Debates of Feb. 13th, 2023

Income Tax Act

[Lianne Rood, Conservative, Lambton—Kent—Middlesex, ON]

Mr. Speaker, skilled trades are a key component of Canada’s workforce and are vital to the strength of Canada’s economy. Skilled tradespeople are critical in maintaining essential sectors, like our health, water, electrical and food systems. They literally build bridges and critical infrastructure.

The demand for skilled tradespeople is high. It is expected to remain high over the next decade or more as Canada’s economy recovers from eight years of the Liberal government. For far too long, many blue-collar private sector workers have found themselves to be an afterthought of politicians in Ottawa.

Our country is facing a shortage in over 300 skilled trades, and the numbers are showing that this will only get worse. Each job that is unfulfilled is an uncollected paycheque that could help a family get ahead.

By 2028, Canada will need to have over 700,000 new tradespeople in place. Some of the challenges that we face today are very different from the challenges we will face in the future and are different from what our leaders faced decades ago. We will have new problems and we will need new solutions.

Action must be taken to address the concerns regarding the shortage of skilled tradespeople, which is far beyond the scope of the bill that we are discussing here today, just as action must be taken to fix the concerns of those who proudly work in the trades today.

That is why we are supporting Bill C-241. Every step to promote trades and make the environment less cumbersome and more appealing to new entrants is a step in the right direction. We must support Canada’s workers and the unions that represent them. The inability to do so would hold back local businesses from growing. It would delay roads, public transit and schools. It would make it harder to improve the health care system and would contribute even more to the rising cost of living that families are battling every day.

After generations of being left behind by the government, it is time to earn trust and build the bridges that will get the bridges built.

During the last election campaign, many residents in my riding spoke to me about the importance of supporting Canadian skilled tradespeople. One simple way that we can do that is by allowing travel expenses to be tax deductible.

Why is this a good first step? The answer is very simple. Many of our skilled tradespeople live and work in rural and remote communities. One of my colleagues has made the suggestion of making the range 120 kilometres because, for some people in my riding, it can take them an hour and a half just to get from their home to the shop to get their trucks. Given that my riding is over 5,000 square kilometres, I can say it is actually a very conservative estimate of how long an individual may have to travel to get to work.

In fact, I spoke with one person who worked as a welder in Arkona, which is a small town in a fairly central agricultural community. They told me it was routine for them to get up at 4 a.m., drive an hour from their home to the shop to load up their truck and prep their crew. They drive another hour and a half south to the morning job site, and then drive an hour northeast for the afternoon. After a long and tiring day, they would drive another hour back home to repeat a similar schedule six days a week.

We are talking about support in this bill for those who work some of Canada’s toughest jobs and who are the most essential workers.

Let me put this in perspective compared to other professions where people can receive tax deductions for travel for their jobs.

The Dewalt or Milwaukee white-collar tool salesperson, who has to travel to remote areas to sell the tools to the building trades workers, will get a government-paid tax credit for their travel. However, the blue-collar IBEW electrician or the UA pipefitter, who has to travel to the same remote job site to put in long hours working and using those same tools, does not get any tax relief from the government for their travel.

Tradespeople work very hard to support their families and have to put forward significant out-of-pocket expenses to be able to perform and remain competitive. The government needs to do more to support our nation’s working men and women. Those are the men and women whose jobs are making them have to shower at the end of the day, who are raising families and who are building the future of Canada.

Inflation and the cost of living have taken their toll on tradespeople just as much as, if not more than, they have for nearly every Canadian. Let us take a quick look at the price of gas for someone, like that welder, who travels 400 kilometres in a day.

The average price of gas is around $1.40 per litre right now. Like most tradespeople in rural Canada, they drive a truck. For those members across the floor who have urban ridings, driving a truck is absolutely necessary for rural tradespeople. It is actually an essential tool for the performance of jobs, especially in our rural areas, not something that can be easily phased out to suit the agenda of the finance minister’s friends in the WEF.

This person's truck has roughly a 700-kilometre range, so they need to buy gas twice a week or more. With a 120-litre tank, they are paying over $250 a week or more in gas, and about $16 of that is carbon tax. I think it quickly becomes clear to what a great extent a travel deduction will amount to large savings that will keep these tradespeople in business. If only we could remove some of the other non-essential impediments.

A similar travel deduction is already available for corporations and self-employed workers in other industries. Passing Bill C-241 would equalize the playing field and incentivize tradespeople to take contracts farther from home, which would be beneficial for smaller communities that have trouble attracting skilled labour. More tradespeople travelling would help generate more spending, which is especially beneficial for smaller and remote communities.

Many tradespeople travel long distances for work, and I am talking about leaving their homes and flying somewhere, sometimes even to another province, across the country or to northern areas to get to a job site. Often they are gone from their families for long periods of time, sometimes even months at a time. I cannot imagine being away for months at a time without being able to see loved ones.

Those of us sitting in the chamber know what it is like to leave our families to come to work for just a week. Imagine leaving our families for weeks. I know I would miss my family if I were gone for weeks, and I know from talking to some of these workers over the last number of weeks that it is a hardship on them. It is a struggle for their families to be apart. Sacrificing time with their kids, spouses or partners in order to try to provide good incomes to support their families can be very difficult, but they make sacrifices every day.

Imagine someone being responsible for paying their own transportation, accommodation and meals to get to a job site, while having to travel with their own tools. There is no other option to receive a tax credit to help offset any of these travel costs. Workers are more likely to take jobs closer to home, and not necessarily in their trades, when they are not compensated.

Travelling as a tradesperson is extremely hard on families. A tradesperson would be able to use some of their tax credit to fly home to see their family, for instance for a long weekend, or even fly their spouse and family to be with them for a period of time in the town where their job site is. Imagine the economic spinoff of that in those small towns.

This bill is not controversial. This bill would help keep families together. It is a pro-worker, pro-jobs, pro-paycheque and pro-worker-mobility bill, all of which is needed to keep Canada going. I am pleased to see that this drive is being acknowledged and even supported by other parties in the chamber.

