Medical Assistance in Dying Committee on May 25th, 2022

[Pamela Wallin]

Okay.

Well, Chair, if I could get you.... Again, this is kind of a recurring theme, but when statements such as that are made, it would be very helpful for the committee here to have actual evidence, because, as I think I have stated before, if people are not going through the correct MAID process, then they have clearly broken the law, so we should be informed about that.

If I could, I would go to Dr. McKenzie. We heard some testimony here—and the statistics show—that those who choose MAID are generally white, wealthy and willing. Is it your position that others, maybe minority groups that are facing severe social issues, aren't being given the opportunity or aren't being presented with this as a possibility or a choice that they might want to make at some point?

[Dr. Kwame McKenzie]

No, that wouldn't be—

[Pamela Wallin]

Okay, thanks. I just wanted to clarify.

[Dr. Kwame McKenzie]

My position would be that most of the information to date that we have on MAID at the moment is...well, it's obviously historical, but we haven't hit a steady state on the numbers of people who are eventually going to be getting MAID in Canada.

We also have changes in the law coming through, as well as changes in guidelines and safeguards, so we don't know exactly where we're going to end up. My worry is just to make sure that we don't end up in a situation where we haven't done enough and MAID is considered an off-ramp for social suffering. I don't think we're there yet, but I don't want us to get there, so it's about being mindful, rather than saying that there is data at the moment showing that we have high numbers of indigenous or racialized or low-income people who are applying for MAID at the moment.

[Pamela Wallin]

No. The statistics in fact say the opposite.

So what kind of a safeguard would you propose, then? Is there something there that you think would prevent that slippery slope?

[Dr. Kwame McKenzie]

Well, I'm not sure that it's a slippery slope, but I want to make sure that we're mindful when we're thinking about it. Just as we tend to say that we want to make sure everybody has had an opportunity for all of the medical treatment that they require, I was flagging that it would be good to also make sure that people have a proper social assessment and they get access to all of the social supports that are required.

I'm not making any grand statements that I know there are huge differences. I just know that there are huge differences in mental health needs coming through because of what we're going through at the moment, and I wouldn't want us to be blindsided by that, so it really is a consideration, then, and trying to look forward rather than saying that there are issues right now.

[Pamela Wallin]

All right. So you're tying that more specifically to the COVID situation.

[Dr. Kwame McKenzie]

Well, there's the COVID situation, but in places like the U.K. they've had the biggest drop in the standard of living since 1950 because of the economic climate and the possibility of a bigger or wider war. I think it's not just COVID. We have climate change and we have significant economic problems that are headwinds that we seem to have to be thinking about. We know that this will change the rates of suffering and the perception of suffering.

That was really the flag I was trying to raise here rather than anything else. I was trying to be balanced. I think if I'd had a bit more time, I'd probably have come across as a bit more humble in my assessment.

[Pamela Wallin]

I think it was just important to clarify. Thank you for that.

[René Arseneault, Liberal, Madawaska—Restigouche, NB]

Thank you, Mr. Chair, a point of order.

[The Joint Chair, Liberal, Marc Garneau]

Go ahead, Mr. Arseneault.

[René Arseneault, Liberal, Madawaska—Restigouche, NB]

I did not want to interrupt Senator Wallin, but I think she asked Dr. Masuda an important question, which she was unable to answer.

Will Dr. Masuda agree to answer the Committee through the clerk?

[The Joint Chair, Liberal, Marc Garneau]

That is exactly what I was going to suggest.

Thank you, Mr. Arseneault.

For technical reasons, Dr. Masuda, you were not able to answer the question from Senator Wallin. We would appreciate a written answer to the question she posed to you. Can you give us a thumbs-up that you'll follow through on that? Okay. Thank you very much.

We'll now go to Senator Martin for three minutes.

[The Joint Chair, Hon. Yonah Martin]

Thank you, Mr. Chair.

Thank you to all of our witnesses.

Mr. Krausert, could you explain what CASP's position is on capacity for MAID for a mental illness or disorder? Could you explain to us what full disclosure for informed consent for MAID for a mental illness would have to look like?

[Sean Krausert]

I think capacity has to be assessed by the doctor, obviously taking into account the condition from which the person is suffering. When we're talking about mental disorders, there is some influence on capacity, that being my experience.

As far as full disclosure is concerned, I think we have to disclose that with a particular condition, for example, there's anywhere between a zero and 100% chance of irremediability, because we don't have the data. I don't know how it could be concluded subjectively without the objective data supporting it. That sort of disclosure I think needs to be done. As the report talks about, there has to be some sort of subjective shared understanding on such things between the practitioner and the patient. It's so subjective.

We bend over backwards in our Criminal Code to protect innocence. People have to be proven guilty, even if it means some guilty people get let go. I'm suggesting that safeguards have to be in place to ensure that those who would regret it and all those impacted by it.... Don't forget that there's a ripple effect between friends, co-workers and contacts. For every one of these deaths, we're talking about a major, major impact. It's not a decision just for the person. It's a decision for the community. We have to make sure that we really have those safeguards in place.

[The Joint Chair, Hon. Yonah Martin]

Thank you very much, and thank you for sharing your personal experience and story. It really gave us a sense of the insights we need to have. I think your voice today was very important.

Thank you, Chair.

Thank you, Senator Martin.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

I have a point of order, Mr. Chair.

[The Joint Chair, Liberal, Marc Garneau]

Mr. Cooper, go ahead.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Thank you very much, Mr. Chair.

I know that we are scheduled to go in camera to consider two motions, but I would submit that just in the interest of time, so that we wouldn't have to log in again, there would be some merit in not going in camera. Speaking to my specific motion, at least, I think it would be appropriate that the motion be considered out of camera, in public.

It's a motion requesting that this committee dedicate six hours to the study of the effectiveness, compliance and enforceability of existing safeguards under the Bill C-14 and Bill C-7 regimes.

[The Joint Chair, Liberal, Marc Garneau]

Thank you, Mr. Cooper. We previously made the decision that we will go in camera for this discussion and for other business as well.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Mr. Chair, I would just put forward a motion that we consider my motion in public, not in camera.

[The Joint Chair, Liberal, Marc Garneau]

Very good. Let's put that to a vote.

I would like to see a show of hands for committee members who would like to—

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Mr. Chair, I request a recorded vote.

[The Joint Chair, Liberal, Marc Garneau]

A recorded vote is fine.

Those who are in favour of supporting the motion from Mr. Cooper, please raise your hand.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

I requested a recorded vote, a roll call.