House of Commons Hansard #161 of the 44th Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was maid.

Topics

Criminal CodeGovernment Orders

8:05 p.m.

Conservative

Jacques Gourde Conservative Lévis—Lotbinière, QC

Madam Speaker, I find my colleague's questions very interesting.

In Quebec, once a patient enters the system and has access to psychiatrists and health care, the results are relatively good. However, the unfortunate part is that there are not nearly enough staff, people and psychiatrists for the number of cases that exist.

Wait times to access this type of service can be six months, even a year or a year and a half, depending on the severity of the case. This unfortunately means that there are some people who, while waiting for treatment, may commit an irreparable act and leave this earth.

Criminal CodeGovernment Orders

8:05 p.m.

NDP

Blake Desjarlais NDP Edmonton Griesbach, AB

Madam Speaker, I just align with one of my colleagues, the hon. member for New Westminster—Burnaby, in relation to doing everything we can for those who may be suffering before it gets to the point of an application for medical assistance in dying.

Earlier today, for example, one of our colleagues gathered folks who were suffering from immense pain and living day by day, not knowing what to do. That pain contributes to their overwhelming feeling of despair, which then leads them to apply for something like medical assistance in dying. In fact, the government could put in place regulations to support these folks before they get to that place. They could ensure psilocybin, a treatment that they are calling for; they have already established a right to have access to this treatment. Would the member speak to the importance of ensuring that we do everything we can to support these folks, including providing medicine that they desperately need?

Criminal CodeGovernment Orders

8:05 p.m.

Conservative

Jacques Gourde Conservative Lévis—Lotbinière, QC

Madam Speaker, I thank my colleague for his very interesting question.

Yes, if there is an opportunity to speed up the approval of certain medications here in Canada to help people with mental health issues, let us do it as quickly as possible.

Criminal CodeGovernment Orders

8:05 p.m.

Liberal

John McKay Liberal Scarborough—Guildwood, ON

Madam Speaker, I understand I am the last member to speak on this debate. I doubt, however, that I will be the last word on this. I am not. I see that I am neither the last speaker nor the last word then.

I have been kind of reluctant, frankly, to engage in this debate because I do not consider myself to be an expert. I have not participated in committee hearings, and I have not had the benefit of listening to the expert witnesses. Therefore, the only thing that I bring to this particular debate is 25 years in and around the mental health system in the eastern part of the GTA. This is due to the fact that my son, technically my stepson, has schizophrenia.

The schizophrenia started to manifest itself when he was about 15 years of age; he is now about 40. As a family, we have been able to make some observations about the current state of the mental health care system in our neighbourhood. We are a well-resourced family; we have been able to access the best that there is on offer in and around the city of Toronto.

Our son has spent some weeks at the Whitby Psychiatric Hospital east of Toronto, one of the best that Ontario has to offer. He has also spent some time at the CAMH in downtown Toronto, which is possibly the leading health care facility in this particular area of health care. He has also spent time at our local Scarborough Health Network; this is a good health network, but my observation is that it is just absolutely overwhelmed.

The previous speaker talked about access in the order of 12 to 18 months. This has been our experience as well, even though we have supported him as a family. As I said, we are well resourced, and his mother, in particular, is fierce in her protection of him.

We started to notice his erratic behaviour when he was around 15. For three or four years, we really did not know what it was, in spite of taking him to various health care experts. When he went off to university, he had his first diagnosed psychotic break. If members know anything about schizophrenia, they know that when one is recovering from that psychotic break, one never regains everything. Over the years, he had a number of psychotic breaks, and each time, he did not fully come back.

The observation is that when one is around 40 years of age, that is as good as it is going to get. One neither gets any worse nor certainly any better. He fills the definition of somebody who has an irremediable condition. It is medically diagnosed, and he has had episodes where we had the police there and things of that nature. Fortunately, as I said, his mother is a fierce advocate for him, and we have been able to stabilize his housing. He is well housed and well fed, which has not always been the case. However, at this period of his life, he is stable.

Over the course of these 25 years, we have made some observations of the system. The first observation is that it is overwhelmed. If the general health care system in Ontario is at its maximum stretching point, the health care system is always stretched beyond that point. I will not say it is broken, but it certainly is stretched.

This is not a condemnation of the people or the personnel who are in the system. They are good-hearted, overworked and exhausted. It is the patients who suffer. I do not have a great deal of faith, based on my observations, that one year from now somehow we will have a better system than we have today. My guess is that it will be closer to generations.

One of my hon. colleagues from the NDP raised the issue of poverty, homelessness and all the other issues that people face. Again, it has been our observation that we as a family have been able to shield him from a lot of things that mental health patients face on a daily basis, such as how they are going to eat, where they are going to sleep, all that sort of stuff.