Despite our differences, I think we all want to keep Canada going and we all want to do what is best to support our Canadian workers. We want to encourage young people to follow their passions, enrol in skilled trades and move beyond the tired mentality that the only way to succeed in life is to acquire multiple degrees.

Do members know that a Red Seal certified tradesperson makes over $68,000 a year? With years of experience, depending on available jobs, they can make well over $300,000 a year. That is comparable to or even exceeds what is expected from a university master's degree. Unfortunately, only one in 10 high school students is considering a career in trades. Something needs to change, and I look forward to a productive discussion about what can be done to make improvements.

Starting with the bill we are debating today, Bill C-241, I have heard, from the NDP side, some suggestions that the travel distance be lowered to 80 kilometres. From the Liberal benches, the ask has been made to have the bill include greater deductions for tools and equipment. I have heard a number from the Bloc say they will take the bill as is and support it.

All of this is fantastic, not only for workers but also for my colleague, who I know has been very open and transparent in his excitement. I will echo his excitement on behalf of my constituents. This bill would have a tremendous impact on tradespeople and their families. Let us roll up our sleeves, get it done and bring it home.

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

The time provided for the consideration of Private Members' Business has now expired, and the order is dropped to the bottom of the order of precedence on the Order Paper.

Criminal Code

[David Lametti, Liberal, Minister of Justice and Attorney General of Canada]

moved that Bill C-39, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

Mr. Speaker, I rise today to speak to Bill C-39, an act to amend an act to amend the Criminal Code regarding medical assistance in dying. This bill would extend the exclusion of eligibility for receiving medical assistance in dying, or MAID, in circumstances where the sole underlying medical condition for MAID is a mental illness. The main objective of this bill is to ensure the safe assessment and provision of MAID in all circumstances where a mental illness forms the basis for a request for MAID.

An extension of the exclusion of MAID eligibility in these circumstances would help ensure health care system readiness by, among other things, allowing more time for the dissemination and uptake of key resources by the medical and nursing communities, including MAID assessors and providers. It would also give the federal government more time to meaningfully consider the report of the Special Joint Committee on Medical Assistance in Dying, or AMAD, which is expected this week.

My remarks today will focus on the legislative history of MAID in this country. I want to be clear that medical assistance in dying is a right, as affirmed by the Supreme Court.

In its 2015 Carter v. Canada decision, the Supreme Court of Canada ruled that the sections of the Criminal Code prohibiting physicians from assisting in the consensual death of another person were unconstitutional. In response, in 2016, our government tabled former Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts regarding medical assistance in dying.

The basic purpose of the bill was to give Canadians nearing the end of life who are experiencing intolerable and unbearable suffering the option to obtain medical assistance in dying. The bill was passed two months later, when medical assistance in dying, or MAID, became legal in Canada for people whose natural death was reasonably foreseeable. It included procedural safeguards in order to ensure that the person’s request for medical assistance in dying was free and informed, and to protect the most vulnerable.

In 2019, in Truchon v. the Attorney General of Canada, the Quebec Superior Court ruled that it was unconstitutional to restrict the availability of MAID to individuals whose natural death was reasonably foreseeable. One year later, in response, we introduced a second bill on medical assistance in dying, the former Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying.

Former Bill C-7 expanded eligibility to receive MAID to persons whose natural death was not reasonably foreseeable. It did so by creating a separate, more stringent set of procedural safeguards that must be satisfied before MAID can be provided. The government proposed, and Parliament supported, these stringent procedural safeguards in recognition of the increased complexities of making MAID available to people who are not otherwise in an end-of-life scenario.

Some of these additional safeguards include a minimum 90-day period for assessing eligibility, during which careful consideration is given to the nature of the person's suffering and whether there is treatment or alternative means available to relieve that suffering. This safeguard effectively prohibits a practitioner from determining that a person is eligible to receive MAID in fewer than 90 days.

Another additional safeguard is the requirement that one of the practitioners assessing eligibility for MAID has expertise in the underlying condition causing the person's suffering or that they must consult with a practitioner who does. The assessing practitioners must also ensure that the person be informed of the alternative means available to address their suffering, such as counselling services, mental health and disability support services, community services and palliative care. It is not enough just to discuss treatment alternatives. They must ensure the person has been offered consultations with relevant professionals who provide those services or care. In addition, both practitioners must agree that the person gave serious consideration to treatment options and alternatives.

The former Bill C-7 extended eligibility to medical assistance in dying to people whose death is not reasonably foreseeable. However, it temporarily excluded mental illness on its own as a ground for eligibility to MAID. In other words, the bill excluded from eligibility for medical assistance in dying cases where a person's sole underlying medical condition is a mental illness. That temporary exclusion from eligibility stems from the recognition that, in those cases, requests for medical assistance in dying were complex and required further review.

In the meantime, the Expert Panel on MAID and Mental Illness conducted an independent review of the protocols, guidance and safeguards recommended in cases where a mental illness is the ground for a request for medical assistance in dying. The expert panel’s final report was tabled in Parliament on May 13, 2022.

The Special Joint Committee on Medical Assistance in Dying also completed its parliamentary review of the provisions of the Criminal Code relating to medical assistance in dying and their application, as well as other related issues, including mental health. We eagerly look forward to the special joint committee’s final report, expected on Friday, February 17.

I would also like to highlight the excellent work of the expert panel, ably led by Dr. Mona Gupta.

This temporary period of ineligibility was set in law to last two years. It will expire on March 17 unless this legal requirement is amended by law. This bill would do just that, and proposes to extend this period of ineligibility for one year, until March 17, 2024.

As I stated at the outset of my remarks, this extension is needed to ensure the safe assessment and provision of MAID in circumstances where a mental illness forms the sole basis of a request for MAID. It is clear that the assessment and provision of MAID in circumstances where a mental illness is the sole ground for requesting MAID raises particular complexities, including difficulties with assessing whether the mental illness is in fact irremediable and the potential impact of suicidal ideation on such requests.

That is why, when some Canadians, experts and members of the medical community called on the federal government to extend the temporary period of ineligibility to make sure the system was ready, we listened. We listened, we examined the situation carefully and we determined that more time was needed to get this right.

