Debates of Oct. 5th, 2023

Affordable Housing and Groceries Act

[Matthew Green, NDP, Hamilton Centre, ON]

Mr. Speaker, we heard the hon. member speak about the housing crisis. I would like to suggest that what we have is a crisis of capitalism. We have the commodification of people's very existence, identified in the real estate investment trust that the member has highlighted. We have Vanguard, BlackRock and others. In my community, we have nine apartment buildings that are facing renovictions and demovictions.

To the people who are going to be meeting in Hamilton in about an hour, from those nine apartment buildings, what do you have to say about the crisis of capitalism and the impacts it has on housing?

[The Deputy Speaker, Conservative, Chris d'Entremont]

I have nothing to say as the Chair occupant.

The hon. member for Kitchener Centre.

[Mike Morrice, Green, Kitchener Centre, ON]

Mr. Speaker, I would say that housing is a human right and it deserves to be more than a preamble in a bill. It needs to be enshrined in legislation.

The House resumed from May 17 consideration of the motion that Bill C-314, An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

Criminal Code

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Mr. Speaker, it is a pleasure to rise and speak on an issue that has been fairly extensively debated over the last number of years. Members will recall that the reason we are having today's debate goes back to 2015, when a Supreme Court of Canada decision ultimately obligated parliamentarians here in the House to develop and pass a law that took into consideration the ruling made by the Supreme Court, with the necessity for the government to provide a framework.

It was not a very easy challenge when that decision was ultimately made. I do not know how best to put it, but the Government of Canada, at the time run by Stephen Harper, ultimately sat on the issue until there was an election. That election saw a change in government, and it was one of the first orders of business that the Government of Canada, under the current Prime Minister, had to deal with.

Over the years, I have been engaged in many different types of debates on all forms of legislation. When I am talking to young people who are trying to get a sense of what we do here in Parliament, I talk about legislation, and I will often make reference to Bill C-7. For Bill C-7, a very passionate debate took place on the floor of the House of Commons back in Centre Block. I can recall it vividly because of all the different emotions that were being expressed on the floor and all the discussions that took place.

It was not taken lightly. If we take a look over the years at the number of Canadians who have been consulted in one form or another with regard to medical assistance in dying, we are not talking about tens of thousands. We are talking about hundreds of thousands of Canadians from coast to coast to coast, in many different forms. They came together to voice opinions and concerns. In fact, we had a standing committee that did an incredible number of consultations, not only with individuals in our communities but with many different stakeholders.

In the debates that I have seen, I do not think we referenced our health care professionals and the important role they played in the debates. I want to start off by talking about that, because I think it is really important that, as Bill C-314 will ultimately be voted on, we understand and appreciate the number of discussions and the amount of effort that took place for the current legislation we have, which was amended.

As we saw, there were some issues that ultimately came out of Bill C-7, which caused another government bill to come to the floor. Again, a lot of repeat discussions took place and it ultimately passed. I think that is why the member has made the decision to propose his private member's bill. The changes that were made in what I think was Bill C-39, although I am not 100% sure and the member can correct me if I am wrong in his closing comments, are what might have brought forward this particular piece of legislation.

To be clear on what Bill C-314 does, it proposes to permanently exclude the eligibility to receive medical assistance in dying on the basis of a mental disorder alone. Wording is really important. I know that in the original debates with all the different stakeholders, and I made reference in particular to our health care professionals, the quality of the presentations and the understanding of the serious nature of the issue were, I would suggest, second to no other out of the debates I have witnessed, in particular given some of the things we heard coming out of committees.

As I reflect on that debate, I think that, in good part throughout the process, we saw many members of Parliament put their party position to the side and reflect in terms of what each believed as a parliamentarian. Maybe it was a crossover of personal beliefs versus the canvassing that many people no doubt had in terms of their constituents and wanting to reflect the general will of their constituents.

At the end of the day, when we think of medical assistance in dying and the issue of a mental disorder, I do not think that we want to try to simplify the message. As we all know, I am not a medical professional, but I have an immense amount of respect for what our medical professionals have to go through in order to be put into a position, because it is not just any and every doctor or nurse practitioner; there is a whole lot more that is involved. Towards the end of the debate, particularly on the second piece of legislation dealing with this particular issue, we had members who stood up and said, “Well, just put in your order”, almost as if someone were going through a drive-through and then it is done. We all know that is, by far, not the case.

I will fall back on the fine work that our standing committees have done. I am going to fall back on the issues and how they were explained, in good part, by the different stakeholders. I am going to stand by what the health care professionals brought forward to us. I will look at the information that was provided and ultimately reflect on what I believe in this particular situation and what a vast majority of the constituents I represent would want me to say on this particular issue. I will do this with very much a sympathetic heart, understanding the difficult situation that, unfortunately, far too many people have to face.

