Thank you very much, Madam Chair.
I want to speak in support of this amendment. I believe it is a modest amendment that would extend the waiting reflection period of 90 days to 120 days. I think this is required in the face of the evidence that we heard. In fact, I would submit that 120 days probably is not enough, but when comparing the 90 days as provided for in the bill versus the modest amendment that we put forward, it is an improvement. What good is a 90-day period when we have evidence that it can take three or four times as long to get psychiatric supports? What good is a 90-day period when one might not be able to access palliative care within the span of 90 days, let alone undertake meaningful palliative care treatment?
Then you ask, 90 days from what day to what day? Under the bill, it's not even 90 days from the time that a request for medical assistance in dying is made. It is 90 days from the first assessment. We will be seeking to address that issue in a subsequent amendment, but I only cite it to underscore the complete inadequacy of the 90-day reflection period as currently provided for in the bill.
I would note the words of Dr. Harvey Chochinov, the distinguished professor of psychiatry at the University of Manitoba, someone who has done significant work in this area, having served as the chair of the external panel. When he was asked about the 90-day reflection period, he stated:
The 90-day clock...is very problematic. There have been a number of studies. For example, a Manitoba study actually found that after 90 days of being diagnosed with a major physical impairment, patients reach a peak in their suicidal ideation. They continue to be suicidal, although it wanes, as much as a year later, and thereafter it's still greater than their match cohort, so 90 days is certainly not an opportune waiting time.
The other thing is that we know that it takes a great deal of time for these people to be able to avail themselves of expertise. Patients who are highly at risk, for example those with chronic pain, may have to wait six months or more, depending on what part of the country they happen to live in, in order to get access to care. My specialty is psychiatry. Again, the waiting list for good psychiatric care is in the neighbourhood of months, up to a year, depending on what part of the country you're in.
The 90 days is problematic for all those reasons, which in large measure are data-driven and data-informed.
I think that summarizes the issue with the inadequacy of the 90-day period, and it's on that basis that I would support this modest amendment to extend the period, because I think we have to proceed with caution. We are talking about a procedure that, if carried out, results in the termination of one's life. There is no opportunity to reverse the decision once the procedure is carried out,
I think this amendment's having regard for that is perfectly reasonable and necessary to protect vulnerable persons, again, given the increased risks they face when the reasonably foreseeable criterion is removed. That is the category of patients who would be the subject of this amendment.
Thank you, Madam Chair.