90-day assessment period, the need to consult with an individual with expertise, a psychiatrist in these cases, and so forth.

We endorse the coming into force of MDSUMC because we have a duty to safeguard the rights of all Canadians. In this case, it's a small group of people tragically afflicted with acute, treatment-resistant mental disorders who, despite many interventions over long periods of time, have experienced unremitting suffering in their lives that cannot be relieved.

At DWDC, we hear from those who, for reasons of fear, embarrassment or stigma, are reluctant to speak publicly about their afflictions but who know only too well what deep, unrelenting suffering means. Even more regrettably, we hear from those who will not speak publicly for fear of being ostracized by their own communities. Often their voices are drowned out by those purporting to speak for them.

You're likely all familiar with the story of John Scully, who has spoken publicly for several years about his mental disorder, but I also hear from Jane and Cathy and others who are not able to speak publicly.

Canada regrettably has a long history of paternalism and arbitrary denial of rights for those with mental disorders, and we have often unfairly conflated mental illness with a lack of capacity. In Starson v. Swayze, the Supreme Court of Canada, discussing the need to redress decades of unfair presumption of incapacity in relation to the mentally ill, wrote, “For this reason it is particularly important that autonomy and self determination be given priority when assessing individuals in this group.”

Every year we hear from thousands of people across Canada who are seeking information or navigating the MAID coordination program across the country. Since Bill C-7 passed, the proportion of these individuals who identify as having a mental disorder as either a sole underlying medical condition or a comorbidity continues to rise.

We anticipate that many of these individuals will likely never be found eligible for MAID MDSUMC, but we cannot continue to deny them the right to apply. Doing so only serves to create further distress and angst. They have been left in an untenable position, unable to apply and suffering grievously.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Long.

That concludes our opening statements. We're now going to proceed with rounds of questions, beginning with the Conservatives for six minutes.

Dr. Ellis.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much, Mr. Chair.

Thank you to the witnesses for being here on this difficult evening.

Certainly, MAID for mental illness has been talked about for an incredibly long time, but to have the calibre of witnesses we have with us in this short time this evening is incredible.

Dr. Gaind, I'm going to begin with you to try to make it more realistic for Canadians out there.

You talked about the difference between suicidality and the desire for MAID. Indeed, suicidality, if I'm not mistaken, is often one of the criteria for diagnosing depression, and you mentioned the inability to distinguish it from the desire for MAID.

For everyday Canadians, could you talk a little bit about that, sir?

[Dr. K. Sonu Gaind]

Thank you for the question. I think it's a very important one because, in my opinion, Canadians have been given false reassurances that the sort of suicidality you're talking about—that's a result of mental illness symptoms—can somehow be separated from other motivations leading to MAID requests for mental illness.

The evidence in the few European countries that allow and provide MAID for mental illness shows that to not be true. In fact, there are overlapping characteristics between those populations. The key issue here is that, when people with suicidality from mental illness attempt suicide, they do not typically succeed nor do they typically try again.

That 2:1 ratio of women to men that I mentioned is a stunning gender gap on which I have not heard a single expansion proponent address in any meaningful way. I would very much appreciate it if any of the other witnesses tonight are willing to address that. However, we think that this stunning gender gap of 2:1 women to men getting psychiatric MAID in the European countries reflects gender-based marginalization. For any psychiatrist, that should be a terrifying statistic because it parallels the 2:1 gender gap of women to men who attempt suicide when mentally ill. Most do not end their lives by suicide, and most do not try again.

What it points out is that, for people with suicidality from mental illness, we try to bring interventions and suicide prevention that can help, but we have no way of knowing whether we should be doing that or saying no and instead sending them through door B where we're going to facilitate their suicide.

The CAMAP guidelines, in my opinion—and I have openly said this—dangerously provide a reassurance that they're doing something that they do not do and that they cannot do. I've looked at those, and this is actually quite literally their stuff on suicide. It's 10 slides. They say that it takes about 10 minutes to go through it, and that includes a four-minute audio clip. There is nothing in there that actually helps separate the suicidality that we want to help with suicide prevention from psychiatric MAID requests except that one about impulsivity. They focus on impulsivity. The reality is that the evidence shows—and this is from the CCA report—that “in Western countries such as Canada, impulsive suicides constitute a small percentage of all suicide deaths, and they often occur when the person has consumed alcohol”.

It goes on, but the point is that many suicides here are not impulsive, so that doesn't help differentiate. The only other differentiating characteristic, when you go through their whole list of questions, is literally, “Is the person planning on doing it themselves, or have they come to you as a MAID assessor?”

Is that how we're deciding what's suicidal and what isn't?

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much, Dr. Gaind.

You talked about the CAMAP guidelines or curriculum. For folks who aren't familiar with them, that's the Canadian Association of MAID Assessors and Providers. You mentioned very clearly that they don't help with determining suicidality versus seeking MAID.

Could you talk a little bit about those guidelines again? I've gone through them myself, but we talk about assessing irremediability, which, of course, I believe is an impossibility. I wonder if you've looked at that curriculum with respect to how it might teach physicians or nurses to do that.

I know I don't have much time, but I just want to plant a thought in your head. As I see it, the CAMAP curriculum is for primary care physicians or nurse practitioners. The likelihood of having psychiatrists performing these assessments, given the inability at the current time to access a psychiatrist, is almost zero.