Therefore, from time to time, it appears that ending one's life is an attractive alternative. I fear that, primarily for those people who are not well resourced and not well shielded from the vagaries of life, who have no job, no relationships and a limited appreciation of their own reality, it would be an attractive alternative to end their life, and that will be made available to them and, I dare say, available a little too readily at times.

These are observations we have made over 25 years. We have made them in the context of a family trying to support someone who would fall within the specific categories that are delineated in the legislation. We frankly have no real faith that this might not be an alternative for our son. That would be tragic for us all because it would not be a death in isolation.

I would also make the observation that we are long on talk in this place and short on resources. We talk about fixing the system. We talk about making resources available. One can pretty well go back through the speeches in Hansard for the last year or two years or five years or 10 years, and each incident of legislation comes with a promise of resources. I wish that were true, but it is not. In our observation, it is only getting more challenging.

In some respects, this legislation is a way out of doing what we need to do to facilitate the health care challenges of our most vulnerable citizens. While I will, with colleagues, support this legislation, I frankly do not think things will change in a year. It may be that they will change in 10 years. I think this is the kind of timeline and horizon that we would be realistically looking at in order to deal with people who would fall within the specific delineated categories as set out in this legislation.

Criminal CodeGovernment Orders

8:15 p.m.

NDP

Lori Idlout NDP Nunavut, NU

Uqaqtittiji, I would like to thank the member for his thoughtful intervention. This is indeed a difficult debate because we are talking about something that is inevitable for all of us. The difference is ending suffering and how some people have the privilege to die with dignity while others have no choice but to feel like ending their lives through suicide.

This is a very difficult question or debate. We want to talk about ensuring practice standards that meet everyone's needs, so mental health issues are addressed and people with mental illnesses also get the help they need. Given his experience with someone with mental illness, could the member talk about how this kind of discussion needs to be opened up in the next year?

Criminal CodeGovernment Orders

8:20 p.m.

Liberal

John McKay Liberal Scarborough—Guildwood, ON

Madam Speaker, I thank the member for an excellent question that centres on the issue of practice standards.

I have no doubt that, particularly where I live in the east part of Toronto, we have the highest-quality practice standards. However, there can be the highest standards and most qualified people in the nation, but if they are overwhelmed by virtue of people being in the system because of the circumstances in which they live, no amount of practice standards will get them out of that.

My focus would be on relieving the suffering by helping those people so that they do not find themselves contemplating this alternative.

Criminal CodeGovernment Orders

8:20 p.m.

Scarborough—Rouge Park Ontario

Liberal

Gary Anandasangaree LiberalParliamentary Secretary to the Minister of Justice and Attorney General of Canada

Madam Speaker, I am not really posing a question. I just have a comment.

My friend from Scarborough—Guildwood is a dear friend and someone I have looked up to for many years. I want to thank him for sharing his very personal experience with us. I know it is something that he has shared on a number of occasions and in a very public way. I think it is important that we all understand that we have people in our lives who are deeply impacted by mental health issues.

As government moves forward on this, that is always something the minister, as well as the government, will continuously evaluate and undertake. I really do want to thank him for sharing his very wise comments with us today.

Criminal CodeGovernment Orders

8:20 p.m.

Liberal

John McKay Liberal Scarborough—Guildwood, ON

Madam Speaker, I want to thank the hon. member for his intervention. We are at a watershed. This legislation kind of fixes the problem. We could pass it or we, as a society, could be serious about the under-resourcing of those who are most vulnerable. I dare say that we are going to try to legislate our way out of this instead of trying to resource our way out of it.

Criminal CodeGovernment Orders

8:20 p.m.

NDP

Blake Desjarlais NDP Edmonton Griesbach, AB

Madam Speaker, I want to thank my hon. colleague for what I think is an important intervention.

I will agree with him in some part that this is an important moment for Canadians. Hopefully, this bill allows us the time to contemplate what the important steps will be to ensure that we listen to community members. This means not only those who are suffering from mental illness but also those who are combatting poverty and their contributors to it. Then, we can actually have a chance to do this work during this period and do the things that we need this law to do to ensure that vulnerable folks do not fall victim to an easy way out.

Could the member ensure that the government works hard to do the consultation, talk to those folks and make sure that there are pathways before this becomes the decision they do not have to make?

Criminal CodeGovernment Orders

8:20 p.m.

Liberal

John McKay Liberal Scarborough—Guildwood, ON

Madam Speaker, I think the hon. member raises an interesting point, and I do not know whether we are agreeing or disagreeing, frankly. I just do not have the faith that a year from now things will change greatly. Where are we? We are still under-resourcing the system, and we are still not providing the care that these folks need. Members can walk down Bank Street on their way home tonight, and there are a lot of people there who are pretty far gone. I just do not think we have the will, as a nation, to do much beyond providing legislation, and we think this is somehow a way out. Maybe it is. I do not know whether I agree or disagree, but I do not have that faith.