We can have as much sympathy as we want for those individuals who are looking at the possibility of getting medical assistance in dying, but it is one thing to sympathize and it is another thing to empathize. Based on everything I have looked at and listened to over the last number of years, I have not been convinced that this is, in fact, the direction that we should be going with regard to Bill C-314. I am just not convinced.

I think that what we ultimately need to do is continue to monitor and look at ways in which we can ensure that there is no abuse of the MAID legislation. We need to continue to show compassion in every way we can. We need to continue to listen to what the experts, individuals and stakeholders are telling us and try to build more value to the legislation so there is a higher sense of comfort in the broader community, which I believe there is today. The mechanisms are there, and there are opportunities to continue to be able to review.

[Monique Pauzé, Bloc, Repentigny, QC]

Mr. Speaker, I am going to address the subject of Bill C‑314; that goes without saying. However, I feel especially compelled to condemn the excessive and inappropriate nature of this initiative from the hon. member for Abbotsford. His bill is being tabled in reaction to an important, sensitive social issue, namely medical assistance in dying.

The fact that my colleague from Abbotsford wants to amend the Criminal Code to include the notion that mental disorders should not be considered grievous and irremediable medical conditions for access to medical assistance in dying is a proposal that does not even need to be made. Mental illness is an extremely complex issue, even a controversial one in medical circles. There are many reasons for that. To begin with, it would be imprudent and dangerous to rush the process of providing access to medical assistance in dying when the sole underlying medical condition is a mental disorder. However, that is not what is happening right now. The Criminal Code will be revised in due course, if necessary. On this point, experts feel that the current provisions of the Criminal Code are adequate to allow for further work on medical assistance in dying.

What I want to speak out against today is what I see as the official opposition's blatant politicization of this issue. Everything looks normal, or almost, when one reads Bill C-314 objectively, but it is the whole message surrounding the introduction of this bill in the House that I want to condemn. I would like to be able to say that some members just do not understand, but I cannot even use that explanation as an excuse for their behaviour.

Although I agree that being unable to afford a home and dealing with inflation and rising grocery prices are not pleasant experiences, associating them with medical assistance in dying for mental disorders is the worst kind of populism. This just shows an appalling ignorance of the many realities experienced by people living with with mental illness or just plain ignorance in general. This is a position of contempt toward people who are working on many fronts to lead a somewhat normal life, despite the suffering caused by their mental condition. With Bill C-314, the Conservatives are putting on their agenda generalizations and falsehoods that they think will win them votes, and I do not see anything good about that.

This debate is a societal debate. When the official opposition claims that the work that will be done next spring is to allow Canadians who are “losing hope”, the phrase used by the leader of the official opposition, to access medical assistance in dying, I think that is completely irresponsible. There is a difference between a request and the acceptance of the request. That is the first thing the member should take into consideration. Just because a request is made does not mean it will automatically be accepted. I want to come back to the fact that the Conservatives are driven by purely vote-seeking motivations and that these statements are false. At press conferences, they tell Canadians that the intention is to provide medical assistance in dying to people whose only condition is depression or other mental health problems. Come on. Depression is reversible. Suicidal ideation is also reversible. They need to stop for a minute and think. In my opinion, it is completely irresponsible to say such things. However, it gets worse. In March, the leader of the official opposition went so far as to include the following generalizations in his preamble:

Those going to The Mississauga Food Bank [are] seeking help with medical assistance in dying, not because they are sick but because they are hungry...

Here is another quote:

...1.5 million are eating at food banks, and some are asking for help with medical assistance in dying because they cannot afford to eat, heat or house themselves.

Honestly, my colleagues cannot be serious. There are plenty of other passages from Hansard I could quote. In any case, if the Conservatives seriously believe that not being able to afford a house or dealing with the challenge of finding a place to live during post-secondary studies are two factors that lead people to want to end their lives, then I would say that things are an absolute mess.

We expect the official opposition to put an end to its demagoguery and simplistic approach, and instead take a more collegial approach where real discussion can take place and where all opinions can be expressed to allow a full understanding of what is at stake. The Bloc Québécois believes that the strategies and messages coming from the official opposition on such an important and sensitive issue do nothing to advance everyone's understanding of the issue.

The subject we are studying deserves serious consideration. We have a duty to Quebeckers and Canadians, and it is certainly not to tell them a bunch of nonsense, as the opposition leader did last March in the quotes I cited earlier. Medical assistance in dying is not a form of treatment for people with depression or suicidal ideation. It is the last resort, after decades of care, interventions and numerous therapies have all failed, when suffering is never-ending and the disease is incurable. I cannot emphasize that enough.

We believe that suffering is not exclusive to people who have a degenerative disease or who are at the end of their life. There is no need to rush this work, since the outcome has not yet been decided, contrary to what the Conservatives would have everyone believe with their message and their populist election strategy.

