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.
12:40 p.m.
Liberal
The Chair Liberal Iqra Khalid
Thank you.
Thank you, Mr. Thériault.
Dr. Gauthier, we are out of time.
We'll move on to Mr. Garrison for six minutes.
12:40 p.m.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Thank you very much, Madam Chair.
I want to start by thanking the witnesses for appearing today, and I stress that I respect the expertise that each brings to this question. In their testimony today, they have raised many issues that I believe need to be dealt with in the broader review, the statutory review that is required, and I'm hopeful that among the parties we can soon reach an agreement about the mandate and timing for that general review to take place.
I want to put two concerns on the record before I ask my question. One, it's important that members of the committee distinguish between those who have actually worked as MAID assessors and providers and those who have not.
The second concern that I wish to raise is even more serious. I'm always concerned when witnesses appear before the committee under the protection of Parliamentary immunities and make accusations about other individuals that amount to, in this case, allegations of malpractice. We have to be very careful when we listen to the testimony of those who have made such accusations rather than referring those cases to professional bodies or to the police, if that's appropriate. Those who make those accusations.... We should seriously consider all the testimony being presented, given what I would call unethical testimony that we've heard from at least one witness today.
I'm going to turn to something more positive now. I want to thank Dr. Rajji for his fair and constructive suggestion on the question of how we, as a committee, will deal with the concept of mental illness as an underlying condition in this legislation.
Dr. Rajji, how big a task do you think it is to have a working group that would establish evidence-based criteria? How long would that take, and how large an undertaking is it?
12:45 p.m.
Chief, Geriatric Psychiatry, Centre for Addiction and Mental Health
Mr. Garrison, thank you for this question.
It is a complex task. It's not a small task, and I think it will have to take, to my mind, as long as it needs to take. The complexity and implications and the strong different opinions play into the timing, and I think the group has to be quite diverse. It has to include the professionals, the psychiatrists and other mental health professionals that... Such an amendment is actually affecting their practice and touching some of the core issues in their field, which is understanding the concept of suicide and what suicide is. What does it mean to have suicide when someone is asking to receive MAID? Are they asking for suicide or not?
It has to also include family members. It has to include people with lived experience themselves. It has to include the other professionals, whom we call allied health professionals, who may not be the most responsible initially, but who also are affected by this practice, and we may need other stakeholders.
Without reaching a consensus about the definition of irremediable criteria, it will be very hard to apply these criteria if we don't know how to define it.
12:45 p.m.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Thank you, Dr. Rajji.
Can I ask Dr. Gupta for her reaction to this suggestion of an expert working group?
12:45 p.m.
Psychiatrist and Associate Professor, Centre de recherche du CHUM, As an Individual
There's no harm in spending more time thinking about these issues; they are complicated issues. I think a lot of work has already been done on these questions and I think that if we look at countries where this practice is permitted, we see that the lack of consensus doesn't go away, so we can continue to study, but I don't know that we're going to learn a lot more that's new.
I think we are already assessing irremediability in the context of mental disorder; we're just doing it with patients who have other conditions as well. I think we can learn from those experiences to help inform the practice with people who have a mental disorder and no other condition, but these complex cases are already being assessed, and people have already accessed MAID as a result, so I think that the exclusion criteria will just prevent a very small number of people from having access.
12:45 p.m.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Then your advice would be that it would be safe to remove this prohibition on mental illness as the sole underlying condition, but also that we could study this further at the same time.
12:45 p.m.
Psychiatrist and Associate Professor, Centre de recherche du CHUM, As an Individual
Another alternative would be to say that there are some really specific safeguards and best practices that we want to get right in this area and we want to give ourselves that time to do it, but let's discipline ourselves and put a deadline on that exclusion clause so that it can't be indefinite. We can say that if this is really what we want to do, then let's be focused on that task and let's ensure that at the same time we respect the wishes, as Mr. Ménard pointed out, of individuals on a case-by-case basis according to their clinical circumstances, which is what both laws always required for every other patient.
