Evidence of meeting #5 for Justice and Human Rights in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was maid.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Stefanie Green  President, Canadian Association of MAiD Assessors and Providers
Ann Collins  President, Canadian Medical Association
Michel Bureau  Chair, Commission on End-of-Life Care
Jean-Pierre Ménard  Lawyer, Ménard, Martin, Avocats
Serge Gauthier  Neurologist and Professor, Departments of Neurology, Psychiatry, and Medicine, McGill University, As an Individual
Mona Gupta  Psychiatrist and Associate Professor, Centre de recherche du CHUM, As an Individual
Leonie Herx  Palliative Medicine Consultant, As an Individual
Tarek Rajji  Chief, Geriatric Psychiatry, Centre for Addiction and Mental Health
Clerk of the Committee  Mr. Marc-Olivier Girard

12:50 p.m.

Conservative

Rob Moore Conservative Fundy Royal, NB

Madam Chair, we are in a five-minute Conservative time slot. Just because it happens that the meeting is going to end when it's Conservatives' turn to speak....

Mr. Lake has five minutes to ask this witness, or any witness, the questions. You can't just make things up as we go along. We've agreed, as a committee, that this is a five-minute spot, and divvying it up is not how these committees work.

12:55 p.m.

Liberal

The Chair Liberal Iqra Khalid

Thank you for raising your concerns, Mr. Moore. We do try to operate as flexibly as we can, obviously, given the committee room times, but I take your point, so I'll ask the clerk how much longer we have this room. We'd like to ensure that we're able to get through all of the questions with the time that we have.

12:55 p.m.

The Clerk of the Committee Mr. Marc-Olivier Girard

Madam Chair, I believe that if the committee goes a little bit beyond 1:00, it would be okay.

12:55 p.m.

Liberal

The Chair Liberal Iqra Khalid

Thank you very much, and thank you, Mr. Moore, for your very kind intervention.

Mr. Lake, I believe you now have the opportunity to ask your five minutes of questions, two of which you've taken, so you have three.

12:55 p.m.

Conservative

Mike Lake Conservative Edmonton—Wetaskiwin, AB

I believe I only took a minute and a half, and then the witness gave up the other 30 seconds.

12:55 p.m.

Liberal

The Chair Liberal Iqra Khalid

Of course. Please go ahead.

12:55 p.m.

Conservative

Mike Lake Conservative Edmonton—Wetaskiwin, AB

My question to Ms. Herx stands.

What would be the criteria for someone with a developmental disability to determine capacity for them to indicate that they want medical assistance in dying?

12:55 p.m.

Palliative Medicine Consultant, As an Individual

Dr. Leonie Herx

I think that's a very complicated issue, Mr. Lake.

It would take consultation with a capacity assessment expert and specialists who are familiar with young adults with disabilities to be able to spend.... A large amount of time would be required to really understand how to best communicate with this person and what level of understanding they have about their unique circumstances and their treatment options.

I can say that as the stakes get higher for decisions, such as a termination of a person's life—I don't think it gets any higher than that—the amount of time it takes to assess capacity needs to be equal to that. The head of the complex capacity assessments at McGill University has told me that her most complex cases take several hours to really understand the person's capacity. It's a very complicated situation.

Most MAID assessors do not have formal capacity training, at least in my experience, and that's the same experience that my colleague at McGill has expressed. Even when we ask for psychiatry to be consulted in these complex cases, it's not always happening. In fact, in examples that I've experienced, I've recommended capacity assessment because I didn't feel the person had medical decision-making abilities, and that was not followed. I even documented it in the medical record and raised my concern with the MAID team. That person went ahead and got MAID anyway. I was told that they do their own assessments for capacity.

I think it's very complicated, and we should be relying on experts when it comes to a matter of life and death.

12:55 p.m.

Conservative

Mike Lake Conservative Edmonton—Wetaskiwin, AB

Ms. Gupta, the disability community, and many in the developmental disability community specifically, have raised significant concerns about this issue, the fact that these changes are being made very quickly and that there are very few protections for people with developmental disabilities.

Do you think that those concerns are valid?

12:55 p.m.

Psychiatrist and Associate Professor, Centre de recherche du CHUM, As an Individual

Dr. Mona Gupta

Thank you, Madam Chair. Thank you for the question.

Any group of persons who have raised concerns about whether there are adequate safeguards, how a law is being implemented and practised, are certainly to be taken seriously, and they are certainly to be considered valid and to be explored.

I think the tension we have with medical assistance in dying is that we have identifiable groups of people who may have characteristics of vulnerability or not have characteristics of vulnerability, but we also have individuals who are requesting assistance in dying, and they have their own characteristics of their own lives and their own conditions.

I think one of the difficulties we run into is how we make considerations and safeguards that take into consideration the vulnerabilities of groups while also respecting the lived experience and autonomy of individuals.

12:55 p.m.

