Evidence of meeting #38 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

Alison Freeland  Chair of the Board of Directors and Co-Chair of MAID Working Group, Canadian Psychiatric Association
Shelley Birenbaum  Chair, End of Life Working Group, The Canadian Bar Association
Joint Chair  Hon. Yonah Martin (Senator, British Columbia, C
Marie-Françoise Mégie  Senator, Quebec (Rougemont), ISG
Stanley Kutcher  Senator, Nova Scotia, ISG
Pierre Dalphond  Senator, Quebec (De Lorimier), PSG
Flordeliz Osler  Senator, Manitoba, CSG
Mona Gupta  Psychiatrist and Researcher, Centre hospitalier de l'Université de Montréal, As an Individual
Douglas Grant  Registrar and Chief Executive Officer, College of Physicians and Surgeons of Nova Scotia and Representative, Federation of Medical Regulatory Authorities of Canada
Claire Gamache  Psychiatrist, Association des médecins psychiatres du Québec

7 p.m.

The Joint Chair Hon. Yonah Martin

Unfortunately, we are out of time.

7 p.m.

NDP

Charlie Angus NDP Timmins—James Bay, ON

Thank you.

7 p.m.

The Joint Chair Hon. Yonah Martin

We'll move on to questions from senators.

7 p.m.

Liberal

The Joint Chair Liberal René Arseneault

Senator Mégie, you're going to start us off.

You have three minutes.

7 p.m.

Marie-Françoise Mégie Senator, Quebec (Rougemont), ISG

Thank you, Mr. Chair.

I have a question for each of the witnesses. I would like a quick answer.

My first question is for Dr. Freeland.

Have training activities already begun for psychiatrists who will have to provide medical assistance in dying? I'd like a yes or no answer.

7:05 p.m.

Chair of the Board of Directors and Co-Chair of MAID Working Group, Canadian Psychiatric Association

7:05 p.m.

Senator, Quebec (Rougemont), ISG

Marie-Françoise Mégie

Okay.

I know that there's already a lack of psychiatric resources to treat patients. So it will have to be shared, psychiatrists will have to follow patients, and others will deal with medical assistance in dying.

Do you have any idea what percentage of psychiatrists want to take this training?

7:05 p.m.

Chair of the Board of Directors and Co-Chair of MAID Working Group, Canadian Psychiatric Association

Dr. Alison Freeland

No, I am not sure about that.

7:05 p.m.

Senator, Quebec (Rougemont), ISG

Marie-Françoise Mégie

Okay, thank you.

Ms. Birenbaum, I'd like to know what criteria the Canadian Bar Association has already established to safely provide medical assistance in dying to people with mental illness.

7:05 p.m.

Chair, End of Life Working Group, The Canadian Bar Association

Shelley Birenbaum

We ourselves as lawyers did not develop criteria. What we have done is look at what's existing now within legislation. If you look at all of those safeguards, especially for “not reasonably foreseeable”, it's a reasonably robust set of safeguards that would ensure people are ready to access MAID. They have to be deemed eligible. It seemed to us that that was a strong legal framework.

Do you want me to articulate the criteria that are in the Criminal Code?

7:05 p.m.

Liberal

The Joint Chair Liberal René Arseneault

You have 45 seconds left.

7:05 p.m.

Senator, Quebec (Rougemont), ISG

Marie-Françoise Mégie

We could check the Criminal Code.

Thank you very much.

7:05 p.m.

Liberal

The Joint Chair Liberal René Arseneault

You still have 45 seconds left, Senator Mégie.

7:05 p.m.

Senator, Quebec (Rougemont), ISG

Marie-Françoise Mégie

No, it's okay. I'll give it to my colleague.

7:05 p.m.

Liberal

The Joint Chair Liberal René Arseneault

The next questions will be asked by Senator Kutcher.

The floor is yours for three minutes.

7:05 p.m.

Stanley Kutcher Senator, Nova Scotia, ISG

Thank you very much to the witnesses.

I'll use my questions, first, to clarify.

The Canadian Psychiatric Association does not represent any psychiatrists in Quebec. Is that fair?

7:05 p.m.

Chair of the Board of Directors and Co-Chair of MAID Working Group, Canadian Psychiatric Association

Dr. Alison Freeland

That would be fair.

7:05 p.m.

Senator, Nova Scotia, ISG

Stanley Kutcher

If you take the CPA and the AMPQ together, that's about 75% of psychiatrists in Canada.

7:05 p.m.

Chair of the Board of Directors and Co-Chair of MAID Working Group, Canadian Psychiatric Association

Dr. Alison Freeland

Can I reframe that? We do have Quebec members who are part of the CPA and the AMPQ. My apologies.

7:05 p.m.

Senator, Nova Scotia, ISG

Stanley Kutcher

Yes. Together it's about 75%.

There was a question about the large number of psychiatrists needed, but we know from the data of the Benelux countries that a very small number of people with a sole mental illness would qualify for MAID. We really have no idea whether we need 5,000 psychiatrists—likely not—or at the beginning we can get by with 100 or 50. This idea that we need a large number of psychiatrists.... I don't know if that makes sense. Does it make sense to you?

7:05 p.m.

Chair of the Board of Directors and Co-Chair of MAID Working Group, Canadian Psychiatric Association

Dr. Alison Freeland

I would agree with that. There are a lot of examples, both in mental health and in medicine at large, where not everyone is part of a new thing that comes out. Not everyone is trained to do everything in all aspects of health care.

7:05 p.m.

Senator, Nova Scotia, ISG

Stanley Kutcher

Then the idea that we need thousands of psychiatrists is erroneous.

In terms of readiness—and I think you used a nice phrase for that—have the standards of medical practice been developed?

7:05 p.m.

Chair of the Board of Directors and Co-Chair of MAID Working Group, Canadian Psychiatric Association

Dr. Alison Freeland

Have the standards for medical practice been developed? We have the national standards, which have been developed with advice to the profession, yes.

7:05 p.m.

Senator, Nova Scotia, ISG

Stanley Kutcher

What about the curriculum? Has that been developed?

7:05 p.m.

Chair of the Board of Directors and Co-Chair of MAID Working Group, Canadian Psychiatric Association

Dr. Alison Freeland

That is correct, yes.