Yes.
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.
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.
10 p.m.
Nurse Practitioner, Primary Health Care, As an Individual
I haven't had any patients, luckily, who have done that, but yes, I have certainly heard of situations in which that's happened. I've actually had patients who have told me that was their plan, because we do ask what they will do if they are not found eligible.
I think it's a difficult situation for patients. That's not a choice they want to make, but they often feel they want to have the autonomy to choose how they want to live and how they want to die, or when they want to die.
10:05 p.m.
Liberal
10:05 p.m.
The Joint Chair Hon. Yonah Martin
Thank you, Mr. Chair. I will direct my questions to Dr. Sonu Gaind. I'll ask them together, if you wouldn't mind answering them both.
MAID in Canada is supposed to be for irremediable conditions. Could someone seeking to qualify for MAID for sole mental illness regain the will to live? That's my first question.
Second, you wrote an article called “The next national apology”. Could you explain why you've characterized the Bill C-7 MAID regime as something that will require a future national apology?
Thank you.
10:05 p.m.
Professor, As an Individual
Thank you for both your questions. I'll answer them in the order you presented them.
On the issue of whether somebody could regain the will to live if they are qualifying for MAID for mental illness, the AMPQ, the Quebec association, wrote a paper supportive of expanding MAID for mental illness. One of the key authors was actually the chair of the current federal panel. Despite supporting MAID for mental illness, even in their position paper they acknowledge that “It is possible that a person who has recourse to MAID—regardless of his condition—could have regained the desire to live at some point in the future.” They then suggest that assessors will have to answer this ethical question each and every time they evaluate a request.
My point is that our law does not say grievous and irremediable conditions are determined by an ethical decision. It should be a scientific decision. On that there is no question that we cannot make those predictions in mental illness. CAMH and every other group that has looked at this, including the AMPQ, has said that.
In terms of the national apology piece, I think you're referring to the piece that I wrote in “The Conversation”. In terms of that, when you link all of this together, if we're not providing MAID for an irremediable condition, one we can predict in a person to be irremediable, then what are we providing it for? What we find we are providing it for is all sorts of other life suffering that is highly conflated with mental illness.
We are exposing marginalized, vulnerable people who actually could get better. We are providing them false, in my opinion, unscientific assessments claiming that they may have irremediability when no one can actually make that determination. Based on that, these marginalized individuals would receive MAID.
To me, that's something I think our country would need to issue an apology for at some point in the future.
10:05 p.m.
Liberal
The Joint Chair Liberal Marc Garneau
Thank you very much.
At this point, I'd like to thank all three witnesses for their testimony tonight and for answering our questions. Your contribution plays an important part in a very difficult and important topic that Parliament is looking at.
Thank you very much, as well for your willingness to come and join us, especially late at night.
Committee members, there are just a couple of very quick things that we need to look at, and it shouldn't take more than five minutes, hopefully. I'll put it in front of you right now.
One is we agree that written briefs would have to be in by May 9 and that they should not exceed 1,000 words. To communicate that, it will be put on the AMAD website in a number of places. If you wanted to go beyond that and actually put out a news release, that's something that requires a motion by the committee.
Is there a desire to put that out, or are you satisfied that if we advertise it on the AMAD website, that will be sufficient?
I don't see anybody raising their hands. It's just something to take into consideration.
10:05 p.m.
Senator, Saskatchewan, CSG
Those people who are interested will be following along. Certainly in the emails I'm getting from people asking to participate, they already know that the website exists.
10:05 p.m.
Liberal
The Joint Chair Liberal Marc Garneau
I suspect you're right.
The second point is by way of information, because there was some discussion about whether the committee might request an extension. I think it's premature to do it at this point, but if it is done, I will let you know that based on House of Commons precedents, the report would have to summarize the work done by the committee and recommend that the committee be permitted to continue its deliberations past June 23 and be granted an extension of x number of sitting days to present its final report.
I would suggest that it's a little premature for us to make that decision at this point. We still have a number of meetings, but it is something you may want to hold in the back of your mind.
The third thing I want to mention is that we are going to meet on Thursday evening for two hours. You may already know that. We have received confirmation that the committee may continue its work on Thursday evening, from 6:30 p.m. to 8:30 p.m.
It will be on palliative care, just to let you know. We're going to be busy on this committee, as you all have noticed. There's no question about it.