As for the state of readiness of the health care system, I would like to take a moment to highlight the great progress that has been made toward the safe delivery of MAID in those circumstances. For example, standards of practice are being developed for the assessment of complex requests for medical assistance in dying, including requests where mental illness is the sole underlying medical condition. Those standards of practice will be adapted or adopted by clinical regulatory bodies and by clinicians in the provinces and territories. These standards are being developed and will be completed in March 2023.

In addition, since October 2021, the Canadian Association of MAiD Assessors and Providers, or CAMAP, has been developing an accredited study program for health professionals. Once completed, that program will include seven training modules on various topics related to the assessment and delivery of medical assistance in dying, including on how to assess requests for medical assistance in dying, assess capacity and vulnerability, and manage complex and chronic situations. That program should be finalized and ready to be implemented next fall.

This progress was achieved through our government's leadership and collaboration with the health system's partners, such as the provincial and territorial governments, professional health organizations, our government's regulatory agencies, clinicians and organizations such as CAMAP.

The Regulations for the Monitoring of Medical Assistance in Dying, which set out the requirements for the presentation of reports on MAID, came into force in November 2018.

These regulations were recently revised to significantly improve the collection of data and reporting on MAID. More specifically, the regulations now provide for the collection of data on race, indigenous identity and any disability of the person. The revised regulations came into force in January 2023, and the information about activities related to medical assistance in dying in 2023 will be published in 2024 in Health Canada's annual MAID report.

I think we can all agree that substantial progress has been made. However, in my opinion, a little more time is needed to ensure the safe assessment and provision of MAID in all cases where a mental illness is the sole basis for a request for MAID.

I want to be clear that mental illness can cause the same level of suffering that physical illness can cause. We are aware that there are persons who are suffering intolerably as a result of their mental illnesses who were waiting to become eligible to receive MAID in March 2023. We recognize that these persons will be disappointed by an extension of ineligibility, and we sympathize with them. I want to emphasize that I believe this extension is necessary to ensure the safe provision of MAID in all cases where a mental illness forms the basis of the request for MAID. We need this extension to ensure that any changes we make are done in a prudent and measured way.

I want to turn now to the more technical part of Bill C-39 and briefly explain how the bill proposes to extend the mental illness exclusion. As I stated earlier in my remarks, former Bill C-7 expanded MAID eligibility to persons whose natural death was not reasonably foreseeable. It also included a provision that temporarily excluded eligibility in circumstances where a mental illness formed the basis of the request for MAID. Bill C-39 would delay the repeal of the mental illness exclusion. This would mean that the period of ineligibility for receiving MAID, in circumstances where the only medical condition identified in support of the request for MAID is a mental illness, would remain in place for an extra year, until March 17, 2024.

I want to reiterate that we need more time before eligibility is expanded in this matter. We need more time to ensure the readiness of the health care system, and more time to consider meaningfully and to potentially act on AMAD's recommendations. This is why I urge members to swiftly support the passage of this bill. It is imperative that it be enacted before March 17. If it is not, MAID will become lawful automatically in these circumstances. It is essential that this bill receive royal assent so that this does not happen before we are confident that MAID can be provided safely in these circumstances. I trust that all colleagues in this place will want to make that happen.

The safety of Canadians must come first. That is why we are taking the additional time necessary to get this right. Protecting the safety and security of vulnerable people and supporting individual autonomy and freedom of choice are central to Canada's MAID regime. We all know that MAID is a very complex personal issue, so it is not surprising that there is a lot of debate. It should go without saying that seeking MAID is a decision that one does not make lightly. I know from speaking with members of the medical community that they take both their critical role in the process and their professional duties toward patients extremely seriously. I trust that medical professionals have their patients' interests at heart, and this sometimes involves supporting their patients' wishes for a planned, dignified ending that is free of suffering.

Once again, I strongly believe that an extension of the exclusion of MAID eligibility in this circumstance is necessary to ensure the health care system's readiness and to give the government more time to meaningfully consider and to potentially implement the AMAD recommendations. I remind the House that those recommendations are expected just one month before the current mental illness exclusion is set to expire. Therefore, I implore all members to support this bill.

[Rob Moore, Conservative, Fundy Royal, NB]

Mr. Speaker, today we are seeing an admission of a process that was far too rushed. Just two years ago, the Minister of Justice appeared at a justice committee one morning and said that there was not a consensus on how to move forward with expanding medical assistance in dying to those whose sole underlying condition is mental illness. However, later that day, after the Senate had amended the legislation to include mental illness, the minister suddenly said in the House that he was confident there was a consensus. The minister's own charter analysis of Bill C-7 said that those whose underlying condition is mental illness needed to be protected.

Therefore, we see evidence now that 70% of Canadians are opposed to this expansion. We know that many Liberal members are voicing their concerns. Will the minister consider delaying this expansion indefinitely, so that those who are suffering with mental illness, such as our veterans with PTSD, are protected?

[David Lametti, Liberal, LaSalle—Émard—Verdun, QC]

Mr. Speaker, I thank the hon. member for his work on this file.

What is different now, two years later, is that we have done a great deal of work. The expert committee, led by Dr. Mona Gupta, thinks we are ready to move forward with the protocol it has developed, as do a number of professionals and professional bodies across Canada, but there is not unanimity. That is why we are proposing a one-year extension so we, along with medical professionals and Canadians, can internalize what the next step will be.

Let me point out that we all have a duty as parliamentarians to not participate in exaggeration or misinformation. What this bill would not do would be to allow a person suffering from depression or anxiety to immediately get MAID. This is for a small fraction of individuals who are suffering intolerably from long-standing mental disorders under long-standing care of medical professionals and who want another option. That is what this is about. It is not about people who are contemplating suicide.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, in a debate as sensitive as this, we would expect every parliamentarian in the House of Commons to lend some dignity to this debate and demonstrate a strong sense of responsibility.

Last week, in the middle of question period, on the topic of mental disorders being the sole underlying medical condition, the official leader of the opposition said to the Prime Minister something to the effect that there were people suffering who were destitute, living in poverty and struggling with depression, and that all this government had to offer them was medical assistance in dying.

