Evidence of meeting #3 for Medical Assistance in Dying in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was maid.

A video is available from Parliament.

On the agenda

MPs speaking

Also speaking

Joint Chair  Hon. Yonah Martin (British Columbia, C)
Félix Pageau  Geriatrician, Ethicist and Researcher, Université Laval, As an Individual
Stefanie Green  President, MAID Practitioner, Advisor to BC Ministry of Health, Canadian Association of MAiD Assessors and Providers
Tim Guest  Chief Executive Officer, Canadian Nurses Association
Marie-Francoise Mégie  senator, Québec (Rougement), ISG
Stanley Kutcher  Senator, Nova Scotia, ISG
Pierre Dalphond  Senator, Quebec (De Lormier), PSG
Pamela Wallin  Senator, Saskatchewan, CSG
Leonie Herx  Chair and Associate Professor, Palliative Medicine, Queen’s University and Chair, Royal College Specialty Committee in Palliative Medicine, As an Individual
Alain Naud  Family and Palliative Care Physician, As an Individual
Audrey Baylis  Retired Registered Nurse, As an Individual
Diane Reva Gwartz  Nurse Practitioner, Primary Health Care, As an Individual
K. Sonu Gaind  Professor, As an Individual
Marlisa Tiedemann  Committee Researcher

10:15 p.m.

Senator, Nova Scotia, ISG

Stanley Kutcher

We're all entitled to our opinions, but facts are a different issue.

10:15 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

Yes, facts are facts.

Does anyone else want to say something?

I have some hands on the screen. I'll start in the top left corner.

Go ahead, Mr. Barrett.

April 25th, 2022 / 10:15 p.m.

Conservative

Michael Barrett Conservative Leeds—Grenville—Thousand Islands and Rideau Lakes, ON

Thank you, Mr. Co-Chair.

With respect to Senator Wallin's discussion about a work plan, I wonder if it wouldn't be prudent to produce that as soon as possible. The reason is that when we discussed the amount of time the analysts needed to produce reports of certain lengths, we were expecting to have four three-hour meetings. Now there are discussions to add as many as 12 hours to the week of May 22. I wonder what impact that would have on the analysts' ability to produce a report of 10 pages or longer.

Further, with respect to the conversation about how many meetings we're having on each subject, I would say that the questions of palliative care have not been resolved. To look back, Senator Kutcher had a further question on the subject. I think there's more to hear there. If we're potentially adding an additional 12 hours of meetings, I wouldn't want to prematurely move on to another issue or another subissue, as it were.

I believe we need a work plan, something we can discuss or that the subcommittee could convene on or discuss, or at least sidebar about, before we come back to a full meeting.

Thank you.

10:15 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

Thank you.

On the question of whether next Monday we should stay on the same subject, I think you're leaning in the direction of a second session on palliative care.

10:15 p.m.

Conservative

Michael Barrett Conservative Leeds—Grenville—Thousand Islands and Rideau Lakes, ON

Yes, sir.

10:15 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

With respect to the work plan, there are a couple of issues we're working on at the moment. I think we're going to have to get together as a subcommittee.

The first—and this has an influence on the analysts' work—is how big a document we want to produce at the end. There's a big difference between 10,000 pages and 20,000 pages. That's something we need to decide, because that has an influence on how much time they need at the back end of this to prepare that report.

Then another factor is the translation. The translation services are probably the commodity most in demand at the moment, and that also can back us up as well. That's why we haven't quite nailed down a firm, predictable work plan at the moment. It's because we're having to deal with that. I will be asking the subcommittee to talk about this, because we need to figure that out.

Then we may be in a better position to put together that work plan that you're looking at, but please bear with us as we try to answer a couple of questions before that so that we're in a better position to put out that work plan.

10:15 p.m.

Conservative

Michael Barrett Conservative Leeds—Grenville—Thousand Islands and Rideau Lakes, ON

That's very helpful. Thank you, Mr. Co-Chair.

10:15 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

Go ahead, Ms. Fry.

10:20 p.m.

Liberal

Hedy Fry Liberal Vancouver Centre, BC

Thank you, Chair.

I wanted to suggest that the issue of palliative care is not actually resolved. However, I think Senator Kutcher made a very good point when he raised the question of whether palliative care services are going down in different provinces. This is not a federal thing. If palliative care services were going down, it would be a provincial thing.