12:45 p.m.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Thank you.
Dr. Rajji, would you agree with Dr. Gupta that we could remove this provision while we're still studying it without great risk?
12:45 p.m.
Chief, Geriatric Psychiatry, Centre for Addiction and Mental Health
No, I don't agree with this, because the specific point here is that we're asking assessors and clinicians to apply criteria during the assessment that have not been defined for a mental illness. I think it's the same when we talk about the age criteria and talk about the capacity criteria. There are definitions. These have been well defined; however, we have not defined what it means to have an irremediable mental illness, so we don't go with the amendment before agreeing as a society on the definition of irremediable mental illness.
12:50 p.m.
Liberal
The Chair Liberal Iqra Khalid
Thank you very much for that.
Seeing that we have just 10 minutes left for questions, instead of doing a full round, at my discretion I will give two minutes each to the speakers I have up next to ask any questions that they like.
I have Mr. Lake, Mr. Kelloway, Monsieur Thériault and Mr. Garrison for two minutes each. If you can please stick to that timing, that would be great.
Go ahead, Mr. Lake. You have two minutes.
12:50 p.m.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
That seems like a strange decision to make, because I had a lot to say, but you're the chair.
First off, I can't believe how fast this committee is studying this matter. This is just, to me, unbelievable that you're racing.... It was interesting to hear the witnesses, every one of them, having to be cautioned against going too fast because they all had so much to say, and for some reason we're racing against time on one of the most complex issues that I've seen in my 15 years as a member of Parliament.
Listening to Ms. Herx's story about Candice was just heartbreaking. I have a 25-year-old son with autism, and I'm trying to get an understanding.... I had some questions, and it's not possible to get an answer in two minutes. I was expecting to have more time for asking how someone with a developmental disability would even indicate...what the criteria would be for their capacity to indicate their willingness to choose medical assistance in dying.
Rarely do I see unanimity in the disability sector, but there's almost unanimity about the fact that this is moving ahead way too fast and that there are way too few protections for people with disabilities.
In the 40 seconds that are left in my time, maybe somebody could give a comprehensive answer to that. Maybe Ms. Herx could give a comprehensive answer to that, because that's how long we have to study something this important.
12:50 p.m.
Liberal
The Chair Liberal Iqra Khalid
Thank you very much for your comments, Mr. Lake.
Dr. Herx, you have 30 seconds. Go ahead.
12:50 p.m.
Palliative Medicine Consultant, As an Individual
I don't think it will be possible to address—
12:50 p.m.
Liberal
The Chair Liberal Iqra Khalid
Dr. Herx, what I would recommend is that you provide written remarks to the committee with respect to the questions that have been raised by Mr. Lake, if that's possible. It is obviously open to all witnesses on the committee to provide written clarifications or written answers if something has been missed.
Thank you very much for that, Mr. Lake.
Now we'll go to Mr. Kelloway for two minutes. Go ahead, Mr. Kelloway.
12:50 p.m.
Conservative
Rob Moore Conservative Fundy Royal, NB
Madam Chair, you didn't let her answer the question. She had 30 seconds, and then you spoke for 30 seconds. Please let the....
Number one, we agreed on a timing for these committee meetings, and we're in a five-minute Conservative slot. The witness has 30 seconds to answer. You can't filibuster her answer, so could we please allow 30 seconds for Mrs. Herx to answer?
12:50 p.m.
Liberal
The Chair Liberal Iqra Khalid
For clarification, Mr. Moore, Dr. Herx had said that she would not be able to answer in those 30 seconds, and so I had clarified for her that she is able to give a complete and full answer by writing in to the committee so that's she's not rushed with respect to providing whatever comments she has to make, and I'll stick to that ruling.
Thank you for raising that flag, Mr. Moore. Go ahead, Mr. Kelloway.
November 5th, 2020 / 12:50 p.m.
Liberal
