Debates of Feb. 13th, 2023

Immigration and Refugee Protection Act

[Claude DeBellefeuille, Bloc, Salaberry—Suroît, QC]

Mr. Speaker, the Bloc Québécois agrees to apply the previous vote, and we will vote in favour of the motion.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Mr. Speaker, the NDP agree to apply and will be voting in favour.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, the Green Party agrees to apply the previous vote and will vote yes.

(The House divided on the motion, which was agreed to on the following division:)

Vote #258

[The Speaker, Liberal, Anthony Rota]

I declare the motion carried. Accordingly, the bill stands referred to the Standing Committee on Foreign Affairs and International Development.

(Bill read the second time and referred to a committee)

Order in Council Appointments

[Mark Gerretsen, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons (Senate)]

Mr. Speaker, pursuant to Standing Order 32(2), I have the honour to table, in both official languages, an order in council for the interim appointment of Mr. Eric Janse as Clerk of the House of Commons.

International Trade

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

Mr. Speaker, I have the honour to present, in both official languages, the fifth report of the Standing Committee on International Trade, entitled “Transporting Goods in Rail Containers: Some Trade Implications for Canada”.

Pursuant to Standing Order 109, the committee requests that the government table a comprehensive response to this report.

Firearms

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Mr. Speaker, these petitioners have requested that Bill C-21, as it is an affront to the private property rights of Canadians, not go forward and that it be recalled.

Animal Welfare

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

Mr. Speaker, I am proud to present e-petition 4190, which was actively promoted by singer Jann Arden and signed by more than 36,000 people across Canada, making it the third-highest petition of this Parliament. The petition is to the Minister of Agriculture and Agri-Food.

The petitioners recognize that banning the export of live horses for slaughter is in the Minister of Minister of Agriculture's mandate letter from the Prime Minister and in the Liberals' 2021 election campaign commitment. They recognize that horses are flown from Canada to Japan in cramped wooden crates in journeys that can commonly take more than 24 hours. They recognize that horses panic easily, have strong flight or fight instincts and have extremely sensitive hearing. They also recognize that since 2010, the NDP has introduced three private members' bills to ban the export of live horses for slaughter.

Therefore, the petitioners call on the Minister of Agriculture and Agri-Food to halt the export of live horses for slaughter.

Water Laws

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, the petitioners are looking at the current situation of Canada's water laws and the threat to Canada's waterways. It is an astonishing reality that no bureau, department or sub-department in the Government of Canada has the word “water” in its title.

The petitioners call for the Government of Canada to update Canada's water laws to ensure that no industry or corporation takes precedence over the health of Canada's waterways and watersheds, and to ensure that Canada's water laws are updated under the guidance of professionals and specialists in the field of water conservation.

Questions on the Order Paper

[Mark Gerretsen, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons (Senate)]

Mr. Speaker, I ask that all questions be allowed to stand.

[The Speaker, Liberal, Anthony Rota]

Is that agreed?

[Some hon. members]

Agreed.

Freedom from Obstruction: Technical Difficulties with Interpretation Services—Speaker's Ruling

[The Speaker, Liberal, Anthony Rota]

I am now ready to rule on the question of privilege raised on February 8 by the House Leader of the official opposition concerning technical difficulties affecting interpretation services.

In his intervention, the House Leader alleged that a breach of his privileges and those of his colleagues occurred because simultaneous interpretation services were not available during a caucus meeting held earlier that day.

Citing past examples, the member noted that technical issues at caucus meetings had resulted in findings of prima facie cases of privilege. While the member conceded that these examples concerned the unauthorized recording of caucus meetings, he argued that the technical issues preventing simultaneous interpretation had the same effect of impeding members in the discharge of their parliamentary duties.

The member for Mégantic—L'Érable noted that, as a francophone, he felt particularly impacted by the failure of the interpretation system, since the majority of the discussions were in English. While grateful for the attempts made by the interpreters to provide service, he expressed concern that francophones are disadvantaged in such situations and that English would come to predominate.

The member for Salaberry—Suroît agreed with the member for Mégantic-L’Érable’s contentions. After having praised the remarkable work done by interpreters, she added that technical difficulties are also regularly encountered in committee meetings. In her opinion, technical issues affecting interpretation in caucus meetings and committee meetings both infringe on the rights of members.