Criminal CodeGovernment Orders

8:25 p.m.

Conservative

Corey Tochor Conservative Saskatoon—University, SK

Madam Speaker, that was a powerful speech and it gives me great hope. We will probably come out of this on two different sides, in different parts of our lives, but I can tell that the member is a good dad and a good person.

For the people watching at home or watching this clip on Facebook later on, even the intervention from my colleague from the NDP gives me great hope. This is not finished. This is not done. We have an opportunity here because there are good people in all parties. I think that this year, this opportunity, gives us, hopefully, some time to reflect on what is important and hear stories like the ones we just heard, that including mental diseases and conditions in MAID is wrong. It shall not be in our society that people seeking help for depression could possibly be turned to medically assisted suicide.

I believe this is a blessing, that we have one year to hopefully convince enough of my colleagues, in all parties, that we need to not just pause this but scrap the idea that we could potentially solve one's mental health problems by providing suicide.

We talk about why we are here and why we are having so much trouble with mental health. I think mental health and addictions, if we talk to different specialists, go hand in hand. I believe we are on a very dangerous course right now with the explosion of mental health issues and the acceptance of hard drugs in our country.

We have an epidemic of overdoses happening right now. That is not medically assisted suicide. That is drugs-assisted suicide. This is not to say that there is an analogy to it, but it is wrong. We should not be allowing this in our society.

We have to do more. We have to do more for mental health in Canada. This is a serious subject. I do not want to get partisan, but our health care system was garbage before the pandemic. It was underfunded and it was on life support before the pandemic. We went through the pandemic and we put our population through so many pressure points that no doubt we were going to have a spike in the abuse of drugs and mental health issues.

The health care system, before the pandemic, was on life support. We kind of muddled our way through it, and here we are today. Other than the announcement a week ago, we have not had an increased health transfer to the provinces, which provide the health care these patients need. They need proper mental health supports, not the MAID 1-800 number.

I am very frustrated with where we are as a society, that this is what the case is, that we cannot get help in this country. It is broken. We cannot find a doctor. We cannot get treatment. We cannot get addiction beds: “Come back in 18 months and we might have a spot for you.” How is that treatment?

I have heard people say that the health care professionals will have check boxes and forms and it has to go through a secondary step and it is going to get signed off on by another professional. Who has time for that? We cannot even find family doctors to see patients for common colds, but we are going to have all these health care professionals who are going to go through all these applications and somehow weed out the ones that should not be there. It is just not going to happen.

It is frustrating that we are here tonight debating this. There is no court in Canada that said that we need to expand MAID for people suffering from mental health issues. Not a single court ruling said to blow this wide open and offer it to anyone who is having issues.

We need to spend this year to think about the ramifications of this.

We heard the member talk about his 40-year-old son. This is the part that gets me. I am a relatively new dad. My two boys are not 40, but nine and seven, and they are going to have challenges as teenagers. We all had challenges as teenagers. We all know teenagers who had challenges, and hopefully not too many of us know teenagers who took their lives. Life is hard sometimes. Teenagers have pressure where it seems like the whole world is on them, and they make that choice. We cannot stop what young adults do.

I worry about my two kids, who are going to go through the same things that everyone in this chamber has gone through: the pressures of being an adolescent, or as was said in here, a mature minor. They are not mature minors; they are teenagers who are going to have tough days. I had tough days.

I do not want my two boys to think that just because they are depressed and having a tough go of it, or maybe having more serious mental health concerns, they can just access MAID and be done. That is the wrong approach for Canada. I will do whatever I can in the next 12 months to convince enough members of this chamber that this bill needs to be—

Criminal CodeGovernment Orders

8:30 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

I am sorry to interrupt the member but would ask that he not bang his finger on the desk. I know he is passionate, but it is hard for the interpreters. I want to make sure we are not affecting the interpreters; I know they have had a lot of challenges lately.

The hon. member for Saskatoon—University.

Criminal CodeGovernment Orders

8:30 p.m.

Conservative

Corey Tochor Conservative Saskatoon—University, SK

I will stop banging on my desk, Madam Speaker, but I am not going to stop banging on my desk in my office or on doors across Canada. We need to stop this. This is not a Canadian approach to health care. We do not offer suicide to people suffering from mental health disorders.

We have 12 months to get this right, and as the last member said, I do not think that health care is going to improve. Our system is way too broken to be fixed in 12 months. He knows it, I know it and everyone here knows it. What are we setting ourselves up for? I would tell all members or anyone watching that as much as this is an emotional and very heated debate, and we need to respect other people's opinions, we also need to have this dialogue.

I would encourage people watching at home to contact their members of Parliament in a respectful way, ask for a meeting and explain their concerns. I suspect a lot of them will have concerns similar to mine on why we should not expand this. They should do it in a respectful manner. I believe there are enough good people in this chamber to stop it. That is my message.