In its report, the Expert Panel on MAID and Mental Illness made 19 recommendations and proposed more stringent safeguards. For example, in recommendation 10, the panel proposed that a psychiatrist independent from the treating team and an independent assessor be consulted. Recommendation 16 involves the implementation of prospective oversight. There are other recommendations.

Under no circumstances would the Bloc Québécois condone providing access to medical assistance in dying in this medical context without the following: a thorough analysis of the practices and standards being considered; discussion with civil society groups, patients' rights representatives, professional associations and other stakeholders; a clear interpretation of the criteria regarding incurability, irreversibility and enduring and intolerable suffering; and the establishment of all of the safeguards and legal processes related to the ability to consent.

Members can count on the member for Montcalm, the Bloc Québécois critic on this file, to do a very thorough job.

I invite all members of Parliament, especially the members of the official opposition who might be tempted to repeat their dangerous generalizations and falsehoods, to read all of the recommendations. There are recommendations that have to do with the assessment process. The Criminal Code requires consultation with a specialist, and the key recommendation is for that specialist to be a psychiatrist. There is also the prospective oversight that I was talking about earlier.

The recommendations relating to implementation fall into three categories: consultation, training and data collection. Simply put, in order to access medical assistance in dying when a mental disorder is the sole underlying condition, there must be a significant history of treatment and therapy. Nothing is taken lightly.

In closing, we have to consider our capacity to pay for the health needs of the patients in question. We have to provide care to these people with irreversible illnesses. As a compassionate and empathetic society, we must take care of patients who meet the eligibility criteria for medical assistance in dying and provide them with a gentle and dignified death. Let us allow this work to continue early next spring without polarization or disinformation.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, in March 2023, legislation to extend by one year the temporary exclusion of eligibility for MAID where a person's sole medical condition is a mental illness received royal assent and immediately came into force. This means that persons suffering solely from a mental illness will be eligible for MAID as of March 17, 2024. Bill C-314, the bill before the House today, would remove this eligibility at least until we have satisfactory answers and guardrails to ensure that we can extend this profoundly permanent step with confidence. In my view, we do not have that necessary confidence today, and I think the majority of Canadians and health professionals, and the data, concur.

Data released in September 2023 from the Angus Reid Institute found that a majority of Canadians, 52%, worry that treating mental health will not be a priority when MAID eligibility is expanded to include individuals whose sole condition is mental illness. A vast majority of Canadians, 80%, are concerned with the mental health care resources available in this country, namely that they are not sufficient. Overall, one in five Canadians says they have looked for treatment from a professional for a mental health issue in the last 12 months, and in that group, two in five say they faced barriers to receiving the treatment they wanted. These obstacles appear to be more of an issue for women, among whom 45% of those who sought treatment say it was difficult to receive, and young Canadian adults aged 18 to 34.

A majority of Canadians support the previous rules governing MAID, first passed in 2016 and then updated in 2021, but there was more hesitation when it comes to this next step. Three in 10 say they support allowing those whose sole condition is mental illness to seek MAID, while half are opposed.

I will turn to some of what the professionals are telling us, starting with the Centre for Addiction and Mental Health. A survey recently of CAMH physicians found a lack of agreement on whether or not mental illness could be considered “grievous and irremediable” for the purposes of MAID and what criteria could be used to determine whether a person is suffering from an irremediable mental illness. The survey also found significant disagreement among physicians on whether or not a request for MAID can be differentiated from suicidal intent. These physicians also highlighted the concerns they had about access to mental health care in the context of expanded eligibility for MAID.

Canada's mental health care system has experienced chronic underfunding, leading to a significant shortage of community- and hospital-based mental health care across the country. Between one-third and one-half of Canadians with mental illness were not getting their mental health needs met before the COVID–19 pandemic exacerbated the mental health crisis and increased the burden on our mental health system and therefore on Canadians. The results of that survey replicate the findings from the Canadian Psychiatric Association's member consultations in 2020 and the conclusion of the Council of Canadian Academies' expert panel working group report in 2018.

Let me turn to the Canadian Mental Health Association, Canada's premier organization dealing with mental health:

CMHA's position, first articulated in a national policy paper in August 2017, and later, in testimony to the Senate in November of 2020, is that until the health care system adequately responds to the mental health needs of Canadians, assisted dying should not be an option....

First, it is not possible to determine whether any particular case of mental illness represents “an advanced state of decline in capabilities that cannot be reversed.”

Second, we know that cases of severe and persistent mental illness that are initially resistant to treatment can, in fact, show significant recovery over time. Mental illness is very often episodic. Death, on the other hand, is not reversible. In Dutch and Belgian studies, a high proportion of people who were seeking MAID for psychiatric reasons, but did not get it, later changed their minds.

Third is the issue of whether this distinction for mental illness vis-à-vis all other types of illness is inherently discriminatory. Denying access to MAID for mental health reasons alone does not [necessarily] mean that those with mental illness suffer less than people afflicted with critical physical ailments.