Being able to participate in parliamentary proceedings and other activities in the official language of their choice is critical to members, committee witnesses and all who interact with Parliament. It is an obligation the Chair takes very seriously. While some have expressed concern about a possible decline, recent statistics compiled by House administration show that the use of each official language by members and by witnesses has been at roughly the same percentage over the past three years.

Our mutual understanding is only possible with the work of our interpreters and the reliability of our audio system. While our audio system that supports simultaneous interpretation generally works very well, issues do, on rare occasions, occur.

In a ruling on a similar matter, one of my predecessors stated on March 3, 2014, at page 3429 of the Debates:

In the case of official languages, the House has a long-standing practice of ensuring the availability of professional interpreters during House and committee proceedings. Indeed, this practice extends to many other activities, such as caucus meetings, briefings or any number of parliamentary activities and events. […] if a technical problem arises with the equipment, proceedings are suspended until the issue is resolved. Members will be familiar with this as it has sometimes happened here in the House.

In this case, when the matter was first raised, I asked for a report from the House administration on the circumstances surrounding the technical difficulties that were encountered. As is the standard practice, technical staff conducted tests of the room early in the morning. However, immediately prior to the start of the caucus meeting, an additional pre-meeting test was conducted and an issue was identified with the audio system. Some mitigating measures were put in place, but the problem nonetheless persisted. The caucus meeting proceeded without interpretation and, unfortunately, the issue was resolved only towards the end of the meeting.

The Chair wants to reassure members that this matter is being taken very seriously by myself and the entire House administration. Technical teams are continuing their tests and troubleshooting to prevent issues like this from occurring again.

While the Chair empathizes with members' frustrations over technical issues that sometimes disrupt our work, in a ruling such as this, the Chair must arrive at a decision within the confines of parliamentary privilege. In other words, the Chair must determine if the technical issues at a caucus meeting impeded members in performing their parliamentary duties and whether the matter should be given priority consideration by the House, but first the Chair must determine if a caucus meeting is, indeed, considered a parliamentary proceeding.

In the same ruling cited earlier, it is stated at page 3430 of the Debates:

Whether a member who is preparing to participate in proceedings—whether through a technical briefing or some other means—is not participating in the proceedings themselves. While such preparation is no doubt important, it remains ancillary to, rather than part of, Parliament's proceedings.

In the case before us, it is the view of the Chair that a caucus meeting is ancillary to proceedings. The member for Salaberry—Suroît also raised concerns relating to committee meetings, which undoubtedly constitute parliamentary proceedings.

That said, it is a well-established practice that the Chair does not intervene in committee matters in the absence of a report from the committee. While the Chair appreciates that there have been interruptions in a variety of committees, none of these has reported it to the House as a potential breach of privilege.

For the issue raised by the House Leader of the official opposition as well as technical issues in committees, there exist other administrative recourses to address them. To this end, the Board of Internal Economy appears to be the appropriate forum.

In light of this, the Chair does not find a prima facie question of privilege.

I thank members for their attention.

The House resumed consideration of the motion that 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.

Criminal Code

[Majid Jowhari, Liberal, Richmond Hill, ON]

Mr. Speaker, I would like to inform the House that I will be sharing my time with the member for Thunder Bay—Rainy River.

I am pleased to rise today to speak to the government's proposed Bill C-39, which seeks to extend the exclusion clause for those requesting MAID and whose sole underlying medical condition is mental illness.

I would like to take a few moments to draw our attention to the MAID monitoring regime and what we know about MAID cases to this point.

Canadians hold personal and very strong views on medical assistance in dying. They deserve accurate and reliable information to inform their decisions and their opinions. This is why we are working to ensure that our public communications are clear and comprehensive through our annual reports.

We know that a lack of accessible information opens the door to misinformation about evolving MAID systems. To be clear, while the proposed legislation would not impact the monitoring regime directly, a year's delay could bring the added benefit of more time to collect and the ability to report on important data regarding those complex cases where death is not reasonably foreseeable.

Putting this into perspective and context, our government acknowledges the importance of the data and reporting in relation to MAID, so much so that the original 2016 legislation obligated the minister of health to collect the necessary information and report annually on MAID activity.

This formal monitoring system is important to informing our understanding in three ways: who applies for MAID in Canada, medical conditions prompting requests and trends in MAID cases since the 2016 legislation.

