Medical Assistance in Dying Committee on June 6th, 2022

[Luc Thériault, Bloc, Montcalm, QC]

Thank you very much, Madam Chair.

I'd like to thank the witnesses for sharing their experiences with us, because it's always interesting to hear people talk about their experiences, and these things are not the exclusive domain of the experts.

This question is for both witnesses.

You will agree with me that, in its most severe form, illness strikes at random. It doesn't discriminate based on gender, ethnicity or age. Why would it be unacceptable to give minor patients between the ages of 14 and 18, for example, the same thing we give to those who have reached the age of majority?

[The Joint Chair, Hon. Yonah Martin]

We'll have Mr. Henry first, then Ms. Mehdi.

[Ahona Mehdi]

As I was saying earlier, we know the prefrontal cortex, which evaluates risk assessment and decision-making, is not fully developed until well into the second decade of life, and sometimes into the third decade of life, so we can't expect youths to be making these decisions.

There's another thing: We can claim doctors will follow procedures that ensure these decisions are really intentional and the person who says they want to receive MAID is rational, but masking is a huge thing that disabled people use, especially disabled youth, in navigating health care systems that consistently show us they don't care about us and are not supporting us. We have—

[Luc Thériault, Bloc, Montcalm, QC]

Excuse me, but I don't have much time, and I don't want to get into a false debate. I will hear from Mr. Myeengun first, and then I'll make a brief comment.

Mr. Myeengun, I'd like you to be brief, please.

[Myeengun Henry]

I didn't have the translation headphones.

[The Joint Chair, Hon. Yonah Martin]

Mr. Henry, do you have headphones you can put on?

[Myeengun Henry]

They sent some, but [Inaudible—Editor].

[The Joint Chair, Hon. Yonah Martin]

You can click “English” at the bottom right-hand part of your screen to—

[Myeengun Henry]

Is that for interpretation?

[The Joint Chair, Hon. Yonah Martin]

Yes, it's for interpretation. Select “English”, please.

Monsieur Thériault, would you like to repeat your question to Mr. Henry.

[Luc Thériault, Bloc, Montcalm, QC]

Of course.

I will simplify my question. Under what circumstances do you believe medical assistance in dying should be allowed for minors?

[Myeengun Henry]

I can barely hear that.

[The Joint Chair, Hon. Yonah Martin]

In which cases do you believe MAID for mature minors could be authorized? That was the question.

[Myeengun Henry]

I think it has to go case by case. With the advice of a medical practitioner, somebody under 18 with a guardian, parent or someone like that would [Technical difficulty—Editor] make that decision. Every case is different, so we can't have a blanket statement saying yes or no on that. I think every case is going to take—

[Luc Thériault, Bloc, Montcalm, QC]

In clinical ethics, one must first and foremost—this is what they teach in medical school—use inductive reasoning for decisions made at the bedside. One can't apply an evaluation grid at the bedside, but must rather try to see what comes out, that is, listen to what the patient has to say, listen to the patient's wishes, and hear how the patient is suffering.

Wouldn't this approach, coupled with an assessment considering all the criteria, provide a safeguard and quite safely permit this practice?

[Myeengun Henry]

I believe they need to have their say, of course. That's telling you from their own perspective how they're feeling. It is very important that we hear that perspective. All of the medical information available, along with the information of the person, is very important. I would agree.

[Luc Thériault, Bloc, Montcalm, QC]

In the Netherlands, one of the two countries that administers medical assistance in dying to minors, the parents of 12‑ to 16‑year-olds are always involved. Parents would have no veto power for 16‑ to 18‑year-olds.

The parents must agree with the decision.

How do you feel about that? Do you really believe people would abuse that?

[Myeengun Henry]

Absolutely. I think that needs to have a lot of perspectives here. They know how their—

[Luc Thériault, Bloc, Montcalm, QC]

If parental consent is also required, what kind of abuses could occur?

[Myeengun Henry]

I'm sorry. Could you say that again?

[Luc Thériault, Bloc, Montcalm, QC]

If parental consent is also required, what kind of abuses could occur?

[The Joint Chair, Hon. Yonah Martin]

Be very brief, Mr. Henry.

[Myeengun Henry]

I couldn't understand the question. I'm sorry.

[The Joint Chair, Hon. Yonah Martin]

Okay. Well, the time has lapsed here. I'm sorry about that.

Lastly, we'll go to Mr. MacGregor for five minutes.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Thank you, Madam Chair.

Ms. Mahdi, welcome to the committee, and thank you for joining us today.

In my home province of B.C., when it comes to health care provision, a health care practitioner can get consent without a parent or guardian if they are sure that a child understands the need for the health care, what the health care involves and the benefits and risks of the health care. That's what allows children to make decisions on immunizations, and it's very important for teenagers and reproductive health care. Just to be clear, you do support that part.

That's very different from what we're talking about today.

What I've noticed in the way that this committee has conducted its hearings is that there is a difference between a person's medical condition and social condition. I understand that medical conditions and the choices about that are very personal, but a lot of witnesses have said that you can't adequately make that choice if you don't have the proper kinds of support open to you.

You talked about the fact that for many disabled youth, the cost of the care is a significant barrier. Can you expand a little bit on that, on how we, as a country, really have to pay attention to those social factors?