Liberal

The Chair Liberal Iqra Khalid

Thank you very much, Dr. Gupta. I appreciate that.

We'll go on to Mr. Kelloway now for five minutes.

Go ahead, Mr. Kelloway.

12:55 p.m.

Conservative

Rob Moore Conservative Fundy Royal, NB

I have a point of order, Mrs. Chair.

12:55 p.m.

Liberal

The Chair Liberal Iqra Khalid

It's Madam, if that's okay. I'm not a Mrs.

Go ahead, Mr. Moore.

12:55 p.m.

Conservative

Rob Moore Conservative Fundy Royal, NB

Madam Chair, what are we doing here? We agree as a committee when we are going to meet. We agree as a committee, we vote as a committee, on what the order of questioning is.

We are all busy people, including our witnesses. We're in a committee that's scheduled to go from 11 o'clock to one o'clock. It's now one o'clock, so why are we doing...? It seems to me that there's a bit of a situation of not being willing to follow the rules unless it's going to disadvantage Conservative members of Parliament who are trying to ask questions and trying to do it within the rules.

We've set out, as a committee, the rounds of questioning, the amount of time it would take and when our meetings end. Our meeting ends at one o'clock. I find it extraordinary that we come to one o'clock.... Witnesses have things to do. I have things to do. I presume that the other members of Parliament have things to do. However, now we're somehow going into another round of questioning when the meeting is over.

1 p.m.

Liberal

Arif Virani Liberal Parkdale—High Park, ON

Madam Chair, could I speak to that point?

1 p.m.

Liberal

The Chair Liberal Iqra Khalid

Yes, go ahead, Mr. Virani.

1 p.m.

Liberal

Arif Virani Liberal Parkdale—High Park, ON

I'll confess to a bit of confusion, because six minutes ago the chair was, I believe, being faulted for not permitting Mr. Lake to ask his full round of questioning. You then intervened with the clerk, who indicated that we have the room available. I thought there was consensus among committee members and the witnesses to continue so that we could could conclude a full round of questioning, which is what I thought Mr. Moore was originally raising a concern about. Now it seems that the exact opposite concern is being raised.

I would ask for some clarity, because I personally believe, and I believe my Liberal colleagues believe, that if people want to ask a full round of questions and if the witnesses in the room are available, we should continue so that we can do just that.

Thank you.

1 p.m.

Liberal

The Chair Liberal Iqra Khalid

Thank you, Mr. Virani.

Before I come to you, Mr. Garrison, I will say, Mr. Moore, that in addressing the concerns you raised at the last meeting about running over time, I had tried to divvy up whatever time was remaining to keep your schedule in mind to make sure that we had an equitable distribution of time for all the members on the committee. That's what I was trying to do.

With your intervention and with the clerk's clarification that we do have the room for another full round of questions, I am happy to make that decision and to allow for another full round of questions.

Go ahead, Mr. Garrison, on this point of order.

1 p.m.

NDP

Randall Garrison NDP Esquimalt—Saanich—Sooke, BC

Thank you very much, Madam Chair. I think we would need unanimous consent to proceed beyond our scheduled time. While I would very much like to hear more from the witnesses and while I have more questions, like everyone else, I have schedules to keep. If I'm being asked to consent to extend the time, I would not agree.

1 p.m.

Liberal

The Chair Liberal Iqra Khalid

Okay. Thank you, Mr. Garrison.

Go ahead, Mr. Moore.

1 p.m.

Conservative

Rob Moore Conservative Fundy Royal, NB

No. We've agreed on speaking times. We've agreed on the rounds. We've agreed that it goes Conservative, Liberal, Bloc, NDP, and then back to Conservative. Changing the rules as we go is not going to be conducive to our being able to have productive committee meetings.

We've heard from witnesses. We've done our rounds of questioning. It's the end of the meeting, and there's not consent to continue the meeting any longer beyond our schedule.

1 p.m.

Liberal

The Chair Liberal Iqra Khalid

Thank you, Mr. Moore.

My understanding is that it is not unanimous that we proceed with extending the committee meeting or not. It is by a majority, so I ask the committee now if a majority of the committee would like to continue the meeting to finish the second round of questions. Unless there's further debate, we'll ask the clerk to administer a vote at this time, whether it's recorded or on division.

(Motion agreed to: yeas 6; nays 5 [See Minutes of Proceedings])

Thank you.

At this time, then, I guess we are done with this meeting today.

Mr. Clerk, please send out a reminder to all the members of the committee to please sign in at least 15 to 20 minutes before the meeting starts so that we can start in a timely fashion and continue the meeting in a timely fashion as well. Thank you, everyone.

I would like to take this moment to thank our witnesses for their time today. We really appreciate it. Again, I will remind you that if there are things that you have not been able to get on the record today and clarifications that you would like to provide, please do submit your written submissions to the clerk so that we can get them on the record and can include them in our deliberations on Bill C-7.

I thank you, everybody, for your time. The meeting stands adjourned.