As such, we have been working in collaboration with provinces and territories, as well as other health care partners, to ensure a robust monitoring system. It is important to understand that this is a significant, collaborative commitment.

Let us begin with a glimpse into what we know right now. As of December 31, 2021, there had been a total of 31,664 MAID deaths in Canada. This is the total number of MAID deaths since the law permitting medical assistance in dying passed in 2016.

MAID deaths represent 3.3% of all deaths in Canada as of 2021. This is very much in line with jurisdictions that have MAID regimes similar to Canada's.

The proportion of all deaths attributed to MAID varies across the country, with the highest rates reported in Quebec and British Columbia, and lower rates in the remaining provinces and territories.

Conditions include multiple comorbidities, cardiovascular disease, organ failure and respiratory illnesses.

Although the current sample is small, 2021 data also shows that, where death was not reasonably foreseeable, 50% of individuals were approved for MAID, compared to 81% of cases where death was foreseeable.

Each MAID request where the person's natural death is not reasonably foreseeable is complex and unique, and early indicators show that approvals for MAID in this stream are much lower than when the person's death is reasonably foreseeable, 50% versus 81%.

The assessment process for a person whose natural death is not reasonably foreseeable is often much more challenging due to the nature and complexity associated with medical conditions of this population. These assessments require detailed clinical analysis of each one of the elements of the eligibility criteria, which define a grievous and irremediable medical condition.

Let us spend a little bit of time talking about the human aspect of this data collection.

We should acknowledge that behind every data element in our annual report is, indeed, a human story. Implicated in each case is a group of people, their families, MAID assessors and providers, health care teams, and most importantly, the person making the request for MAID. The data we collect comes from thoughtful and compassionate conversations involving people who are making the most important decision of their lives and the MAID practitioners. The practitioners are responsible for assessing the requester in accordance with the person's wishes and the law. Through these discussions and the recording of information arising from them, we have a robust monitoring and reporting system for MAID in Canada.

MAID practitioners must ensure that every requester is aware of the services available that might relieve their suffering. This includes exploring treatment options, facilitating referrals and following up on the outcomes. When faced with a MAID request where death is not reasonably foreseeable, assessors spend much more time gathering the necessary information about the person and their condition. The process often involves a review of many years of treatments, surgeries and/or medications, as well as consultation with one or more experts in order to exercise due diligence in making a decision regarding eligibility.

New regulations for the monitoring of medical assistance in dying came into force on January 1 of this year. The MAID monitoring system will report on an expanded set of MAID data points that are collected according to these new regulations. The additional information should provide a greater understanding of persons applying for MAID whose natural deaths are not reasonably foreseeable, as well as their associated circumstances.

In conclusion, we are committed to transparency and accountability across all levels of government to ensure public confidence in the MAID regime. We are honouring this commitment by providing Canadians with accurate and reliable information on MAID as it continues to evolve in this country.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Madam Speaker, I was very surprised listening to my colleague talking about the numbers they have. In 2016 there were 1,200 cases of MAID. That doubled in 2017 and doubled again in 2018. It was over 10,000 in 2021. That is nearly 30 people dying in this country every single day. That is more than double all the deaths from breast cancer or all the suicides in this country. We were promised a process to make sure we were not implementing a regime that was doing this without really strong checks and balances.

I find it staggering that the member could say this thing is working when we see such massive increases, much higher than in Europe or anywhere else, in medically assisted death in this country.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Madam Speaker, let me clarify and reiterate what I said in my intervention. I talked about the total number of MAID-related deaths in 2021 being 10,950, of which 2% related to MAID for individuals whose deaths were not reasonably foreseeable. The numbers the member is quoting might be accurate, but that was not the point I was trying to make. As I also indicated, the total was nearly 30,000 since 2016, when the legislation came into force.

[Richard Bragdon, Conservative, Tobique—Mactaquac, NB]

Madam Speaker, I just want to follow up on the statistics my hon. colleague from Timmins—James Bay pointed out from across the way. They are staggering. When we begin to consider them, it should cause all Canadians to pause, reflect and say that the legitimate concerns many of us raised in this House when this was first proposed continue to this day. There are inadequate safeguards in place to protect those who are struggling with mental illness and have other ailments in their lives that have challenged them for a particular season. MAID opens the door to a decision of such finality that it can cause grave consequences for many Canadians and their families.