I would like my colleague to share his thoughts on these types of comments that, in my opinion, will prevent us from having a calm and productive debate not only from a theoretical perspective, but also with respect to the situation with the bill and what it really covers. In short, we are talking here about misinformation.

[David Lametti, Liberal, LaSalle—Émard—Verdun, QC]

Mr. Speaker, I thank my colleague for his question and comment.

The criteria for receiving medical assistance in dying in situations where the person is not at the end of life are very strict and rigorous, particularly when it comes to the subject we are considering today and in cases where mental illness is the only factor.

A person cannot automatically get medical assistance in dying just by requesting it. It is much more serious than that. Our practitioners, the medical community and those who provide medical assistance in dying take their responsibilities very seriously.

With regard to the comment made by the leader of the official opposition, I completely agree with my colleague. That shows a rather jaded attitude toward a subject that is very complex and morally difficult for many people. We therefore have to be respectful about it, even in our discussions.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Mr. Speaker, like the minister, I have been here since 2015, so I have seen the entire legislative journey of medical assistance in dying, and I have also been the NDP's member on the special joint committee, both in the last Parliament and this one.

Back when Bill C-14 was passed, there was a requirement in that act for a statutory review of the legislation. We did have Bill C-7, and the government did accept the Senate amendment, even though it was contrary to its own charter statement on the matter. It was only after that that we established the special joint committee, which was then delayed by the 2021 election and did not get up and going until May of last year.

In the context of that, I think the Liberals have, in some instances, put the cart before the horse before we have had the appropriate review, but I would also like to hear his comments because there is a crisis in funding for mental health in this country. We have had the Canadian Mental Health Association talk about this. I would like to hear from the justice minister that his government can make a commitment to bring mental health care funding up on par with that of physical care. There is a real crisis, not only in my community, but also in communities from coast to coast to coast. I think that is going to be an important component of this conversation.

[David Lametti, Liberal, LaSalle—Émard—Verdun, QC]

Mr. Speaker, I thank the hon. member for his work on the special committee, and we look forward to the recommendations of the special committee. One of the reasons to have a delay is precisely to take what that special committee might recommend better into account.

Mental illness is an illness, and I strongly support initiatives to better resource the encadrement, the support we are giving to people suffering from mental illness. It is something that our government has recognized.

We put $5 billion into the system a number of years ago. However, when we did that for mental illness, we found that we could not guarantee that the provinces would actually spent that money on mental illness. In the current set of negotiations between the Minister of Health and his counterparts, as well as the Prime Minister and his counterparts, we are trying to build some accountability into that system, but we definitely do agree with the need to invest in greater mental health resources, particularly in this case. We want people to be able to live a dignified life with the supports they need to accomplish that.

[Gary Anandasangaree, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Mr. Speaker, some have opined that the extension sought today is potentially for re-debating the issue of mental health as a sole and underlying condition for MAID. I am wondering if the minister could outline why that is not the case.

[David Lametti, Liberal, LaSalle—Émard—Verdun, QC]

Mr. Speaker, we passed the law in 2019. Part of the parliamentary process was the interactions between the House and the Senate. We came to a compromise at the end of that process with the Senate to include mental illness as a sole criterion with a two-year delay.

We felt at the time that this could be done in two years. COVID intervened and an election intervened, but we do feel that a great deal of work has been done, in particular, by the expert committee. However, in order for everyone to internalize those recommendations, and for faculties of medicine, provincial and territorial bodies, and expert groups to build out the didactic materials, we need another year, but this is only a year extension. Of course, this would also give us time to look at what the special committee reports on this particular area, as well as evaluate other suggestions it makes.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

Mr. Speaker, it is always a pleasure to rise on behalf of the people of Kamloops—Thompson—Cariboo.

I wish to recognize the life of Danilo Covaceuszach. I just saw his obituary in the Kamloops This Week. May eternal light shine upon him.

In reference to that last answer from the Minister of Justice, it really is incumbent, in my view, that the Minister of Justice listen to the people of Canada, and people in my riding have been asking that the minister reconsider this. His answer to the parliamentary secretary says to me that he is not prepared to do so. This is amidst the charter statement from his own department saying that this has inherent risks and complexity. Given that, is he saying unequivocally before the House that there is not going to be any reconsideration of this before the next year?

[David Lametti, Liberal, LaSalle—Émard—Verdun, QC]

Mr. Speaker, I thank the hon. member for his work as a critic and his work on committee.

We are in a far different place than we were two years ago. We have now done a great deal of the work, particularly at the federal level, on mental illness as the sole criterion for seeking MAID. As I said, a number of leading experts feel that we would have been ready next month to have moved forward. We are trying to be prudent and to allow others to internalize the learning that has been developed over the last two years.

I mentioned before, and I will repeat it again, that this is a small fraction of people who are in the non-end-of-life scenario. Indeed, the people in the non-end-of-life scenario generally are a small fraction of those who seek MAID. It is not the case that somebody will simply be able to get MAID by going to their doctor and saying that they are contemplating suicide. That is not the case, and we are misleading Canadians if that is what we say.

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

Mr. Speaker, I rise to speak on Bill C-39, a legislation that imposes a new arbitrary deadline of March 2024 in place of the Liberal government's arbitrary deadline of March 2023 whereby persons with a sole underlying mental health disorder would be eligible for MAID.

I support Bill C-39 only because it is better than the alternative, namely that in one short month from now, on March 17, MAID would be available to persons with a sole underlying mental health disorder. This would be an absolute disaster and certainly result in vulnerable persons prematurely ending their lives, when otherwise, they could have gone on to recover and lead healthy and happy lives.

Rather than imposing a new arbitrary deadline that is not grounded on science and evidence, what the Liberal government should be doing is abandoning this radical, reckless and dangerous expansion of MAID altogether. This is why I wholeheartedly support Bill C-314, which was introduced last Friday by my friend and colleague, the member for Abbotsford, and would do exactly that.