That is true. The statement continues, saying, “What is different about mental illness specifically, is the likelihood [or not] that symptoms of the illness will resolve over time.”

We do not have the benefit of appropriate guidance from the Supreme Court of Canada on this issue, and that is something we need to take into account.

It is also noteworthy that with only 7.2% of Canada's health budget dedicated to mental health care, Canada spends the lowest proportion of funds on mental health among all G7 countries. For example, in the U.K., the National Health Service spends 13% of its budget on mental health care. According to the OECD's recent analysis of spending on mental health worldwide, it concluded that even that is too low, given that mental illness represents as much as 23% of the disease burden. The historical underfunding of mental health has been most pronounced in community-based mental health services and I think that ought to be taken into account.

According to the Canadian Psychiatric Association, perhaps Canada's foremost experts on mental health diagnosis and treatment, its members are profoundly split on this issue. The CPA's most recent member consultations in 2020 found that 41% of respondents agree that persons whose sole underlying medical condition is a mental disorder should be considered for eligibility for MAID, 39% disagree or strongly disagree, and 20% were undecided.

According to CPA president, Dr. Grainne Neilson:

Balancing the commitment of psychiatrists to provide treatment, care and hope for recovery with a person's lived experience of suffering and right to enact personal choice in health-care decisions, including MAiD, is a fundamental challenge, particularly where death is not naturally reasonably foreseeable.

Equitable access to clinical services for all patients is an essential safeguard to ensure that people do not request MAiD due to a lack of available treatments, supports or services. Poor access to care is particularly relevant for people of low-socioeconomic status, those in rural or remote areas, or members of racialized or marginalized communities.

The Canadian Psychological Association, another very important group in this matter, states the following:

Many mental disorders are managed, not cured. Medications for mental disorders are largely palliative. While it is possible that medications and psychotherapy may successfully treat an episode which then doesn’t recur, it is often the case that mental disorders require management across a lifetime.

In assessing whether a condition is incurable and irreversible, consideration must be given to equity of access to interventions. Wait lists for publicly funded services are long. Services, like psychotherapy offered in communities by psychologists, are not funded by Medicare. Needed services are not always available in rural or remote communities. To fully address whether a condition is resistant to intervention, that intervention must be accessible.

It is not.

The mental functions required to give consent to MAiD are the very ones sometimes impaired with a serious mental disorder, despite the grievous and irremediable suffering the disorder imposes. Consideration must be given to how to assess capacity despite the impairment in thinking that can accompany serious mental disorders.

I believe that we must act cautiously and prudently, and we must take a phased approach in this area. As has been noted by all parliamentarians, this is an intensely sensitive issue with grave moral and consequential concerns.

Adequate time, in my view, is needed to facilitate a comprehensive national conversation about acceptable safeguards and the availability of medically assisted dying for those suffering from psychological or mental health conditions alone, so that we minimize negative impacts on people living with mental health problems and illnesses when they are most vulnerable, and on their caregivers and health professionals.

I think holding that national conversation must involve people living with mental health problems and illnesses, and their experiences because they play a central role. We must get their input into what mechanisms must be there to minimize the risk of wrongful death.

It is going to be my position to support this bill and I think we must move very cautiously. I do not think that we can say that we can never move into this area, but I think we can say with confidence that now is not the prudent time.

[Len Webber, Conservative, Calgary Confederation, AB]

Mr. Speaker, today I rise to speak to Bill C-314, an act that would amend the Criminal Code in regard to medical assistance in dying.

This enactment would amend the Criminal Code to provide that a mental disorder is not a grievous and irremediable medical condition for which a person could receive medical assistance in dying.

This is not the first time I have risen in this House to speak on the issue of medical assistance in dying, MAID, and I thank the hon. member for Abbotsford for the opportunity to speak to his bill.

As we know, MAID is an extremely complex issue that has generated some strong opinions on both sides. In May 2016, when I rose here to speak in support of the MAID legislation, I stated that, “when it comes to something as personal and sensitive as death, it is better to have options available, even if we do not like them, even if we do not believe in them. It is better to have some legal framework [in place] than none at all.”

I quoted from many letters I received from constituents in my speech back then and read letters from Ken, Connie, Valerie, Debra Lee, Catherine, Tracey, Doug and David. They all shared their personal perspectives with me, and it was extremely helpful in my own personal deliberations.

In the years since MAID was legalized, I have come to have known a number of people who have found comfort, personally and for their families, in the MAID process. Their death was foreseeable, there was no chance of recovery and when the dying process appeared to be both prolonged and cruel, it was an option they took advantage of. Their death was dignified, it was planned and it was peaceful. It allowed them to say their goodbyes to their loved ones, to their friends, when they could.

However, that being said, I am a very big proponent of hospice and palliative care, which must always be a viable and an available option to someone contemplating MAID. In the strongest of terms, MAID cannot be seen as a substitute for good palliative care, and it should never be.