[Dr. K. Sonu Gaind]

I would say that there are some psychiatrists who are willing to perform these, but in my opinion, they're willing to perform these in the absence of evidence. The fact that they're willing to do something that evidence shows they can't should not be reassuring.

I have looked at the evidence of this, and once again, there is no evidence that shows that we can predict irremediability in mental illness. It is vastly different—vastly different—from other medical conditions and neurodegenerative diseases.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Dr. Gaind, tell us a bit about the future—not that I think you can predict it. When we look at where we've come with diagnosing and treating mental illnesses of all sorts, what do you see in the future that should give us all hope around this and...that we should not have MAID for mental illness?

[Dr. K. Sonu Gaind]

I think there are many promising developments in psychiatry and mental health. I'm not trying to suggest that we're always able to help everyone. I think we all recognize that it can be challenging sometimes.

We have to remember what MAID is about. MAID is about predicting who will never get better, and we can't do that. If we can't do that with mental illness, we will be providing death under false pretenses.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you, sir.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Gaind.

Thank you, Dr. Ellis.

Next is Dr. Hanley, please, for six minutes.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you very much.

I want to echo Dr. Ellis in thanking the witnesses for gathering, not just on Valentine's Day but in the evening and on short notice, and being able to provide us with this really useful testimony.

Obviously, there have been years of deliberation on this, including the recent committee meetings. I'm trying to put my questions into a framework of “what now?” What do we do after Bill C-62 in terms of next steps? How do we best prepare?

I'd like to start with Dr. L'Espérance. I want to understand more about what we can learn from the experience of Quebec and how you see the direction in Quebec, particularly for MAID eligibility for mental illness. I understand from Bill 11 that this is a permanent exclusion. Is there anything we can learn as a country from the deliberations of Quebec?

Where do you see Quebec's health system in terms of readiness for mental illness as a sole underlying medical condition? How do you reconcile that with the direction of the legislation in Quebec?

[Dr. Georges L'Espérance]

Actually, we have no experience in Quebec in terms of approving MAID in cases where a mental disorder is the sole underlying condition, because we are subject to the Criminal Code, like the rest of Canada.

The Quebec committee that studied the expansion of medical assistance in dying set aside the issue of patients whose sole condition is a mental disorder because there was not enough evidence of a society-wide consensus on the issue. However, the committee's report was prepared before the report of the expert panel commissioned by the federal government, which was tabled in May 2022. So that's a factor.

What would Quebec's position be now that the expert panel report has been tabled? I couldn't tell you. I'm not a psychiatrist, which is fortunate for patients. However, I am relying on what is presented by the experts, particularly in the report by pan-Canadian experts mandated by the federal government.

We cannot completely exclude the problem of mental health, because we would be denying certain rights, but we need very strict guidelines with a long-term view. In our discussions, we always talk about an illness that had afflicted patients for 20, 30 or 40 years and whose quality of life has deteriorated grievously as a result of a mental health disorder.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you very much.

Ms. Long, since the most recent report was issued by the special committee, “The Road Ahead”, what are you hearing from Canadians?

[Helen Long]

Certainly we have tried to share the news that a possible delay was forthcoming, in a staggered bite-sized way, so that people were better able to digest that and to understand that there might be a delay. There are people who will call very distressed. We've made more crisis calls—so calls for police intervention—in the last two months than we have in the last three years, because people have been waiting. In many cases, based on our consultations with clinicians and assessors, we believe that many of these people will never be eligible for MAID, but they need to know that they can apply. They need to be able to move on and take the next steps.

We've heard from people who are significantly upset, angered and impacted by the changes and the continued delay. When the bill first passed and then it was two years and then it was another year, for these people, who have been suffering for decades and have tried every treatment—if you read the stories on our website, they've tried every treatment multiple times over years—to hear, “Okay, now it's three more years,” is devastating for them. I can't impress that upon you enough.

[Brendan Hanley, Liberal, Yukon, YT]

Do you believe that there is social consensus? If there isn't, do you see a role for the Supreme Court? Do you anticipate a court challenge?

[Helen Long]

I'm not a constitutional lawyer. I think the committee, previously, has certainly heard from those experts. I do think there will be a challenge at some point. That has been raised multiple times in the past, and I think, each time, the people who felt they might stand up as plaintiffs thought, “Well, I can get through one more year,” or “I can get through these first two years.” Now that we're at what will be six years and there are three years to go, I believe that is a very likely possibility.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Long.

Mr. Thériault, you have the floor for six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

First of all, I'm going to make a comment about our two psychiatrists.

It seems to me, from what they have told us this evening, that they are of the same opinion. They are testifying as individuals to tell us that they are at odds with the Canadian Psychiatric Association, the Canadian Bar Association, the Association des médecins psychiatres du Québec, the Federation of Medical Regulatory Authorities of Canada, the Canadian Association of MAiD Assessors and Providers—we have a lot of comments on that—and the Collège des médecins du Québec.

According to Dr. Gaind, the members of these organizations are ideologically motivated activists. We used to see that in the former Soviet Union, where science was pitted against ideology. When someone disagreed with the other person's opinion, they accused the other person of basing their position on ideology. It's called “scientism.” That said, this is not the place for an epistemological debate.

The fact remains that I am interested in Bill C‑62, but I haven't heard anything on the bill, which contains a very important provision. Do you believe that we should postpone the provision indefinitely? Do you agree with the three-year period? I would just like to know what you think.

Dr. Gagnon, you have the floor.