One would expect that before deciding to expand MAID in cases of mental illness, a responsible government would take the time to study the issue thoroughly and consult widely with experts. After all, we are talking about life and death. We are talking about a significant expansion that would impact a vulnerable group of Canadians.

However, the Liberal government is not responsible, and that is not what happened. This is why the government finds itself in the mess it is in today with this rushed, 11th-hour legislation to delay the expansion.

Instead, the Minister of Justice accepted a radical Senate amendment to Bill C-7, which established an arbitrary sunset clause. That set in motion this expansion of MAID in cases of mental illness, effective in March of 2023. To provide some context, Bill C-7 was a response to the Truchon decision; its purpose was to remove a critical safeguard, namely that death be reasonably foreseeable before someone is eligible for MAID. It was a terrible piece of legislation that the government should have appealed but did not.

As bad as the bill was, when it was studied at the justice committee, of which I was a member at the time, nowhere in the bill was there any mention of expanding MAID in cases of mental illness. The justice committee did not hear evidence on that point. Indeed, when the minister came to committee, he said that there were inherent risks and complexities with expanding MAID in cases of mental illness, and therefore, it would be inappropriate to do so.

The bill went over to the Senate, and all of a sudden, the minister unilaterally accepted the amendment. Then what did the Liberals do? After little more than a day of debate, they shut down debate on a bill that had drastically changed in scope and rammed through the legislation for this expansion of MAID in cases of mental illness.

There was no meaningful study and absolutely no consultation with experts, including psychiatrists; persons struggling with mental illness; or these person's advocates. There was nothing. In short, the justice minister made the decision to go ahead with this significant expansion and then said the issue would be studied later. Hence, there was the establishment of an expert panel that was appointed after the government had already made the decision to go ahead. One would think that if an expert panel were going to be appointed, it would be appointed before deciding. However, that is not what happened with the justice minister and Liberal government.

We saw a special joint committee established after the fact. Talk about getting it backward, putting blind ideology and hubris ahead of science and evidence, and showing a total disregard for the concerns and lives of Canadians struggling with mental illness. Had the Minister of Justice and the Liberal government done their homework at the outset, they would have learned very quickly that this expansion of MAID cannot be implemented safely.

I serve as a co-vice-chair on the Special Joint Committee on Medical Assistance in Dying. As early as the spring, the committee heard from multiple witnesses, including representatives of the mental health community, and most importantly with respect to some of the clinical issues, leading psychiatrists. The body of evidence showing that this cannot proceed safely was overwhelming. One of the key reasons cited for this was that in the case of mental illness, it is difficult, if not impossible, to predict irremediability. In other words, in the case of mental illness, it is difficult or impossible to determine whether someone can recover and become healthy. This is a serious problem.

Let us look at some of the evidence that was available to the minister in the spring. Dr. John Maher, a clinical psychiatrist and medical ethicist who appeared before the committee, said, “Psychiatrists don't know and can't know who will get better and live decades of good life. Brain diseases are not liver diseases.”

Dr. Brian Mishara, a clinical psychiatrist and professor at the Université du Québec à Montréal, told the committee, “I'm a scientist. The latest Cochrane Review of research on the ability to find some indicator of the future course of a mental illness, either treated or untreated, concluded that we have no specific scientific ways of doing this.”

Even the government's expert panel conceded the difficulty in predicting irremediability. At page 9 of the expert panel report, the panel observed, “The evolution of many mental disorders, like some other chronic conditions, is difficult to predict for a given individual. There is limited knowledge about the long-term prognosis for many conditions, and it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient.” The government's own expert panel said that it is difficult, if not impossible, to predict irremediability.

If one cannot predict irremediability, persons who could go on to lead healthy and happy lives may have their lives prematurely ended. This is a problem that the government cannot avoid and that has not been resolved. Let me remind this House that, under the law, one must have an irremediable condition in order to be eligible for MAID. However, here we have leading experts and psychiatrists, including the government's expert panel, saying that it is difficult, if not impossible, to predict irremediability.

According to the psychiatrists who appeared before the special joint committee, what that means is that medical assessments in cases of mental illness for MAID are going to be decided on the basis of “hunches and guesswork that could be wildly inaccurate.” Those are the words of Dr. Mark Sinyor, a professor of psychiatry at the University of Toronto, who appeared before the special joint committee. These words were echoed by other psychiatrists who appeared before our committee.

The expert panel did not use such language, but it essentially conceded the point in its report because it was unable to come up with any objective standard by which to measure whether a patient's condition in the case of mental illness is irremediable. Instead, the expert panel ridiculously and recklessly said that it was going to wash its hands clean of this and that it was going to give a big green light and say it can all be done on a case-by-case basis. There would be no objective standard whatsoever; all would be guesswork and subjective assessment.

At the special joint committee on the issue of predicting irremediability in the context of mental illness, Dr. Mark Sinyor said that physicians undertaking a patient assessment “could be making an error 2% of the time or 95% of the time.” A 95% error rate is the risk on a matter of life and death, on a procedure that is irreversible and results in the termination of someone's life. For persons who are struggling with mental illness, this is the government's solution. The minister just stood in this place and said, “Damn the evidence. Damn the facts. We are going full steam ahead”.

I cannot think of a more reckless approach than the one the Liberal government has taken on an issue of profound importance to so many Canadians. It is not just the issue of irremediability, although given that this cannot be resolved, it should be the end of the matter. In addition, psychiatrists and other experts at the special joint committee emphasized that in the case of mental illness, it is very difficult to distinguish between a request motivated by suicidality versus one made rationally. In fact, suicidality is a symptom of mental illness, and indeed, 90% of persons who end their lives by suicide have a diagnosable mental disorder.

To illustrate how radical the government is, I note that when the Ontario Medical Association surveyed Ontario psychiatrists in 2021, 91% said they opposed the expansion of MAID for mental illness under Bill C-7. About 2% expressed support. Some 91% were against, 2% were in support and the reset were undecided. This speaks to how reckless, how radical, how extreme and how out of touch the government is on the question of expanding MAID in the case of mental illness.