Through my family’s volunteer experience with Hospice Calgary, and later with my wife’s final days with breast cancer at the Agape Manor Hospice care facility, I saw first-hand how critical it is we have a proper, well-funded palliative care system here in Canada. I saw then how underfunded this specialized care is within our health care system, and it is still that way today.

Canadians should have access to the support and care they need while living through one of the toughest times in their lives. We need to do better and we can do better, but we certainly have a long way to go.

However, today we are here to address the concerns of Canadians when it comes to the implementation of MAID with mental illness as the sole eligibility. This is the gist of Bill C-314. Should there be a permanent exclusion from MAID for people whose sole underlying condition is a mental disorder?

Back in 2016, during the original MAID debate, I had a meeting with a constituent, a young man named Anton. He came to my office, and Anton is the reason I am rising to speak today. He was a 25-year-old or 26-year-old, fit, good looking, articulate, intelligent and healthy young guy. When I say “healthy”, though, I mean in the physical sense only.

Anton came to my office to discuss his desire to have access to medical assistance in dying. He literally wanted to die. He shared with me his mental struggles and he said he was tired of living and he just wanted to die. It was something I just could not comprehend. This young guy seemed to have everything going for him and he wanted to die.

Anton felt the requirement in MAID that one’s death be foreseeable was unfair, a barrier and should not be in the legislation. He felt if one wanted to die, one should be allowed to through MAID, no questions asked. It should be as easy as going to get a haircut, he said.

I did ask him if he ever thought of taking his own life and why he would need MAID. He said he did not want to put a bullet in his head, jump off a chair with a noose around his neck or cut his wrists. That seemed too fearful for him, too painful and unfair for whomever would find him. We talked for what seemed like hours in my office.

I found it odd that he never once mentioned anything about a doctor, any treatments he was receiving or any medication he was on, so I asked him if he had seen a doctor. He had not spoken to a single health professional about his desire to end his life. I encouraged him to, and I said he needs to talk to somebody because I was certainly not the guy to talk to about suicidal tendencies. When he was leaving the office, he said he would seek some help. I gave him a hug, and I have had many sleepless nights since wondering if there was anything else I could have done.

About three months later, Anton requested another meeting with me. He told me that he had sought help and went to see a doctor. Whether it was a psychiatrist or psychologist, I do not know, but he told me of his horrific episode. The very doctor who Anton went to seek help from called the police, saying that Anton was a danger to himself and needed to be protected. Anton was taken away by the police and locked in a padded room for 14 hours without any food or water. He told me he only got out because he finally convinced authorities that he was fine, that he was normal and that things were good. He basically had to lie his way out. He said it was the worst experience of his life. He asked for help and had gotten none.

That is the problem. Many Canadians are just not getting the mental health assistance they need. Clearly, we need to put better supports in mental health and people's access to that help. We should be careful in asking police to be mental health professionals. We need to make sure we have the right people in the right place at the right time. I am pleased to hear that some police forces are now using health professionals in the field, but we still have a long way to go.

We need to put vulnerable Canadians back in control of their lives. We want to see them get the help they need and provide them with the social and mental health supports they need. We must never give up on them and allow them to prematurely choose MAID over access to mental health care.

Since 2016, I have heard nothing from Anton. I have often wondered whether he is still alive or dead. Before this speech, I tried to seek him out, and I went to social media. I had some assistance and found some information on Anton. I discovered that he had found love abroad. He is working to bring his new wife or girlfriend to Canada and is excited to start a new business. I know that if MAID legislation in 2016 had permitted mental health as a sole reason, it is quite possible that Anton would have ended his life without exploring all of his options. He never would have found the love and support that he has today.

I am very grateful for the perspective that Anton has given me on this issue, as it has profoundly convinced me that those whose sole condition is a mental disorder should not have access to medical assistance in dying. That is why I support the hon. member for Abbotsford's private member's bill, Bill C-314.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Mr. Speaker, I would first like to pay my respects to my colleague, whose personal accounts were very moving. Our hearts go out to Anton's family.

As we know, Bill C-314 amends the Criminal Code to provide that a mental disorder is not a grievous and irremediable medical condition for which a person could receive medical assistance in dying. The Bloc Québécois supports access to medical assistance in dying when a mental disorder is the sole underlying medical condition. We agree with the expert panel that the safeguards currently in place in the Criminal Code are sufficient. We think the exclusion should be maintained for one more year in order to give health care professionals a chance to develop standards of practice for cases of medical assistance in dying related to mental illness and to become familiar with those standards.

I would remind the House that the Bloc Québécois's position on medical assistance in dying has always been to uphold the consensus in Quebec, which came about following five years of consultations, specifically that medical assistance in dying is a right. Everyone has the right to die with dignity, of their own free will and with as little suffering as possible.

