Madam Speaker, it is an absolute honour, as always, to stand here in the House of Commons to debate things that are of critical importance to Canadians. Certainly, having had the opportunity to serve on the Special Joint Committee on Medical Assistance in Dying, I think it is important to have the ability to stand here today and allow Canadians to understand some of the difficulties that exist and why Conservatives put forward a dissenting report, which is easy for Canadians to find.
Much of the deliberations at the special joint committee were related to mental disorder as the sole underlying medical condition, so-called “mature minors”, persons with disability and advance requests. Clearly, the plight of Canadians under the NDP-Liberal government has increased the usage of MAID in this country, and I will go on to cite several examples of that as we go through this. I think that it is absolutely and incredibly important to look forward to. If I may, I will read a bit from the dissenting report.
We acknowledge that medical assistance in dying is a complex and deeply personal issue on which reasonable and well-intentioned people can disagree. However, there are serious problems with Canada's MAID regime.
Vulnerable people are being put at risk because of the Liberal government's failures. Regardless of one's views on MAID in principle, these issues cannot be ignored.
After nine years of increased poverty and despair under this Prime Minister, Canadians are turning to MAID because they cannot afford to live with dignity.
I would say that this statement is incredibly important in allowing Canadians to understand that, as far as Conservatives are concerned, those Canadians who are well intentioned and well informed are about to speak about this incredibly emotionally charged topic in a hopefully non-partisan way on behalf of Canadians.
As a former practising physician, these are issues that came up multiple times when I was practising medicine. Medical assistance in dying is something that came about during my time in practice. When I first started practising, medical assistance in dying was not out there to be considered. That being said, I certainly feel it is something that I can provide some insight on.
I think one of the other things that is really important for Canadians to understand, and I know my colleague spoke a bit about this, is how Canada and the Canadian regulations around MAID are perceived around the world. I will quote the American Journal of Bioethics. The title of this particular article is “When Death Becomes Therapy: Canada’s Troubling Normalization of Health Care Provider Ending of Life”. It is a telling commentary on how the regime here in Canada is perceived.
I will quote a bit from the article:
Undeniably, a strikingly higher number of people die with direct health care provider involvement in Canada’s euthanasia regime, euphemistically termed “Medical Assistance in Dying” [MAiD], than under a California-style assisted suicide system. Daryl Pullman rightly identifies several key reasons: the fact that in about all cases it involves a lethal injection by health care providers, rather than assisted-suicide with self-administration of medication; the law’s vague and broadly interpreted access criteria; “acquiescence and […] indifference of federal and provincial authorities, the courts, and medical associations”; and, briefly mentioned, the failure to treat ending of life as a last resort.
When I think of those incredibly emotional words, because they are incredibly emotional, I often wonder how we realistically got to a spot where we are in a culture of death and we believe in the ability to simply hand over our essence of life to a health care practitioner. How did we get there? How have we failed as a society to simply say, “Life is no longer worth living. Just go ahead and kill me.”
I can remember when the debates on this first began and everybody talked about the slippery slope argument, saying that we would never go down these roads and that this would simply be for those with a reasonably foreseeable natural death. Canadians, in their heart of hearts, because of who we are, really believed that the expansion of MAID would never happen. I have heard my colleagues in the House today speak a lot about how it is people's right to die. What about their right to live? Once again, this is a country that is incredibly developed with great riches and wealth. This is the golden age of Canada, if one were to use that term. How did we get to the point where it is not about caring about each other, but about saying, “Yes, I agree with you. Just go ahead and end it because your life is not worth living.”
As we begin to contemplate those things as a country, I do believe that it is incredibly important to value human life and to say that it is important. Are there folks out there who are suffering? There absolutely are, and I certainly will come back to that.
Before we talk about some very sad examples, the other important thing to talk about is the state of palliative care in Canada. I had the opportunity as a physician to witness an incredible change in how palliative care is delivered where I live in Nova Scotia. It was absolutely life-changing to have a driving force behind a palliative care program where I live that enabled care, which had historically been delivered by family physicians, to go to a quality team of palliative care providers that was able to provide a much more nuanced way for people to continue to live a life, even though it was difficult. I might be so bold as to say that my great friend Dr. David Henderson was the person leading that charge.
Historically, where I had the opportunity to work in our hospital in Truro, Nova Scotia, palliative care was provided by family physicians. Realizing that many symptoms during the end of life and the dying process were very difficult to control, this great physician, Dr. Henderson, came along and was able to begin to educate all of us family physicians who were delivering care to make us better providers. As time went on, many folks began to realize that they were not very good at palliative care, which not everybody is good at, if I can use that terminology. They also began to realize that there were certain skills, not just in determining which medications to give at which time but also in speaking to patients to understand what their goals and desires were. Was it that they simply wanted their pain and suffering to be alleviated at all costs, or did they want to be more functional in their abilities? Those are incredibly important conversations to have with patients.
Dr. Henderson also realized that delivering care at people's homes was an essential part of palliative care because, of course, folks often feel much better when they are able to stay in their own homes and have the distressing symptoms alleviated there. Dr. Henderson was a great advocate to say that we also needed to have nurses trained in palliative care who can then be the extenders of physician care at home or in the hospital. Dr. Henderson has been a wonderful advocate for the palliative care program in Nova Scotia and, indeed, across the country.
The sad state of affairs is that good-quality palliative care such as I have described does not exist across the country. I would suggest that colleagues here in the chamber give that a good thought because I do believe if good-quality palliative care existed across the country, perhaps some of the conversations we are having now would be quite different.