In the face of the overwhelming evidence that we heard at committee, we issued an interim dissenting report calling on the Liberals to put a halt to this radical and reckless expansion. The minister ignored our interim dissenting report. He ignored the experts. He ignored the evidence. It appears he is so blinded by ideology that it is impossible for him to see what is in plain sight: This cannot be done safely.

In December, when it was evident that the minister was not listening, the Association of Chairs of Psychiatry in Canada, which includes the heads of psychiatry at all 17 medical schools, said to put a halt to this expansion. However, the minister still was not prepared to act. Indeed, it was not until the day after Parliament rose for Christmas that he had a late afternoon press conference where he made some vague commitment to introducing legislation in which there would be some type of extension. Then, with only 17 sitting days left before the expiration of the sunset clause, the minister finally saw fit to introduce this bill. I think this very clearly illustrates the shambolic approach with which the government has handled this issue.

We now have legislation, but what does this legislation do? As I noted at the outset of my speech, it provides for a new arbitrary deadline, even though issues of irremediability, suicidality and capacity to consent have remained unresolved for the past two years. There is absolutely no evidence that those issues are going to be resolved a year from now.

What we have is nothing more than an arbitrary deadline, and a year from now, we are going to find ourselves in exactly the same place. Let us be clear. When we speak about suicidality, irremediability and capacity to consent, these are not issues to be brushed under the rug. These are serious legal and political issues that are fundamental to determining whether this can go forward.

In closing, whether this expansion takes place a month from now or a year from now, it will be an absolute disaster and will result in persons struggling with mental illness having their lives wrongfully terminated. It is time for the government to get its head out of the sand, stop being blinded by extreme ideology, follow the science, follow the evidence and scrap this ill-conceived expansion.

[Gary Anandasangaree, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Mr. Speaker, at the outset, let me say how fundamentally different a view I have of the committee hearings and of the many experts who came forward and testified at the special joint committee, which is set to release its report on Friday.

I note that the member mentioned the expert panel. On one side he says it is supporting his position, and on the other side he is saying it is proposing to go ahead with MAID for those with mental health issues as the sole underlying condition. I do not think he can have it both ways.

Ultimately, the expert panel has recommended that we move forward. We have consulted with an enormous number of individuals and organizations. We have heard from them at committee, and I think it is very clear that we should be going forward. However, there is a need for prudence and a need to ensure there is a little more time available for experts to be ready with the right training.

I ask the member why he is being misleading in his debate regarding the many people who came forward and gave us a different perspective than his at committee.

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

Mr. Speaker, I am not misleading anyone. If anyone is misleading, it is the parliamentary secretary, with the greatest of respect to him.

I am not having it both ways. He mis-characterized what I said with respect to the expert panel. I said that the expert panel acknowledged what other experts who appeared before the committee acknowledged, which is that irremediability is difficult if not impossible to determine. Then, the expert panel washed its hands of coming up with recommendations on how this could be implemented safely. It offered no objective criteria. It said it could be done on a case-by-case basis.

My point with respect to the expert panel is how flawed of a report it was. The government's own expert panel said to go ahead with this, but if we read the fine print, it provided plenty of reasons why the government should not go ahead with it, not by not extending it, but by scrapping it altogether.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, as a Conservative, my colleague from St. Albert—Edmonton has never made so many references to science. I understand that he is passionate about this, but he is claiming that the report of the expert panel says things that it does not, particularly with regard to ending one's life prematurely in the case of mental illness.

The only way for a person to end their life prematurely is by attempting or committing suicide. A person who is suicidal will never be given medical assistance in dying based on the assessment of one or even two experts. Feeling suicidal is a reversible condition. A suicidal state is reversible, and the condition for obtaining medical assistance in dying is the irreversibility of the mental disorder. The expert panel report states on page 13 that “the incurability of a mental disorder cannot be established in the absence of multiple attempts at interventions with therapeutic aims.”

A person who attempts suicide and comes under pediatric care as a result will have to be monitored. They will probably never have access to medical assistance in dying on the grounds of a suicidal disorder. Eligibility must be established over a period of years, not in a crisis situation. The individual will also have to prove that they have tried every form of treatment and have never refused treatment that could have treated the condition.

This is a sensitive subject, so people should be careful what they say. I hope my colleague will see reason. Those across the aisle are not the only ones vulnerable to blinding ideology

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

Mr. Speaker, I want to thank the member for Montcalm, who serves on the special joint committee and is a very thoughtful member on it.

At the end of the day, the member is arguing that somehow expanding MAID in cases of mental illness could be appropriate, but what he is demonstrating is exactly the opposite. He is highlighting why it would be inappropriate, given the fact that suicidality is a symptom of mental illness and given the fact that 90% of persons who commit suicide suffer from a diagnosable mental disorder. I think that all underscores the fact that this is not acceptable.

Expanding MAID for mental illness is not an appropriate treatment. It is not an appropriate solution for mental illness. What the government should be doing, instead of offering the mentally ill death, is offering the mentally ill hope, support and the care they deserve.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Mr. Speaker, I have served on the special joint committee both in the previous Parliament and in this one. It was a lengthy amount of work, and certainly there was some very difficult testimony to go through.

I do not want to cover the same ground that previous members have asked questions on, so maybe I will change tack.

My friend, the member for Courtenay—Alberni, is our mental health and addictions critic, and he has constantly asked the government to bring mental health care funding up to parity with physical health care, understanding that there is in fact a real crisis. When I look at the conditions in ridings like mine, where we see the opioid crisis and the way it has been ravaging communities, there is so much underlying trauma and so many undiagnosed mental health disorders that are not being addressed.

I would like to invite the member to comment on that. In the midst of this very difficult conversation, and I agree that Bill C-39 is a necessity, we have to take this opportunity in time to make sure that our system is appropriately resourced and funded so that we are getting to Canadians who are falling through the cracks.

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

Mr. Speaker, the member for Cowichan—Malahat—Langford has contributed thoughtfully to the special joint committee.

In answer to his question, I note that during the 2021 election campaign, the Prime Minister claimed that mental health was a priority of the government. He committed to a $4.5-billion mental health transfer, but none of that money has gone out the door. There is no mental health transfer.