That's factual data we can get. If palliative care services are going down, we can get that data. If those services are going down and being replaced by MAID services, that's something we can also get the Library of Parliament to research for us.

We have not very many meetings coming up, and we still have not touched on the very difficult and thorny issues. Mental health, mental illness is a single issue. We have not discussed minors. We need to get our teeth into that, because those are really complex issues. I think the palliative care issues are clear and factual, but these others are really cognitive issues, complex issues that we need to get to the bottom of.

I think we should move on to something else at the next meeting. We can get information on palliative care and come back to it when we get the information from the Library of Parliament.

10:20 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

Thank you.

We agreed that we would go with palliative care as our first area of study. Now perhaps we can put in a request to the Library of Parliament to dig up the information that Senator Kutcher is asking for, but I think we should go with palliative care for this Thursday. I don't think we should bring everything to a grinding halt on that at this particular point.

Your point about getting some assistance from the Library of Parliament, perhaps, to answer the questions is a good one.

I go to my fellow co-chair, Senator Martin.

10:20 p.m.

The Joint Chair Hon. Yonah Martin

Thank you, Mr. Co-Chair.

In regard to Senator Wallin's question about Thursday, I didn't get a chance to communicate with all the senators because it was happening in real time, but I'm going to make it a top priority to ensure that information is shared more quickly. I just wanted to let Senator Wallin and my colleagues know.

Regarding palliative care, it's a very important and complex issue. Beyond getting some of the numbers, I think we need to hear more about it. A review of palliative care should have been done, and we didn't have a chance to assess the lay of the land, especially how it intersects with MAID.

I would strongly recommend that we keep two sessions per topic. They are all complex in my opinion.

10:20 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

Thank you, Senator.

Senator Mégie, you had raised your hand, I think. Forgive me, I didn't see it.

Right. You've had your answer.

Thank you, colleagues.

Does anyone else want to comment?

Mr. Anandasangaree, you have the floor.

10:20 p.m.

Liberal

Gary Anandasangaree Liberal Scarborough—Rouge Park, ON

Thank you, Mr. Chair.

With respect to a subcommittee meeting, is it possible to schedule one this week outside of the schedule for MAID? I think we need about an hour so we can hammer out some of the outstanding issues that we discussed at the subcommittee last Wednesday, and that would resolve a lot of the discussions that we're having today with respect to palliative care. At this point, if we do a two-hour session on Thursday on palliative care—I believe a number of witnesses spoke on that issue today—we can probably do a two-hour session next Monday, May 2, and then have the last hour for some other item we can move on to.

10:25 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

Thank you.

When we can have a subcommittee meeting, we need to have one, because this is certainly something we need to deal with. I can't answer your question, but we'll get back to you as quickly as we can.

Go ahead, Mr. Thériault.

10:25 p.m.

Bloc

Luc Thériault Bloc Montcalm, QC

Mr. Chair, first, we know that we will be meeting this Thursday. That's a good thing since the Board of Internal Economy, the BOIE, won't be sitting on Thursday. That will allow us to meet.

However, we don't know whether the BOIE will be sitting next Thursday or not. Before meeting in subcommittee in a situation we don't know, I would prefer that we take some time to hold a meeting in subcommittee after our Thursday meeting, but not before Thursday.

At present, we are kind of going in circles. We don't have the information we need to establish a work plan. What we established was that there would be no extension of our work, at least for now. According to the work plan, we had to meet the June 23 deadline, which was a bit unrealistic, in my opinion, but fine, we have already debated that question, last time.

We now know that four three-hour meetings would be added during the break week, but let's wait a bit to see how many BOIE meetings we will have for establishing a work plan.

Meeting this Thursday to discuss palliative care, that works. After that meeting, if we don't have any more information, we will see whether we are going to continue on that subject or move directly on to advance medical requests. That is my position.

As for us, I think we have a pretty full week.

10:25 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

Thank you, Mr. Thériault.

The only problem is that if we decide on Friday not to hold a meeting on palliative care next Monday and to choose another subject, it will be too late to call witnesses.

I'm hearing people say they would like to have a second meeting. Others think one meeting is sufficient. That said, I think it would be preferable to have a second meeting.

Senator Dalphond, you have the floor.

10:25 p.m.

Senator, Quebec (De Lormier), PSG

Pierre Dalphond

Thank you, Mr. Chair.

