Yes.
Can I explain?
Evidence of meeting #2 for Medical Assistance in Dying in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was case.
A recording is available from Parliament.
Evidence of meeting #2 for Medical Assistance in Dying in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was case.
A recording is available from Parliament.
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
Yes.
Can I explain?
Liberal
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
It matters if what they're saying is that there isn't clinical readiness. If the clinicians who do MAID say that there isn't clinical readiness, then that would be a concern. If it's about clinicians disagreeing about whether MAID for mental illness should be allowed, that is irrelevant to the decision. That is your decision. That's a public policy decision, not a clinical decision. Clinical readiness is clinical, and the clinical community for MAID has demonstrated its readiness.
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
I'm glad you brought that up, because I was going to go there.
If you're dealing with a patient who has terminal lung cancer and you get 10 doctors to examine that person, they're all going to agree that it's incurable, right? Is that fair?
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
It depends. I'm sorry, but—
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
—clinicians disagree all the.... You're not going to get 10 out of 10, necessarily.
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
I think you could probably get 10 doctors. However, if you have 10 psychiatrists who examine a person with a mental health condition, you're not guaranteed to get 10 consistent views on the issue, are you?
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
That's just like in almost every other medical situation.
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
No, I'm talking about.... This is why it's important, Professor. There's a very important distinction, in my opinion, between serious physical medical conditions and what we're talking about here, which is mental health. In the former, you're guaranteed to get a consensus on the diagnosis. If I have a broken arm, 10 doctors are going to agree that I have a broken arm 10 out of 10 times. However, if I have a mental health condition, I'm not going to get 10 out of 10 doctors who say I have a mental health condition.
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
What I would say to that is that there are physical conditions for which you are not going to get 10 out of 10 agreement from people, and there are some mental disorders about which you would get 10 out of 10 agreement from psychiatrists. What we demonstrate—
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
Okay, but what I'm saying is that if I have a broken arm—Professor, you're not a doctor—10 out of 10 people are going to agree that I have a broken arm. You can't argue with that, can you?
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
No, but what I'm saying is there are some psychiatric.... It doesn't—
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
If I have a mental health condition, you're not always going to get 10 out of 10 people who agree that I have a mental health condition.
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
You're taking—
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
You can't say that with the same degree of certainty, can you?
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
It's not the same thing. It's apples and oranges. You're asking about one specific—
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
No, it's a medical diagnosis, and that's what we're talking about.
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
No, you're not giving the diagnosis. You give the broken arm, but then you say “mental health”. What you have to do to make it apples and apples is give a specific mental disorder and then compare it to a broken arm. You could get mental disorders that you will get 10 out of 10 for, and you will get physical disorders, other than a broken arm—
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
Okay. Thank you for that.
There are cases where you will, but there are cases where you won't. Is that fair?
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
Yes, and the point is that this is, therefore, discriminatory.
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
That's an important distinction when you're talking about medical assistance in dying, isn't it?
Professor Emeritus, Faculties of Law and Medicine, Dalhousie University, As an Individual
No, because you're discriminating. You're drawing a distinction between mental illness and physical illness. There are characteristics—what you're pointing to is this notion of consensus about whether it's incurable or not—which will fall on both sides of mental and physical. You can't justify treating mental differently from physical, given that the element you've identified falls on both sides.
Liberal
James Maloney Liberal Etobicoke—Lakeshore, ON
I agree that you shouldn't treat them differently if you can say with absolute certainty that the accuracy of the medical diagnosis is the same in both circumstances, and I don't think you or anybody else can say that.
Liberal
The Joint Chair Liberal Marcus Powlowski
We're over the time. As much as this has been a very good back-and-forth, we will move on to the next person in line, which is my friend Monsieur Thériault, for five minutes.
Mr. Thériault, you have the floor.