What safeguards are going to be put in place to stop this from being abused any further?

[Majid Jowhari, Liberal, Richmond Hill, ON]

Madam Speaker, first of all, I do not think that MAID has been abused, especially as it relates to mental health. As I intervened, I lost my father to cancer back in 2016. At that time I wished the MAID option were available to us. Having said that, we have felt in our government that the base of 219 cases is not representative enough of the data that we want. We want to ensure that the safeguards we should have are in place and strengthened. This is the fundamental reason that we are extending the timeline by a year and introducing this bill. If this bill is to protect those individuals who are dealing with mental illness, then they need all the supports to be able to make that decision.

[Julie Dabrusin, Liberal, Parliamentary Secretary to the Minister of Natural Resources and to the Minister of Environment and Climate Change]

Madam Speaker, I listened with interest to the member about what further things we need to be considering and thinking about. Could he elaborate a bit more on what he thinks are the most important factors that we need to be thinking about in this place as we consider this legislation?

[Majid Jowhari, Liberal, Richmond Hill, ON]

Madam Speaker, aside from the timeline that we have set to make sure that we have more data to be able to analyze the situation, it is also important to work with the provinces and territories to ensure that they have the processes, guidelines and support system they need. Then they can help those individuals who are in the process of making that decision to receive the support they need to come to the right decision.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Madam Speaker, I support this legislation putting a one-year hold on allowing MAID for mental illness.

We need to hold off on this until we have a broader consensus as to if and how we are going to do this. We need more safeguards in place. If we are going to do this, we need to make sure that we do it right. I do not think that we ought to have an automatic start date in one year as is planned.

To be clear, yes, I support this legislation in that MAID for mental illness will not be allowed beginning in March. However, from my perspective, we ought to make this hold indefinite. I know there are a lot of people out there who are really worried about this legislation because they have loved ones who are going through a hard time and they think, probably rightly, that some of those people will want to access MAID.

There are parents, siblings, partners, spouses and friends who are worried. Parents touch my heart the most because they are worried that the lives of their children could be affected. I can certainly sympathize with this because I have six children of my own. One does not have to be a parent to realize that almost everyone goes through a difficult time at some point in their life, hence our concern.

I know there are also a lot of psychiatrists out there who are really worried about this. There are psychiatrists who know that if their patients were to have more treatment, they would probably get better, but they are requesting MAID at this time.

Both these groups have legitimate concerns about this legislation. At the moment, I do not think the safeguards are in place, and if implemented now, the law would end up affecting a lot of people in a way that was not intended.

What is the intention of the law? I would submit that the intention of MAID for mental illness is that it should only apply to a very small group of hard-core cases. This seems to be the case in Holland, where only one in a thousand people, I am told, who apply for MAID for mental illness are actually granted it.

It is not intended for a 25-year-old who was abused as a child and has had intermittent depression ever since. It is not intended for the 30-something-year-old who remains depressed a couple years after the breakup of a marriage. It is not intended for somebody who is schizophrenic and is fine on their medication, but having stopped their medication, now wants to access MAID.

Some out there may say, “Why not? It should be the individual's choice”. As a teenager, I read Jean-Paul Sartre, and at the time, I agreed with him that the ultimate choice in life is being over nothingness. Perhaps I still agree with this. However, neither suicide nor attempted suicide is illegal in Canada. The question today is what role, if any, the state has in assisting suicide.

I worked a lot of years as an emergency room doctor, and I saw many people who were suicidal. My job was to assess whether people were suicidal, and if they were, to bring them into the hospital even if it was against their will. The law gave me the power to do so.

Many people would ask what right I have to tell someone what to do with their body and say that it should be their own choice. My response to them is that I think there are two legitimate reasons for the state intervening to prevent suicide.

One is in order to protect people from themselves. When someone is in the depths of depression, they do not see a light at the end of the tunnel. They cannot contemplate the possibility, let alone the probability, that they are going to get better. That is the nature of depression. That is what makes someone suicidal. Most of us know that, eventually, with a change of circumstances and enough time, people actually do get better.

