Medical Assistance in Dying Committee on April 28th, 2026

[Roderick McCormick]

I don't have statistics in front of me, but generally, we have higher rates of mental illness, and certainly, that's reflected in some of the symptoms and in terms of addiction and incarceration. The suicide rates are three times higher. They're much higher for the north and remote communities, for Inuit and for males versus females. There is a shocking discrepancy between that and what the rest of Canada experiences.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Yes, and we're definitely hearing from professionals that it's really a regional problem. In certain areas, you can get access, but in many areas, you can't.

I appreciate all of the work you're doing. Thank you.

[Roderick McCormick]

Thank you.

[The Joint Chair, Liberal, Marcus Powlowski]

We'll go to Mr. Grant for five minutes.

[Wade Grant, Liberal, Vancouver Quadra, BC]

Thank you, Mr. Chair.

I want to thank all the permanent members here for the work they're doing at this committee. It's a very important topic.

I thank the witnesses for coming forward.

Mr. Belanger and Dr. McCormick, my name is Wade Grant. I'm from British Columbia. I was formerly the First Nations Health Council chair, and I know that both of you have had interactions with the First Nations Health Authority. I grew up on a first nations reserve, where many of my relatives died way too young because of suicide and other things. We know that, far too often, first nations and indigenous communities will have to announce a state of emergency because of the overwhelming number of people, especially the young people, who are.... According to your stats, suicide is the number one cause of death for indigenous youth and those under 44. It's nine times higher for the Inuit community, three times higher for first nations and two times higher for Métis.

I grew up and went through that, and it shows that people are not getting the treatment they're searching for. You said this in your statement today, Mr. Belanger. I'm just wondering if you can explain a little more about how their needs are not being met or are being partially met and also what comes into play when people don't seek help because of the mistrust they've had for health care.

[Neil Belanger]

In a former life, I was the executive director of health for first nations in the north. We put in programs. We had an epidemic of suicide crises in the north in B.C. We worked with foreign nations to put together programs to try to address those things.

The unfortunate aspect is that funding within first nations communities is often inadequate to deal with mental health issues and to deal with home care. There's very limited disability-related funding that is provided, and access to clinicians is very difficult. You're looking at six months to a year or two longer in northern communities and sometimes even longer.

The distrust with government and government agencies still exists as well. Anti-indigenous racism in Canada has gone up exponentially over the last couple of years, and racism within health care is rampant. We know the cases of Joyce Echaquan and Keegan Combes. We know about the “In Plain Sight” report. There's all of this apprehension to go out and seek something—outside the community where your family is, where your supports are or where you are part of a community—in other communities and systems where you may not even be welcomed.

As has been noted, there are limited economic opportunities within communities and limited infrastructure. Some communities are dealing with massive housing problems. Again, the whole thing is the lack of availability of mental health services, and it's a struggle that has continued for a long time.

[Wade Grant, Liberal, Vancouver Quadra, BC]

Thank you, Mr. Belanger.

Dr. McCormick, you mentioned that indigenous rights are collective rights. Far too often, we look at individual rights. When I was on the First Nations Health Council, we issued the 10-year strategy on the social determinants of health, which was adopted by 84% of 176 chiefs back in 2023. We talked about the community-driven, nation-based approach. It's the “two-eyed seeing” approach for first nations to be able to make sure that the health and well-being of their people come home to them.

Maybe you can expand a bit on the work that you've done on that and how it's working when first nations' culturally sensitive and traditional ways of healing have been brought forward.

[Roderick McCormick]

There's been a growth of movement towards traditional healers, healing and ceremonies. A number of the health centres in B.C. have traditional healers as part of their staff. Ceremonies have been so valuable in people's healing. Those are being brought back. There's hope for the future, but a lot of it is what we have to do ourselves as indigenous communities. I'm a researcher, and I often say, “re-search is the search again for what we once knew”, because we had some really good systems in place before colonization. We've tried for years now to get help from federal and provincial governments and organizations. A lot of money has been spent, but not a lot of help has been provided.

I believe that the secret is community empowerment, community engagement, ownership and self-determination in many ways when it comes to mental health services. Obviously, we're going to need some finances to do that, but we have to find the solutions ourselves, because government just hasn't been able to do it for us.

[The Joint Chair, Liberal, Marcus Powlowski]

Thank you, Dr. McCormick.

Mrs. DeBellefeuille, you have the floor for five minutes.

[Claude DeBellefeuille, Bloc, Beauharnois—Salaberry—Soulanges—Huntingdon, QC]

Thank you very much, Mr. Chair.

I'd like to thank the witnesses for their testimony.

Mr. Belanger, I'm a member who represents Akwesasne, the Mohawk community in my riding. Having been made aware by the grand chief, I know that there is indeed a lack of social and health services—not only for mental health, but across the broad field of health care—in the communities. Above all, there are substance use problems due to opioid addiction. These are very acute problems. We have discussed this in our area, in our community, and we deplore the fact that indigenous communities aren't better supported to deal with these significant health issues.

In all provinces, including Quebec, there is also a lack of funding and support in all health care sectors. That's why we would have liked to see today's economic statement include some new investments in health care for people who need it in the communities, as well as in provincial public services. We were disappointed to see that there weren't any. We have even been told that transfers to the provinces for health and social services will be reduced over the coming years.

