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.