I also think it important that we understand that seven million Canadians do not have access to primary care. Of course, that does affect the quality of care overall in terms of how Canadians are able to manage symptoms of their illness and understand their illness, because of course in Canada, primary care is the way we access the system. Once again, the demise of our much-cherished health care system has certainly accelerated at the hands of the NDP-Liberal government over the last nine years.
As I mentioned, a recent report from CIHI lays out clearly that 5.4 million adults do not have access to primary care, which we know translates into about seven million Canadians without access. This means they are unable to get lab work, diagnostic imaging or referrals to specialists unless they are in walk-in clinics or they are visiting emergency rooms, which we know then creates an entire other type of problem.
Those things being said, I do want to get to some examples about MAID in particular. There are several quotes about MAID in Ontario. For example, PBS reports, “in Ontario, more than three quarters of people euthanized when their death wasn’t imminent required disability support before their death in 2023”. A professor of health in the Netherlands has stated, “Canada seems to be providing euthanasia for social reasons, when people don’t have the financial means, which would be a big taboo in Europe.”
We begin to again unpack those types of things. A report just this morning outlined that 40% of Atlantic Canadians have difficulty paying for the basic necessities of life. The article cited food, rent and home heating. That is a disturbing feature when we hear what the professor in the Netherlands said. Of course, the Netherlands has had a MAID regime for quite some time now.
The other statistic we need to be aware of is that it would seem poverty is a contributing factor in Ontario's MAID provision: “People in the lowest ‘material resource’ category represent 20 per cent of the general population, but they make up 28.4 per cent of Track 2 MAiD recipients, compared to 21.5 per cent of Track 1 recipients.” When we begin to understand some of these statistics, not to be foolish about it, but as we might say, “Houston, we have a problem.”
The impact of the housing crisis seems to be a factor. Persons identified as having housing instability made up 48.3% of track 2 MAID deaths in Ontario, an absolutely staggering figure. Isolation is also a definite factor in track 2 cases: Ninety per cent of track 1 MAID recipients provided the name of an immediate family member, spouse, sibling or child as their next of kin, compared to 73% of track 2 recipients. People who accessed MAID via track 2 safeguards were more likely to have provided the name of a friend, extended family member or other person, such as a caseworker, lawyer or health care provider.
As I started off my remarks with, here we are in this incredible country in which we live, and people are socially isolated. They are unable to afford housing and access services.
The other disturbing trend, of course, is the significant increase in MAID in Canada. In 2019, there were 5,631 cases of MAID reported in Canada, accounting for 2% of all deaths. The total number of deaths marked a 26% increase over the number of MAID deaths in 2018. In 2020, there were 7,595 cases of MAID reported in Canada, 2.5% of all deaths, and the toll represented an increase of 34.2% from the year prior.
In 2019, as I mentioned, 5631 cases of MAID were reported, and by 2022 there were 13,241 MAID deaths reported in Canada, accounting for 4.1% of all deaths nationwide. This is a year-over-year growth rate in the 30% range. The total number of medically assisted deaths reported in Canada since the introduction of the federal MAID legislation is 44,958 Canadians. It can therefore be projected that the number of MAID deaths, as well as the share of these deaths represented in the annual death toll, will increase in 2024 and may reach up to 5% of the national total of deaths.
As we begin to look at these things, we see that this is a very disturbing trend. I do want to quote a couple of disturbing cases that I think we all need to be aware of. They are readily available in open-source literature.
Christine Gauthier, a disabled veteran and former paralympian, was offered MAID by a caseworker from Veterans Affairs Canada during a phone call in which she discussed her deteriorating condition. Gauthier had for five years been seeking to get a wheelchair ramp in her house. As a veteran myself, this is particularly disturbing.
We know that there are other cases of veterans who called Veterans Affairs for help, simply for their mental health, and of course were offered MAID as part of what the individuals at Veterans Affairs thought was appropriate in terms of offering treatment to veterans. It is appalling that folks who sign on the dotted line to serve our country, to uphold our values elsewhere and potentially, of course, to put their lives on the line are offered death as opposed to help.
In another case, Normand Meunier, a former truck driver who had been paralyzed from a spinal cord injury in 2022, was forced to spend 95 hours on a stretcher after being admitted to a hospital in Saint-Jérôme, Quebec, with a respiratory virus in January 2024. This led him to develop a severe pressure sore that eventually worsened to the point where bone and muscle were exposed and visible. Mr. Meunier, in terrible pain for the ensuing two months, opted to end his life, and he passed away on March 29.
When we look at these stories, we see that they represent a failure of a health care system, as I quoted from a report, “when death becomes therapy”, as opposed to understanding that we need a health care system that is responsive to the changes that have been foisted upon us by the NDP-Liberal government.
I think it is also important to talk about the blue seal program for Canadians that the next Conservative government will put forward. It would allow international medical graduates to have their qualifications and experience recognized quickly as they come to this country and want to serve Canadians and to have a better paycheque in order to be able to look after their families as well.
That will be something, of course, that a Conservative government will be able to put forward, as we have had multiple discussions with the stakeholders and decision-makers at both provincial and national levels. I think it is incredibly important we give Canadians hope that there is help on the way and that the way things are is not the way they need to be forever. Change is possible.
We also know that understanding exactly how the MAID regime works is important on behalf of Canadians. Consultation needs to be had, and we need to be able to replace the hurt that Canadians, sadly, are now experiencing with hope for the future so they once again can be prosperous in the dream and the contract of being a Canadian: If we work hard, we will be able to achieve a job with a reasonable paycheque, put food on our table and a roof over our head, live in dignity in this country, and not have to worry about death being the therapy for all that ails us.