I can't disagree with you that there's a lack of services, but we still have to address medical assistance in dying. I think you're using the word “euthanasia”. I don't know if that's a misinterpretation, but in our clinical language, legally speaking, we're talking about medical assistance in dying, not euthanasia. Medical assistance in dying is a request that comes from an individual in their own right who chooses a way to die with dignity. There's palliative care, among other things. Medical assistance in dying involves a number of types of care. Lethal injection is just one type of care available as part of medical assistance in dying, so it isn't imposed. I don't see it as a type of care being imposed on a community, but as an option that individuals in their own right can accept.

I'll move on to my questions now. Forgive me for not having listened to all the previous testimony, since I'm not a permanent member of this committee, but I truly have a desire to better understand and learn.

Are there many people in your communities who have an incurable and persistent illness, such as cancer or multiple sclerosis? In your communities, do people turn to medical assistance in dying to relieve their suffering and die with dignity, or is it a type of care that you don't ask for because of your culture or your way of approaching life?

[Neil Belanger]

For our organization, and for me as the CEO, we deal with disabilities and with track 2. I don't know the frequency within the Gitxsan Nation or any nation of how many people might be requesting MAID or taking MAID under track 1. I haven't heard of any from my chief or the members in my family. It doesn't mean it doesn't happen, but I just don't have that expertise.

To go back, respectfully, I listened to your comments and appreciate them. I do, but medical assistance in dying is a euphemism that was put in place to.... It's non-culpable homicide in the Criminal Code. That's what it is. It is part of a process where we have indigenous and non-indigenous people with disabilities who are burdened and weighed down by pressures, from the lack of services you just described, to a point where they are making a decision that I believe is coerced. Even though people say it is a decision they make themselves, when you have all these pressures and everything else—

[Claude DeBellefeuille, Bloc, Beauharnois—Salaberry—Soulanges—Huntingdon, QC]

Mr. Belanger, I don't wish to be rude, but I have to interrupt you. Medical assistance in dying is currently unavailable to people with mental health disorders, so we can't talk about coercion. We're discussing the possibility of expanding access to it. Currently, medical assistance in dying exists for physical health problems, such as cancer, when the end of life is foreseeable.

The question I asked you was the following: Do people seek out this care in your communities?

[The Joint Chair, Liberal, Marcus Powlowski]

You have a very short time to answer the question, Mr. Belanger.

[Neil Belanger]

Okay.

Again, under track 1, I couldn't give you that information.

[The Joint Chair, Liberal, Marcus Powlowski]

Thank you.

We'll move now to Senator Dalphond for three minutes.

[Pierre Dalphond]

Thank you very much to the members of the panel.

First, Mr. Belanger, I recognize that you came before us in 2022. We worked together to have recognition of the Indigenous Disability Awareness Month almost 12 years ago. You've been involved in that for a long time.

When you appeared before us in 2022, you said that the federal government had not consulted with indigenous groups and nations before pushing for MAID. You said that you thought it was not really compliant with the UN declaration, or UNDRIP now. Have there been consultations between the Government of Canada or Health Canada and the indigenous groups since 2022?

[Neil Belanger]

There have. I think it began in 2023 or 2024. I'm not sure of the dates. Health Canada started to do an online consultation and provided some funding to different disability groups for indigenous perspectives on end-of-life care.

As I'm sure you know, Senator, it was on for a year. It had to be extended because of a lack of uptake. At the end of the day, they had 250 respondents from across Canada, 50 of whom they eliminated. In 2024 the population in Canada of those who identified as indigenous was 1.8 million, so the response rate was 0.001222%. I mean, I guess you could consider that a consultation. I don't know if it's that valuable.

We actually met with Health Canada in relation to that. We gave them a six-page document on our concerns about the online consultation. We had a meeting with them as well to address our concerns. I wouldn't say it was a productive meeting, but it was cordial. They offered us the possibility of a contract to do more consultations. We said that if we did that, then we would talk about the history of the AMAD committee. We'd talk about the recommendations. We'd talk about the implementation of MAID, including recommendations from mature minors and advance directives. I know that's not part of what we're looking at today, but we wanted to give the whole view for our communities and for the people we serve, so that they could have informed knowledge and could better answer questions on the survey than what had been provided. We never got a call back.

[Pierre Dalphond]

I'm sorry to interrupt, but there's almost no time left.

At the time, you were also stressing the fact that you had difficulty accessing mental health support. Has the situation improved for indigenous communities?

[Neil Belanger]

Do you mean in accessing mental health services?

[Senator Pierre Dalphond]

Yes.

[Neil Belanger]

I don't think so, no, not from our experience as a service provider.

[Pierre Dalphond]

Thank you.

[The Joint Chair, Liberal, Marcus Powlowski]

Thank you, Senator Dalphond.

Senator Moodie, you have three minutes.

[Rosemary Moodie]

Thank you, Mr. Chair.

I'd like to thank you, Professor McCormick, for sharing your areas of research with us and helping us understand all the work you've done in the past. I would like to ask you one or two questions around this work.

First of all, in terms of helping me understand, would you agree that across indigenous communities, people hold quite a wide range of views on MAID—that in fact there are indigenous people who request, who have been found eligible and who have received MAID; that this is happening on reserve and in communities; and that there are indigenous MAID assessors and providers in Canada?

Are you aware, and would you agree, that this is the existing situation right now in indigenous communities here in Canada?

[Roderick McCormick]

Yes. As my colleague mentioned earlier, the report that was done looking at the experiences of indigenous people and MAID pointed out that a lot of people didn't know about it or had very little knowledge about it, so it was easy to get confused, I think. That was one of the findings.

Certainly, it does exist. I know of—