Instead of providing support and help, the government has been almost singularly focused on offering death, on offering MAID to persons who are struggling with mental health. It speaks to how misplaced the priorities of the government are. It also speaks to the fact that once again, like so much of what the Prime Minister says, his words are nothing more than empty words.

[John Barlow, Conservative, Foothills, AB]

Mr. Speaker, I want to thank my colleague from St. Albert—Edmonton for the incredible work he did on the committee. I was able to sub in a couple of times and was certainly impressed with his advocacy.

One thing that has arisen lately is the government's officials offering MAID to our veterans. I have a constituent who is one of those veterans and is an advocate. This was very upsetting.

I want to get the member's opinion on the slippery slope this legislation is on and the message it is sending to vulnerable Canadians, like those who have mental health issues. What kind of message is this legislation sending to those vulnerable Canadians?

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

Mr. Speaker, the message it is sending to persons who are struggling with mental illness is that their life is not important and that we are going to offer them death instead of help and support.

The member raises the issue of veterans who are offered MAID completely inappropriately and, frankly, in contravention of the Criminal Code. The Minister of Veterans Affairs, when he came to the veterans affairs committee, said that it had happened once or twice and that he had undertaken a thorough review. We now know that is not true and that it has happened multiple times. It speaks more broadly to how the government has mishandled MAID in so many different ways.

[John Nater, Conservative, Perth—Wellington, ON]

Mr. Speaker, pursuant to Standing Order 43(2)(a), I would like to inform the House that the remaining Conservative Party speaking slots will be divided in two.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, I would like to begin by providing some background on Bill C-39, which is not rocket science, when it comes down to it. Then I would like to talk about the philosophical foundation for dying with dignity, as well as the context and whether or not medical assistance in dying should be extended to patients whose sole underlying medical condition is a mental disorder. I would also like to talk about mental illness generally in our societies and the experts' report before finally concluding my speech.

The context is rather simple. This is not about rehashing the entire debate. We are studying Bill C-39, which simply defers the provision in Bill C-7 that would have ended the two-year exclusion for mental disorders on March 17, 2023.

Following consultations, the government has decided to extend this exclusion clause for one year, which means that on March 17, 2024, mental disorders, or rather individuals whose sole underlying medical condition is a mental disorder, would be eligible for MAID, subject to the conditions, limits, guidelines, standards of practice, safeguards and precautionary principles outlined in the expert report.

Before voting, I invite all parliamentarians in the House to read the report of the expert panel. It contains precautionary principles that do not lend credence to last week's comments by, for example, the leader of the official opposition. It really puts into perspective the ideology underlying the comments by my colleague from St. Albert—Edmonton. Let me dive right into this matter.

Why is there such a delay? The reason is that we believe things should be done properly by the medical world. When a mental disorder is the sole basis for a request for MAID, how prepared are those working in this field across the country to ensure that MAID is adequately and safely delivered in light of the safeguards?

More providers and seasoned assessors will be needed. I should note that the experts did say that assessing whether a person with a mental disorder has the capacity to choose MAID is something they are already doing. Often a person may have cancer and also suffer from a mental disorder. It is not the sole underlying medical condition, and they still need to establish the person's capacity to decide for themselves. Again, in response to the oversimplification by my colleague from St. Albert—Edmonton, first a person needs to want MAID, and then they need to meet the criteria.

As far as mental disorders are concerned, to meet the criteria, this is not going to happen overnight or anytime soon. It is going to take decades before anyone can have access. It is going to take time for the whole range of necessary treatments and possible therapies to be tested without the condition that the person demonstrate that they cannot bear any more and that their pain cannot be relieved. That is a long way from people living in poverty, who are depressed and who might have access to medical assistance in dying. We are far from it.

That being said, what are we talking about? When we talk about medical assistance in dying, I know that everyone in the House wants to do the right thing. Everyone has the best of intentions and wants to look after the best interests of patients and people who are suffering. However, being compassionate does not square with undermining human dignity. Human dignity is grounded in the capacity for self-determination.

Those are the philosophical premises. The law grants any individual with a biomedical condition the right to self-determination. Nothing can be done without the patient's free and informed consent. To that end, the role of the state is not to decide what that patient, who is the one suffering, needs. Rather, the state must ensure the conditions needed for them to exercise free will, so that patients can make a free and informed decision.

Historically, it was difficult to fight medical paternalism. At one time, people who had reached the terminal phase of an incurable disease did not have the right to die. The right to die was acquired, and it was called palliative care. Life was artificially prolonged, and people died from clinical trials or new therapies rather than dying a peaceful death in palliative care. However, palliative care is not a substitute for medical assistance in dying.

I find it strange that my colleague thinks it is unacceptable to grant access to medical assistance in dying to someone whose soul is suffering, and that he even opposes any form of medical assistance in dying, even when people are at the end of their life. He is opposed. At some point, if people are opposed, they need to explain why.

Why does the law recognize people's right to bodily autonomy throughout their lifetime but take it away from them at the most intimate moment of their lives? The government or our neighbour is not the one dying, so on what basis is the government giving itself the authority to decide for us at the most intimate moment of our lives?

These are the ethical and philosophical grounds and principles behind our position. Just because someone has a mental disorder does not mean that they should also be subject to social discrimination and stigma. Even though mental illness is now considered to be an actual illness, mental health is still not on the same footing as physical health. Mental illness results in discrimination and stigma.

Should we be telling people who have to deal with such discrimination and stigma that they will also never be given the right to MAID, even if they have been suffering from a mental illness and have had schizophrenia, for example, for 25 or 30 years? On what grounds are we refusing them that right? That is the basis of the expert panel's report. Do we give that right to someone with a mental disorder who is suffering, who has tried everything, whose problems are far from over and who says that they cannot go on?

There are people out there who have an ache in their soul, and unfortunately, we lose them when they attempt suicide. It is really no better. We absolutely must fight against suicide because it is one decision that cannot be undone.