The Bloc Québécois is of the opinion that it is wrong to draw false analogies between the different problems in society and the specific issue of access to medical assistance in dying when a mental disorder is the sole underlying medical condition. We are of the opinion that it is possible to defend the right to self-determination, which is what medical assistance in dying is, while contributing to improving our health care systems, especially our mental health services. On that note, the Bloc Québécois would remind the House that the government has not substantially increased health transfers. That is affecting the system.

I would like remind the House that, in this debate, it is not a matter of offering people euthanasia as an answer to society's ills, contrary to what the Conservatives are saying. It is frankly irresponsible to suggest that the government's actions are causing people to become depressed and that the government's solution is to offer them medical assistance in dying.

It is also important to remember that the Conservative leader spread disinformation by failing to mention the context, when he stated in his communications that the government decriminalized dangerous drugs. The context is that Ottawa authorized a three-year pilot project in British Columbia to decriminalize the possession of small quantities of drugs. It is a pilot project based on practices used in Portugal with the explicit goal of curbing the overdose epidemic that is happening in British Columbia. The hope is that this pilot project will set a course to help Canadians and Quebeckers with addictions.

What is more, it is misleading to say that the governments will be providing medical assistance in dying in less than a year. That suggests that people will have their request for medical assistance in dying approved in less than a year, when that is not at all the case. As the experts on the Special Joint Committee on Medical Assistance in Dying pointed out, it will take at least a decade, maybe several decades, before a person can get medical assistance in dying for a mental disorder. It will have to be established that decades of therapy using multiple approaches have done nothing to treat the patient's mental health condition. In short, that is the complete opposite of what is being said by the Conservative leader, who is suggesting that a temporary depression is sufficient grounds to access medical assistance in dying.

In the Truchon and Gladu ruling, the courts had determined that the criteria were too restrictive, hence the evolution of this legislation. At the end of a press conference, a journalist asked the Conservative leader if he was prepared to use the notwithstanding clause to block access to medical assistance in dying. The Conservative leader skilfully dodged the question by mentioning that it is not currently before the courts. The Bloc Québécois is curious to hear what his colleagues think of this.

It should also be noted that the expert panel did not recommend deferring the exclusion measure. This is a request by professional associations. Although the expert report is entitled “Final Report of the Expert Panel on MAiD and Mental Illness”, the experts recommend changing the terminology to “mental disorder” because “mental illness” does not have a standardized definition. The panel finds that its recommendations on safeguards, protocols and directives should apply to all clinical situations in which several or all of these important concerns are present, namely incurability, irreversibility and capacity. The expert panel considers that the safeguards currently included in the Criminal Code are adequate for cases of medical assistance in dying when a mental disorder is the sole underlying medical condition.

As my colleague from Repentigny said earlier, the panel made 19 recommendations to proceed with requests for medical assistance in dying when a mental disorder is the sole underlying medical condition. They fall into five broad categories: the development of practice standards for medical assistance in dying; the interpretation of the term “grievous and irremediable medical condition”; vulnerabilities; the assessment process; and implementation.

Briefly, the panel recommends that practice standards be developed and shared with professional associations so they can adapt and adopt them. It should be noted that the government set up a task group to address this and that these practice standards were published in early 2023.

When it comes to interpreting the expression “grievous and irremediable medical condition”, the criteria of incurability, irreversibility and enduring and intolerable suffering, which are currently contained in the Criminal Code, must be duly established. They must be appropriately interpreted in applications for MAID when a mental disorder is the sole underlying medical condition. Although the expert panel acknowledges that it is impossible to establish fixed rules surrounding treatments, their duration, number and variations, they must nonetheless be part of the considerations for accessing medical assistance in dying. Simply put, for someone to have access to MAID when a mental disorder is the sole underlying medical condition, that person must have a significant history of treatments and therapies.

With regard to vulnerability, this involves ensuring that applicants have access to sufficient resources—housing, pain management, community support—so that their choice to access medical assistance in dying is not based on an adverse social circumstances. Again, the Bloc Québécois reiterates that increasing health transfers and funding the construction of social housing must be permanent priorities for the federal government.

As for the recommendations regarding the assessment process, the key recommendation is that the Criminal Code requirement, in this case consulting a specialist, involve a psychiatrist.

Finally, the recommendations for implementation can be broken down into three areas: consultation with stakeholders, training, and data collection for monitoring purposes.

As my hon. colleague and friend, the Bloc Québécois member for Repentigny, explained, this is a serious subject. We must set partisanship aside and work with the expert panels.

[The Deputy Speaker, Conservative, Chris d'Entremont]

The hon. member for Abbotsford for his right of reply.

[Ed Fast, Conservative, Abbotsford, BC]

Mr. Speaker, medical assistance in dying will soon be expanded to include those with mental illness, including depression. My bill, Bill C-314, would reverse this terrible decision. My bill is very narrow and would not repeal the other provisions of Canada's medical assistance in dying laws.