I would just like to make one little comment. I sense that we want to work quickly. I am finding it a bit hard to proceed this way without having the documents from the people testifying before us.

Today, several witnesses referred to what they had said in their briefs, which we have not seen. I admit that I would have liked to ask them questions based on their briefs and not hear a summary of their briefs. Because then, if I have questions to ask them, the witnesses won't be there.

Regardless of the topics you want to study and the order in which you want to do it, I would suggest that the written documents arrive before the witnesses appear. If translations and documents are ready now for next week, I will be prepared to play with the topics to hear the witnesses' views after reading their briefs. In fact, it is very rare for me to take a position on something without having read the documents from the person testifying.

10:25 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

I understand the logic behind what you're saying.

Again, the problem is that we can't require that witnesses provide us with their documents in both official languages when they are going to appear. They can send us documents. If they send them and the documents are in only one language, we have to have them translated before giving them to you. We can't give you documents translated into both languages in time for the meeting unless they are already bilingual. It's an inconvenience, but if we proceed that way, it will prolong our timetable considerably, unfortunately.

Remember, it was only a few days ago that we started to contact all the witnesses to invite them to appear, so as not to lose any time. They can't provide us with their briefs in both official languages before they appear. In some cases, they are not obliged to send us their briefs. They can send them after they appear, if they wish.

It's late in the evening, but I think for the moment there are three things that come out of this.

We should ask the library to do a little bit of research on the questions with respect to palliative care that you raised, Senator Kutcher.

We will try to have a subcommittee—I can't tell you exactly when—to discuss something towards having a work plan, but that will be based on our making decisions about the size of the document and those kinds of things.

The third thing, for the moment, is that given that there are different points of view, I would suggest that we plan to discuss palliative care both this Thursday and next Monday night. Is that something you can agree with for the moment?

Just a moment, Hedy. Our analyst Marlisa had her hand up first.

Go ahead.

10:30 p.m.

Marlisa Tiedemann Committee Researcher

Thank you.

I'm really sorry. I'm not trying to complicate issues.

Absolutely, we will make a request to the library to see if they can find data relating to provincial spending pre- and post-MAID with respect to palliative care. Unless somebody has already done that research, it will likely [Technical difficulty—Editor] so we'll do our best.

If the committee wishes to go ahead with an additional meeting on palliative care, most of the witnesses who had been identified in the work plan have been exhausted, with the exception of those on the Liberal witness list. I offer that if that helps people determine whether or not we need or would like to have another meeting on palliative care. We would need more witnesses from some of the parties to be able to do another full meeting.

Thank you.

10:30 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

You're saying we don't necessarily have witnesses. If we get six witnesses this Thursday, we will not have more witnesses to fill up the next session.

10:30 p.m.

Committee Researcher

Marlisa Tiedemann

We have identified three panels and nine witnesses, but after that, there wouldn't be a balance of perspectives on panels beyond those three panels.

10:30 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

Okay.

Go ahead, Mr. Cooper.

10:30 p.m.

Conservative

Michael Cooper Conservative St. Albert—Edmonton, AB

Thank you, Mr. Co-Chair.

On that point, from our side there are a number of names we could provide, so that would not be an issue.

10:30 p.m.

Liberal

The Joint Chair Liberal Marc Garneau

That would not be an issue. Those would have to be provided very quickly.

Now it's Senator Wallin, but we need you to put your headset back on. Hedy, you can do yours too while you're waiting.

Go ahead, Senator Wallin.

10:30 p.m.

Senator, Saskatchewan, CSG

Pamela Wallin

Because we've run through the list of witnesses, I think we should maybe move on. We can always come back to palliative care if the data suggests there is something there that we need to really drill down on. I agree with Hedy that we really need to move on to other issues.

Our time has been so crunched because this committee was not convened, and now we're trying to cram and meet at all hours of the night and day. There were comments made about how we had agreed to do this and we had agreed to do that, which I was not informed about, and as I say, our schedules are very different. We travel at different times. Some of us go to places that are difficult to get to.

I'd like to make sure that at the very least we hit all of the major topics in the time we have allotted in case extra days don't come up or in case some of us can't participate, and then, maybe sooner than later, we can have that conversation about asking for more time so that we might be presenting an interim report, because this schedule is nothing short of insane for topics that are so fundamental. That's what really concerns me.

Thank you.