Criminal CodeGovernment Orders

8:30 p.m.

Conservative

Scott Reid Conservative Lanark—Frontenac—Kingston, ON

Madam Speaker, we are talking about mental illness, mental distress and depression as being reasons why it may be permissible to ask for assistance in dying. I look at this and say that we have come a long way. Our laws were based on some court rulings surrounding people who wanted to die because they had lost their ability to control their bodies. They had ALS; they had no control over their bodies at all. They could not actually go through the act of committing suicide, but they maintained razor-sharp consciousness and a strong will. Sue Rodriguez is one example.

We should not go from that to somebody who is essentially having a failure of will. That is what depression is, being unable to formulate plans to carry on and instead saying there is an easy way out. This seems to me to be fundamentally dangerous, to be almost leading people on. It seems to me this is an obvious underlying problem.

I am glad to have a year to slow down this progress in the wrong direction. Quite frankly, I think we should be very much looking at some entirely different direction. The idea that the courts are somehow going to impose on Canada in the situation of depressed people, people who are struggling because of circumstances that are hard in their lives, is that “life is hard; death is easy”. It is absolutely outrageous to say, “This is it. The kingdom of death is upon us; that is just dandy".

I guess I am asking my colleague to offer some commentary on this national abdication of will that seems to be, at best, coming a year from the present.

Criminal CodeGovernment Orders

8:35 p.m.

Conservative

Corey Tochor Conservative Saskatoon—University, SK

Madam Speaker, the member's question will give me an opportunity to once again underline what the member is trying to get at, which is that this is wrong. Leadership is not just putting something to the courts and following a ruling. On this one, the courts were not even asking for mental health to be a factor in MAID.

Maybe this is the point where backbenchers and other parties, cabinet ministers or MPs can take these 12 months to consider all the arguments, for and against. I have a very tough time with including mental health. I do not think there is a single honest, good reason why someone should access MAID because of depression or other serious mental health issues.

Criminal CodeGovernment Orders

8:35 p.m.

Conservative

Scott Reid Conservative Lanark—Frontenac—Kingston, ON

Madam Speaker, I did not expect to get a second chance to do this, so I will just make the observation that, with regard to mental health and mental issues, the definition of most illnesses and diseases have not changed over time. The definitions surrounding ALS, for example, have not changed substantially over time.

However, the definitions of various mental illnesses under the Diagnostic and Statistical Manual of Mental Disorders, or the DSM, have changed constantly. DSM-4 was dramatically different in many respects from DSM-3, DSM-2 and DSM-1. These are, to some degree, arbitrarily defined illnesses, and to say that we can make a firm and meaningful, as opposed to subjective, medical determination that someone is in a position where they are sufficiently mentally ill that they qualify for medical assistance in dying seems to me to be very strange indeed and very subjective.

I talked, perhaps with too much rhetorical flourish, about the triumph of the kingdom of death over life. However, the triumph of subjectivity over objectivity, while wearing objectivity's clothes, seems to me to be profoundly unwise and, once again, a very good reason to say that we ought not to be going down this path. I will leave it there and ask again for the member's commentary.

Criminal CodeGovernment Orders

8:35 p.m.

Conservative

Corey Tochor Conservative Saskatoon—University, SK

Madam Speaker, my understanding of mental health, the DSM, a lot of the mental health disorders and how they are diagnosed or rated is that there is a system where we ask the patient how they feel, on a scale of 1 to 10, in different categories. We kind of gauge where they are, and we have an understanding of the disorder or the mental health issue that they are facing. It is very subjective and difficult. It is not like they can do a blood test to find out if someone is positive or negative, or that there are other physical ailments that can actually be measured to understand that the person is not going to recover from them.

Mental health is different. There are also advances. This is the thing that should give hope. There are medical advancements that are treating people whom we never thought we could treat before, and a lot of that has to do with mental health. There are chances now that we can revisit some of these diseases and disorders with modern pharmaceutical solutions or therapies that have not been tried before in the western world. That is where we have to spend our energy.

We also have to put those extra resources into health care. That means a larger transfer. That means the Liberals' coming through on their $4.5-billion promise for health care in the last election. They have yet to deliver a single penny on it.

Criminal CodeGovernment Orders

8:40 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

We will resume debate.

There being no further members rising for debate, pursuant to order made on Monday, February 13, the motion is deemed adopted and Bill C-39, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), is deemed read a second time and referred to a committee of the whole, deemed considered in committee of the whole, deemed reported without amendment, deemed concurred in at report stage and deemed read a third time and passed.

(Bill read the second time, considered in committee, reported, concurred in, read the third time and passed)

It being 8:41 p.m., the House stands adjourned until tomorrow at 10 a.m., pursuant to Standing Order 24(1).

(The House adjourned at 8:41 p.m.)