There is no national consensus on expanding MAID to include mental disorders, none. The most recent Angus Reid poll found that a very small number of Canadians actually favour expanding assisted suicide to the mentally ill, somewhere around 28%.

The mental health community has raised significant concerns. A recent letter to government from the heads of seven Canadian psychiatry schools implored decision-makers to hold off on expanding assisted suicide to the mentally ill. Similarly, the Canadian Psychiatric Association does not support the expansion of MAID due to the many ethical and clinical concerns that have not been resolved. They argue that mental illness is often highly treatable and that patients should be provided with the treatment they need to manage their symptoms and lead fulfilling lives.

Stakeholders have deplored the lack of social and economic supports for persons with mental illness and how this can lead people to consider MAID. They have pointed to the fact that the federal government has not fulfilled its promise to deliver dedicated mental health and palliative care funding to the provinces, leaving Canadians without access to the support that would lead them to choose life rather than death.

Many others have joined the chorus. They note that the issues of suicidal ideation, irremediability and competency have not been resolved, ensuring that Canadians will needlessly die because we have rushed ahead with expanding MAID.

At greatest risk are those suffering from depression, veterans suffering from PTSD, the opioid addicted on our streets, our indigenous communities and those seeking to escape a life of poverty. The government has even signalled its openness to allowing children to access assisted suicide, presumably without their parents' consent.

Last year, in my home town of Abbotsford, Donna Duncan was swiftly approved for assisted suicide after failing to receive proper treatment for chronic mental health issues. Her assisted death happened so quickly and so totally blindsided her daughters, Alicia and Christie, that they referred the case to the RCMP. Is this the dystopian world we are leaving behind?

Has anyone consulted with our first nations? Meaghan Walker-Williams of the Cowichan Tribe recently wrote in the National Post:

As a Sixties Scoop survivor, my lifelong personal journey back to my community of Cowichan has also been marked by the painful consequences of policies that didn’t respect or understand Indigenous cultures. Another policy, blind to my culture, may soon join them: assisted suicide for mental illness.

She concludes by saying, “it's crucial that the narrative remains firmly rooted in upholding the sanctity of life—a cornerstone of Coast Salish teachings.”

I note that the government originally excluded the mentally ill from its MAID regime and went to great lengths to explain why that was necessary. It was only after the unelected Senate included the mentally ill in Bill C-7 that the government suddenly enthusiastically embraced the idea.

The question is this: Should Canadians be able to trust their government to act in a way that values the life of every Canadian, or do we give up on the most vulnerable among us? Someday, all of us will have to give an account.

A famous world leader by the name of Moses once challenged his own people with a choice and a promise: “I have set before you life and death, blessing and curse. Therefore choose life, that you and your offspring may live”. I want my descendants to live, to prosper, to thrive, and I want the same for our mentally ill, our Indigenous peoples and indeed all Canadians. It is time to end this experiment. With so much uncertainty, surely we should err on the side of life, not death.

I respectfully ask members to support Bill C-314.

[The Deputy Speaker, Conservative, Chris d'Entremont]

The question is on the motion.

If a member participating in person wishes that the motion be carried or carried on division, or if a member of a recognized party participating in person wishes to request a recorded division, I would invite them to rise and indicate it to the Chair.

[Ed Fast, Conservative, Abbotsford, BC]

Mr. Speaker, I would ask for a recorded division.

[The Deputy Speaker, Conservative, Chris d'Entremont]

Pursuant to Standing Order 93, the division stands deferred until Wednesday, October 18, at the expiry of the time provided for Oral Questions.

A motion to adjourn the House under Standing Order 38 deemed to have been moved.

Air Transportation

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, the cost of flights in Nunavut is astronomical. All 25 communities that I represent are fly-in communities. A flight to Ottawa can cost over $5,000. It costs more to fly within our own country than it does to destinations such as Mexico, London or Nuuk.

Most of my constituents cannot choose to take vacations, because it is simply not affordable. There are no other options. Flying is an unfortunate reality of living in Nunavut, yet Nunavut does not have adequate airport infrastructure to ensure that prices are affordable.

Nunavummiut have seen increases in fares since the government first approved the Canadian North-First Air merger. I understand these increases were a result of Transport Canada undertakings that made it impossible for Canadian North to maintain sustainable operations. It is difficult and expensive to run an airline in a territory as large and sparsely populated as Nunavut. Imposing onerous conditions on one of Nunavut's only airlines is not the solution. The 25% annual fare increase that Transport Canada has allowed for is also far too high. That is four times the rate of inflation. For a $3,000 flight between Ottawa and Iqaluit, the fare could be raised by $750 this year.

When the government announced its new deal with Canadian North last April, they promised to maintain fares and departures while providing a more efficient service. In the last few months, I have received many complaints about the disruptions experienced by my constituents.