The other legitimate reason for the state to interfere is to protect loved ones. A person who commits suicide is dead; they feel no pain. However, the loved ones continue to live the rest of their lives with the anguish of losing someone, often haunted by feelings that perhaps it was because of something they did or did not do.

The suicidal individual's inability to appreciate the possibility that they might get better should certainly make us reluctant to allow MAID for people with mental illnesses. Some people would ask whether there are people who really will not get better and who are irremediable. That is the requirement of law: The illness has to be irremediable.

The problem with that is that doctors are not really good at determining who is irremediable. Doctors do not have a crystal ball that can predict the future. In fact, studies show that doctors are not good at determining who is irremediable.

A recently published study by Nicolini et al. looked at clinicians' ability to determine irremediability for treatment-resistant depression. It reviewed 14 different studies. I will cite its conclusion: “Our findings support the claim that, as per available evidence, clinicians cannot accurately predict long-term chances of recovery in a particular patient with [treatment-resistant depression]. This means that the objective standard for irremediability cannot be met”. Furthermore, there are no current evidence-based or established standards of care for determining irremediability of mental illness for the purpose of MAID assessments.

As a long-time doctor, I find it absolutely mind-boggling that there are practitioners out there who are willing to administer MAID to someone knowing that perhaps with a bit of extra time the person would have gotten better. Good doctors worry about making mistakes. Good doctors do not want to kill off their patients. It seems to me that if there is even one person who is administered MAID and who, if they had not been given MAID, would have gone on to a happy life, that is a horrific tragedy. I would say it is something akin to capital punishment when it turns out the person was actually not guilty of the crime. If this happens, it is certainly on the conscience of every one of us in this place.

The number of people we can confidently say are irremediable is probably small. Some would say no, but I would offer a few comments. One is that anyone under 40 should never be considered irremediable, and in fact anyone under 60, unless they have had ongoing years of illness. I would also suggest that somebody who has not tried every kind of treatment and has not seen a lot of doctors and therapists should not be considered irremediable. Who is left? Perhaps if there is some 75-year-old who has no family and who has undergone many years of illnesses, tried every sort of treatment available and seen numerous doctors and no one can help, then maybe, and I emphasize the “maybe”, they should be considered for this.

Do I believe that the law, as implemented now, would really be confined to that small number of cases? No, absolutely not. Like a lot of members, I have been paying attention to the media and have heard of the many cases where we are just left shaking our heads that somebody would allow MAID for that. The reality is that there are a lot of practitioners out there with a very liberal approach to allowing medical assistance in dying, who seem to be willing to base it on perhaps just a phone call, practitioners who do not think it is necessary to talk to the family, to get to know the patient, or to consult someone who knows the patient.

Some people will say that the decision about standards of care and safeguards should be left to the colleges of physicians and surgeons. As a 35-year member of the College of Physicians and Surgeons of Ontario, I totally disagree with that. This is not the kind of decision that is normally left to the colleges, nor should it be; this is the kind of decision that should be left to the elected representatives, who in turn are accountable to the people.

In summary, if we are going to allow medical assistance in dying for mental illness, it should be to an exceedingly limited number of people. If we were to implement the law as it is now, I think a lot of people would be getting it whom the law was not really intended for, nor do I think we are that close, so I think there should be no fixed date on which this law comes into effect. When are we going to know we are ready to do this? I would suggest it would be when there is some consensus from the psychiatric community. From all the surveys I have seen, the majority of psychiatrists are against this, which is certainly one indicator.

We need to take however much time is necessary to do this right. This is not like other decisions made by the House of Commons. If we mistakenly take a life, all of the politicians in this room, all of the bureaucrats in Ottawa and all of the Supreme Court justices cannot bring that life back.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Madam Speaker, I really appreciate my hon. colleague's perspective. I heard a lot about the intention, and sometimes we have intention versus impact, so I am curious what he thinks the impact would be of just extending the deadline, as opposed to actually throwing out the legislation or supporting Bill C-314.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Madam Speaker, the question before us now is really the coming date for implementation, which is mid-March. The intention of the legislation right now is to give us more time, and that is entirely appropriate.

We pride ourselves on making our decisions based on evidence. If we are going to make decisions based on evidence, then this certainly has to be given more time, which means that there has to be a delay on this so that it does not come into effect in March. What comes after is for us to determine. I personally think there ought to be indefinite time until we get this right.