In the report, the experts set out several precautionary measures. They talk about structural vulnerabilities like poverty. On page 11 of the report, the experts state the following: “In the course of assessing a request for MAiD—regardless of the requester's diagnoses—a clinician must carefully consider whether the person's circumstances are a function of systemic inequality”, and, if so, this should be addressed.

With respect to suicidal ideation, experts offer us another precautionary measure. It is not enough for a person to request MAID to have access to it.

The report states: “In any situation where suicidality is a concern, the clinician must adopt three complementary perspectives: consider a person's capacity to give informed consent or refusal of care, determine whether suicide prevention interventions—including involuntary ones—should be activated, and offer other types of interventions which may be helpful to the person”.

What is this claim about people who are depressed being able to request MAID? Members need to stop talking nonsense. That is not what the expert panel's report says. It says that incurability can be established over the course of several years. The patient must have exhausted all available therapies and treatments. However, that does not include overly aggressive therapy.

What does the member for St. Albert—Edmonton think should happen? When a person with a psychiatric disorder says that they reached their breaking point years ago, should psychiatric science insist that there is a treatment out there and that it is going to find it? That is what I mean by overly aggressive therapy.

Overly aggressive treatment may exist for all types of illness. Who gets to decide when it is too much? The Supreme Court and the Superior Court of Quebec have told us that it is up to the patient to decide. That is important, because the member for St. Albert—Edmonton keeps saying that we are cutting lives short, ending lives prematurely.

In reality, the opposite is true. Everyone wants to live as long as possible. People who are on what we call the second track, whose natural death is not reasonably foreseeable, want to live as long as possible. What they do not want is to be denied help when they reach their breaking point. If we do not give them access to MAID, they will find their own way to avoid ending up in that situation, because it is currently illegal for them, and they will end their lives prematurely. They will commit suicide.

The ruling that some contend should have been appealed to the Supreme Court states that there is an infringement on the right to life. The Conservatives' position infringes on the right to life because it forces people to end their lives prematurely rather than waiting for the moment of death, which sometimes is in one or two years. As proof, there is the case of Ms. Gladu. She did not go ahead with MAID, but she was relieved to know that she had that option. She did not commit suicide; she died naturally.

However, if her suffering became intolerable, she knew that she could access MAID because our compassionate and empathetic society would take care of her and ensure that she had a peaceful and dignified death. This meant that she could have the death that she did. Many people say that they choose to end their lives because they are not certain that they will be taken care of.

Is there anything more devastating than a suicide? That is a societal failure. We cannot be complacent about suicide attempts, about people feeling suicidal. In the health care system, mental illness, which is an illness like any other, absolutely must have all the necessary resources.

I just want to say a few words about the governments' ability to pay for the health care needs of the patients I am talking about, given the feds' post-pandemic offer. Governments have to deliver care to these people with irreversible illnesses, but they will not be getting money to do so. Over the next 10 years, they will barely be able to cover indexing on chronically insufficient funding. The federal government's share will go up from 22% to 24%. I hope government members are not too proud of that, especially considering that, during the third wave, people told us the system was in critical condition. The pandemic had destabilized it to the point that it would take 10 years to recover from the pandemic's side effects on patients without COVID. Right in the middle of the third wave, the Prime Minister said it would all be dealt with after the pandemic. We were told an agreement was imminent. I figured that they would come close to the $28 billion everyone expected, that they would give the governments of Quebec and the provinces the predictable funding they needed to rebuild their systems, take care of people over the next 10 years and finally recover from the pandemic.

I have heard the Conservatives say they will honour that small percentage. Of all the G7 countries, Canada still has the best borrowing capacity. If debt is unavoidable, what better justification for it than taking care of our people and restoring and rebuilding our health care systems?

I hear people say that individuals who have had an incurable mental disorder for years should not be given access to MAID on account of structural vulnerabilities. According to the expert report, however, two independent psychiatrists would have to be consulted. Not only would two independent psychiatrists be required, but we also have to consider recommendation 16. So far, I have been talking about recommendation 10, but my colleagues should hold on to their hats, because recommendation 16 states that, unlike for other kinds of MAID, when mental disorders are involved, there would be something called “prospective” oversight. This is different from retrospective oversight, as required by Quebec's commission on end-of-life care, which requires a justification every time MAID takes place. No, this does not happen after, but rather before, in real time.

This prospective oversight needs to be established in each jurisdiction, which is precisely what the delay will be used for. This additional safeguard needs to be established in controversial cases. According to the expert report, when an individual's capacity cannot be properly assessed, MAID is not provided, period. It is not complicated. There will be no slippery slope.

If there is a slippery slope, there is the Criminal Code, the courts, the police. Evil people do not belong in the health care system. They would be fired. If they do harm, they can be taken to court. To my knowledge, the provisions allow action to be taken.

My esteemed colleague seems to assume that everyone in health care is necessarily evil, which is absurd. The slippery slope is based solely on health care workers having evil intentions. However, to work in that field, people have to demonstrate skills proving the opposite. Consequently, all the precautionary measures and principles in this report are sufficient, in my opinion.

What needs to be done now is to ensure that people get training. Not all Quebec psychiatrists have read the report. If they listen to interviews given by the member for St. Albert—Edmonton, they will wonder what is happening with their profession.

We must be able to see things realistically and proportionately, provide training, and ensure that we implement a law that will be both accessible and equitable throughout the country. We must avoid situations where an institution that does not want to provide MAID prevents someone from accessing it, if it is their choice and they meet all the criteria.

This is still a dangerous situation. It is happening in Quebec, and the college of physicians warned last week that, in a simple case of MAID for a terminal patient, some doctors did not want to refer the patient to another doctor who was willing to provide it.

[Gary Anandasangaree, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Mr. Speaker, I thank the member for Montcalm for his speech.

I have to say that it has been a pleasure working with him over the last several months at the AMAD committee. He is an exceptionally thoughtful individual and I have learned a great deal from him.

Based on his numerous years of experience with MAID, and this particular issue of mental health as the sole underlying condition, could he outline for us, in a very short way, why he thinks there is a need to extend the deadline for the implementation of this provision?