Gjoa Haven only has one or two flights per week, which can leave families in southern facilities for extended periods of time. For example, if a person from Gjoa Haven has a medical appointment in Yellowknife, that patient will most likely end up in Yellowknife for weeks because of cancelled or overbooked flights. These are patients who, because of the lack of a health care system, are forced to leave their territory to access basic health care services that are available to the rest of Canada.

The mayor of Arctic Bay wrote to me, saying they are seeing nine fewer flights per week compared with last year. This is unacceptable for communities that rely on these flights for food, health, education, tourism, infrastructure and economic development. My office is hearing many similar stories from constituents who have been stranded due to cancellations, delays or rescheduled flights.

Nunavummiut struggle every day with the excessive cost of living in the North. Not only are they battling the rising costs of food, fuel and housing, but they are also paying thousands of dollars more for essential appointments. According to the federal government release, the deal signed with Canadian North would provide “the access to air services they need, while at the same time ensuring Canadian North remains a viable service provider”. When will the government admit that it will not do so?

[Vance Badawey, Liberal, Parliamentary Secretary to the Minister of Transport]

Mr. Speaker, the First Air-Canadian North merger was approved, as was mentioned earlier, in 2019, with terms and conditions around pricing, scheduling and employment, amongst other elements that would be in place until mid-2026.

The sudden onset of the pandemic, which drastically changed the air transportation landscape in northern Canada, has had a lasting impact on Canadian North's ability to comply with these conditions while continuing to serve communities, return to profitability and maintain services. Passenger levels in the North remain below 2019 levels and are lower than in other regions throughout the country.

The lasting impacts of COVID have required us to vary the original terms and conditions, while at the same time ensuring that important safeguards remain in place for northern Canadians for the remainder of the period subject to obligations.

In this context, Transport Canada has negotiated new terms and conditions with Canadian North, which were subsequently approved by the Governor in Council. These conditions are intended to strike a balance in ensuring the airline's continued operations and financial resiliency, while maintaining some conditions to maintain the public interest, such as imposing caps on fare increases and profit margins, as well as ensuring the balance of service. These terms and conditions will be in place for the next three years.

Furthermore, the new terms and conditions include an obligation by Canadian North to be subject to assessment by an independent monitor, reporting to the Minister of Transport, and to provide financial and scheduling data to ensure compliance with the new terms and conditions.

The Government of Canada shares concerns over air affordability and accessibility in northern Canada, which is why the Government of Canada insisted on maintaining safeguards for Canadians when deciding to vary the terms and conditions.

At the same time, we have acted to ensure that Canadians in northern communities continue to receive the air services that they rely on. It is our understanding that the merger related terms and conditions to which Canadian North is subject do not supersede the contractual obligations it has with the territories around medical and duty travel. In this context, Canadian North will need to adhere to the conditions laid out in the agreements it holds with the territories.

I will add, and the member does recognize this, that we on the transport committee are working with the member for Yukon to look at these arrangements, as well as other arrangements to, once again, strike that much-needed balance in the northern part of our country.

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, I would like to thank the parliamentary secretary for his response. I did have the pleasure of travelling with him when he was part of the indigenous and northern affairs committee, and know that he has direct experience with the challenges of travelling in my region.

Another example of what it is like to fly in Nunavut is that one of my constituents was on a routine flight from Iqaluit to Ottawa. This flight was cancelled twice, then re-booked for days later. It would have caused her to miss an important meeting. As a result, she had to take a much more expensive flight with Air Canada through Edmonton.

She was told that she was not eligible for compensation and would have to dispute her claim through the Canadian Transportation Agency. She was also advised that this process would take up to 18 months. This is unacceptable. Nunavummiut do not have thousands of dollars and many months to wait for compensation for essential travel. Are these delays what the government had in mind when it introduced the air passenger bill of rights?

[Vance Badawey, Liberal, Niagara Centre, ON]

Mr. Speaker, the Government of Canada is concerned with ensuring that northern Canadians have access to the air transport they require.

COVID-19 placed serious pressure on the ability of Canadian North to continue to provide services to northern Canadians while at the same time avoiding financial losses. To ensure ongoing service in the north, Transport Canada recently reached the agreement I spoke about earlier with Canadian North to vary their merger related terms and conditions. These aim to strike a balance between addressing public interest concerns while maintaining the sustainability of the airline.

In conclusion, the Government of Canada, in approving these new terms and conditions, ensured there remained safeguards for Canadians, especially in the north, such that each community will continue to be served and that fare increases would be representative of the new realities of the market and capped to ensure that the balance is maintained.

[The Deputy Speaker, Conservative, Chris d'Entremont]

The motion that the House do now adjourn is deemed to have been adopted. Accordingly, the House stands adjourned until tomorrow at 10 a.m. pursuant to Standing Order 24(1).

(The House adjourned at 6:49 p.m.)