Evidence of meeting #5 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 access.

A recording is available from Parliament.

On the agenda

Members speaking

Before the committee

Joint Vice-Chair  Hon. Pierre Dalphond (Quebec (De Lorimier), ISG)
McKinnon  Professor, Department of Psychiatry and Behavioural Neurosciences, McMaster University, As an Individual
Thorpe  Full Professor, Department of Community Health and Epidemiology and Department of Psychiatry, University of Saskatchewan, As an Individual
Gubitz  MAID Provider, Canadian Association of MAID Assessors and Providers
Green  MAID Provider, Canadian Association of MAID Assessors and Providers
Rosemary Moodie  Senator, Ontario, ISG
F. Gigi Osler  Senator, Manitoba, CSG
Kristopher Wells  Senator, Alberta, PSG
Close  Senior Research Fellow, Australian Centre for Health Law Research, Queensland University of Technology, As an Individual
Crawford  Chief Medical Officer, 9-8-8: Suicide Crisis Helpline
Grant  Registrar and Chief Executive Officer, College of Physicians and Surgeons of Nova Scotia
Sareen  Head of Psychiatry and Professor, Department of Psychiatry, University of Manitoba, As an Individual
Singh Gandham  Assistant Clinical Professor, Department of Family Medicine, University of Alberta, As an Individual
Prokopy  Vice-President, Policy and Advocacy, Ontario Hospital Association
Young  Vice-President, Medical Affairs, and Chief of Staff, Waypoint Centre for Mental Health Care, Ontario Hospital Association

8:10 p.m.

Senator, Alberta, PSG

Kristopher Wells

Thank you.

Dr. Crawford, suicidality is not uniquely associated with mental illness, as we've heard from previous experts. When your organization receives phone calls asking questions about MAID, how is your organization providing accurate and objective information to those callers?

8:10 p.m.

Chief Medical Officer, 9-8-8: Suicide Crisis Helpline

Allison Crawford

Do you mean about MAID?

8:10 p.m.

Senator, Alberta, PSG

8:10 p.m.

Chief Medical Officer, 9-8-8: Suicide Crisis Helpline

Allison Crawford

We do not. We have an explicit policy that we treat every instance as an opportunity for suicide prevention.

8:10 p.m.

Senator, Alberta, PSG

Kristopher Wells

Then you wouldn't refer them to any MAID-appropriate services.

8:10 p.m.

Chief Medical Officer, 9-8-8: Suicide Crisis Helpline

8:10 p.m.

Senator, Alberta, PSG

Kristopher Wells

Thank you for that.

Dr. Grant, at our last committee meeting, on April 21, one witness stated in their testimony that clinicians cannot be entrusted with the great power and responsibility of MAID MI-SUMC. How would you respond to that criticism?

8:10 p.m.

Registrar and Chief Executive Officer, College of Physicians and Surgeons of Nova Scotia

Douglas Grant

It's hard to respond to it because I don't know the basis from which it comes. Clinicians are licensed with an extraordinary depth and range of responsibilities that involve life and death across a number of disciplines. I don't know why this is distinguishable.

8:10 p.m.

Senator, Alberta, PSG

Kristopher Wells

Just to re-emphasize what you said, regulators are ready and will enact this law should Parliament move forward.

8:10 p.m.

Registrar and Chief Executive Officer, College of Physicians and Surgeons of Nova Scotia

Douglas Grant

We're awaiting instructions.

The Joint Chair Liberal Marcus Powlowski

Thank you.

We are back to the second round.

The Joint Vice-Chair Hon. Pierre Dalphond

Mr. Lawton, you have two minutes and 33 seconds.

8:10 p.m.

Conservative

Andrew Lawton Conservative Elgin—St. Thomas—London South, ON

Dr. Grant, Senator Moodie asked you what you would do if allegations of criminal misconduct were referred to you. I want to confirm that I understood your answer to be that you would investigate them internally and not refer them to police. That is what you said twice.

8:10 p.m.

Registrar and Chief Executive Officer, College of Physicians and Surgeons of Nova Scotia

Douglas Grant

If I did, I misspoke. If we have a concern that arises with us that is on its face criminal, we immediately phone the RCMP. We get it quite often in other domains of regulation. Typically, if there's merit to the concern, we'll apply interim sanctions if those are available to us—as in suspend the physician's licence—and then refer it to the RCMP or law enforcement.

8:15 p.m.

Conservative

Andrew Lawton Conservative Elgin—St. Thomas—London South, ON

I'm relieved to hear that. Thank you.

8:15 p.m.

Registrar and Chief Executive Officer, College of Physicians and Surgeons of Nova Scotia

Douglas Grant

I'm sorry if I misspoke.

8:15 p.m.

Conservative

Andrew Lawton Conservative Elgin—St. Thomas—London South, ON

Dr. Close, just for clarity, you have a Ph.D. and not a medical doctorate. Is that correct?

8:15 p.m.

Senior Research Fellow, Australian Centre for Health Law Research, Queensland University of Technology, As an Individual

Eliana Close

That's correct.

8:15 p.m.

Conservative

Andrew Lawton Conservative Elgin—St. Thomas—London South, ON

I want to talk about the very important question of physician readiness. This is not from people on the outside of the system looking in. These are comments made by MAID assessors and practitioners in your own research.

Here's one: “We're not infallible. There are stupid clinicians. We need to make sure it's done well and oversight’s mandatory.”

Here's another one: “Maybe I've been doing things wrong for five years. I don't know”.

Here is another one: “I agree there's oversight on my ticky-boxes, but there's no oversight on the quality of my work.”

How do you rationalize your claim that there is robust oversight already when the practitioners cited in your own research would seem to contradict that thesis?

8:15 p.m.

Senior Research Fellow, Australian Centre for Health Law Research, Queensland University of Technology, As an Individual

Eliana Close

It's important to take that research in its context. Those participants were talking about different oversight mechanisms and making more general comments.

With respect to the comment about not knowing if there's oversight on my “ticky-boxes”, that was specifically a comment on the lack of transparency in the British Columbia processes. I wholeheartedly support more transparency around that.

These comments were also illustrating that oversight shouldn't just be about following all the elements of the Criminal Code. Oversight should also be about continuous quality improvement and learning from mistakes. That is where there is a role in Canada that we see is there but could be bolstered.

8:15 p.m.

Conservative

Andrew Lawton Conservative Elgin—St. Thomas—London South, ON

Thank you. I have only 10 more seconds.

You mentioned retroactive oversight. To be clear, that would be oversight when the patient is already dead. Is that correct?

8:15 p.m.

Senior Research Fellow, Australian Centre for Health Law Research, Queensland University of Technology, As an Individual

Eliana Close

Retrospective, yes, is after the patient is dead.

8:15 p.m.

Conservative

Andrew Lawton Conservative Elgin—St. Thomas—London South, ON

Thank you.

The Joint Vice-Chair Hon. Pierre Dalphond

Thank you.

Next and probably last before the break is Dr. Jaczek.