Palliative care will be on Thursday night for two hours. The next meeting is next Monday, a week from today. Do you want to reserve the three hours for palliative care, or is there a feeling that two hours will do it on that subject and that we can move on the the next subject, which is advance requests or advance directives?
10:10 p.m.
Liberal
10:10 p.m.
Liberal
The Joint Chair Liberal Marc Garneau
Yes, Thursday is on palliative care, but do you want a second full session on palliative care, or are you ready to move on to advance directives?
Senator Wallin, your hand is up.
10:10 p.m.
Senator, Saskatchewan, CSG
Yes. It's not specifically on that question, but is there the possibility of getting some kind of a work plan? We all appreciate how busy this committee is going to be, but we all have other committees as well, and we kind of run on the MPs' schedule, because you have votes and whatnot. We also have our own schedule of committees and work and commitments in our chamber.
Is there some intention that you will actually map that out, so that if a Thursday comes up, we need to be able to plan for that?
10:10 p.m.
Liberal
The Joint Chair Liberal Marc Garneau
We live in an imperfect world, Senator.
At the moment, the plan is two sessions per subject. If we find as we go through them that we need a bit more, we'll have to cross that bridge when we get to it. We haven't a whole bunch of sessions ahead of us, but at the moment, the plan is for two per subject. What I was bringing up tonight was a way of perhaps fine-tuning it a bit if people thought that maybe, in the case of palliative care, one session might be enough.
The other thing, of course, is that we don't know when those Thursday nights will be liberated. We'll do four sessions—
10:10 p.m.
Liberal
The Joint Chair Liberal Marc Garneau
Yes, we're going to have to play that one by ear. The BOIE is not going to give us advance notice a long time ahead of time. We have to be a bit nimble on this.
A work plan would be very nice, but I can't do anything better at this moment other than ask if you want to have two sessions per subject matter, and we can fine-tune as we go along. As I was suggesting tonight, it's something that you'd maybe want to consider, or do you want to keep next Monday night also for palliative?
Go ahead.
10:10 p.m.
Senator, Saskatchewan, CSG
I'm fine to go to advance practice. I'm great with the other issue, which is the maximum notice that we can get. If you only just discover that we are meeting next Thursday or this Thursday night, it would be really helpful if we could be informed of that as a membership as quickly as possible. That was—
10:10 p.m.
Liberal
The Joint Chair Liberal Marc Garneau
Believe me, we are trying to do that. We're doing it. We're doing this in real time all the time.
Go ahead, Monsieur Arseneault.
10:10 p.m.
Liberal
René Arseneault Liberal Madawaska—Restigouche, NB
Personally, I propose that we complete the discussion of palliative care on Thursday, as scheduled, and move on to another subject next week.
10:15 p.m.
Liberal
10:15 p.m.
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
I was going to say exactly the same thing, but Mr. Arseneault said it. Tonight, we essentially dealt with palliative care.
10:15 p.m.
Senator, Nova Scotia, ISG
Thank you very much, Mr. Chair.
First of all, I'd like to thank you for raising the potential for an interim report, or not a complete report. It's something we can think about as we go forward. I think this is such an important topic that to be rushing it would not be fair to the people who are waiting for this report.
The second thing is on palliative care. Would the witnesses we are going to hear be able to resolve a conundrum that came out of the discussion we heard today? There were some people saying that funding for palliative care has gone down. Other people were saying funding for palliative care hasn't gone down and that in fact more people are getting palliative care. It's hard for me to square that circle. I don't know the answer to that. We really need to know the answer to that. That's a very fundamental point.
Do the witnesses we're going to hear next time have that information, or is it something that the Library of Parliament could provide for us if we asked for it? I don't know enough about how this should work.
10:15 p.m.
Liberal
The Joint Chair Liberal Marc Garneau
You're right that we heard different opinions, but I don't know if the witnesses.... I can't predict whether they will shine the proper light on it or not. If there continue to be two camps, perhaps we could ask for some help from the analysts or—
10:15 p.m.
Senator, Nova Scotia, ISG
Right. This sounds to me like it's fairly factual. One could get data province by province and by territory and look at the budget lines and what happened and see how many people have received palliative care over that time, etc. That should be possible.
10:15 p.m.
Liberal
The Joint Chair Liberal Marc Garneau
Hopefully, we will get six witnesses this Thursday. Perhaps they will all lean in the same direction and give you a better sense of who's right. That's part of the job.
People have different opinions, unfortunately. I know it's factual, as you say, but perhaps we'll uncover that.