Debates of Feb. 13th, 2024

Government Business No. 34—Proceedings on Bill C-62

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

Mr. Speaker, I always consider it an honour to rise in the people's House to speak in regard to matters of great importance and consequence for the nation of Canada. I rise with mixed emotions today as, obviously, many Canadians have been grappling and dealing with this issue and have been considering and discussing the issue for years and months. Even more recently, with the expansion of MAID, which has been happening at an unbelievably rapid rate, more Canadians are growing more concerned. Therefore, today, I hope to add my voice to the calls for absolutely increasing the implementation of safeguards and for putting in place the safeguards necessary to prevent this absolute augmentation in access to MAID by more and more vulnerable Canadians.

Canada has historically been known as a nation of great hope, where the dreams and aspirations of individuals could be fulfilled, for them and their families. We have had a great reputation on the world stage for many years as a peaceful people and a hopeful people, but disturbingly, we are hearing more voices, not only within our own country but also internationally, raising the alarm bells at the direction our nation has taken, especially as it pertains to it becoming more available to more Canadians who are at high risk to be able to access MAID and to make a decision of such finality in times of great vulnerability.

It has been said, and I have said it in the House before, in regard to this debate, that the character of a nation is revealed in how it treats its most vulnerable. Those battling with mental illness and having bouts of anxiety, depression, fear and despair are definitely among our most vulnerable. It would behoove the House and the current government to ensure every safeguard possible is put in place to provide a pathway of hope that would foster and encourage life, even in the midst of uncertainty, in the midst of overwhelming odds and in the midst of some huge obstacles that come across a person's pathway. The last thing we should be doing in the House is expediting and making it easier for more Canadians to access MAID.

It is troubling, not just for many members on this side of the House; we have heard testimony at committee from many reputable organizations whose representatives are speaking out with grave concerns at the direction this country is going. I want to add a few quotes into the record as it relates to this.

There are a couple here from the Society of Canadian Psychiatry. It states, “it is impossible to predict in any legitimate way that mental illness in individual cases is irremediable. A significant number of individuals receiving MAID for sole mental illness would have improved and recovered.”

This is another quote from the Society of Canadian Psychiatry: “Evidence shows that individuals with suicidal ideation symptomatic of mental illness cannot be differentiated or identified as distinct from those seeking MAID for sole mental illness. Suicidal individuals who could benefit from suicide prevention will receive psychiatric MAID instead.” This again is not coming from a partisan perspective. This is coming from the Society of Canadian Psychiatry.

We are fostering a culture that encourages giving up in the face of grave adversity, when Canadians historically have been the types who have faced great challenges, have overcome huge obstacles, have come through adversity, have come out the other side and have become stellar examples of what it is to overcome great challenges in life. I want that to be our continued reputation, not easy access to a decision that has such finality and such a dire consequence.

Another quote from the Society of Canadian Psychiatry says, “the political process leading to the planned expansion of MAID for mental illness has not followed a robust and fulsome process, has not reflected the range of opinions and evidence-based concerns on the issue, and has been selectively guided by expansion activists.”

Those are huge statements of fact. If they are to be considered, they should give direction, and clear direction, to this House, on how we should proceed going from here.

This time I will quote from what would not be known as a far right extreme voice. I am quoting from a Washington Post article that reads, “empowering a mentally ill person to invoke a physician’s aid in ending his or her suffering — by ending life itself — inverts the most basic goal of psychiatry, which is to prevent suicide rather than to facilitate it”.

Dr. Madeline Li, a professor in the department of psychiatry at the University Health Network, told the BBC, “Making death too ready a solution disadvantages the most vulnerable people, and actually lets society off the hook”, and she went on to say, “I don't think death should be society's solution for its own failures”. These are professionals at the top of their professions, speaking to the grave direction that we are heading in as a country, as it relates to medical assistance in dying.

Of those who advocate for the most vulnerable among us here in Canada, the CEO and the executive vice-president for Inclusion Canada said, “MAiD for people with disabilities who are not terminally ill is a discriminatory disaster”.

Again, these are the chief advocates for the most vulnerable among us. We should listen to their voices as we consider this and bring to the House the voices of the many concerned Canadians who have risen up, written my office, made phone calls and contacted colleagues, I am sure, on numerous occasions to say that this is not the direction that they would have ever anticipated Canada to go, and this is not the direction that we should go.

In closing, I am drawn to a story of a gentleman I got to know, a dear friend of mine. I share this story with his permission. Robert McCoy is a gentleman from my riding of Tobique—Mactaquac who had a huge challenge in his life. He is a young man with a young family, who began to lose sight in one of his eyes. It quickly spread to his other eye, and he became completely blind. He did not know how he would provide for his family since he had worked in the woods and was a skidder operator. He was not sure how he could make provisions for his family. It seemed overwhelming. He spoke about this publicly as part of his story. He told me he was so desperate in those times that he seriously considered taking his own life. He even planned it out. He thought maybe if he could somehow step inadvertently in front of a truck or a vehicle, because he was blind, that his family and other people would think it was an accident, and they may be able to at least continue on the insurance and make ends meet. It was a very low point, but he told me that in his desperation, he cried out. Yes, faith was important to him, but he felt like he heard at that moment a very clarion voice inside that said, “You will survive”.

That one moment became enough for him, along with the encouragement of his wife and family, to start over again. A woods worker put himself through learning how to live with blindness, went to university and got a degree. He now has a Master of Sociology and is a professor at St. Thomas University in Fredericton.

I am glad to say that Robert McCoy is doing very well; I spoke to him today. I am glad that during that time he did not have ready access to voices who would encourage him to go down this particular path as a potential solution to his problem. I am glad he chose the pathway of hope, of recovery and of overcoming obstacles. As parliamentarians, we should be doing everything we can to foster a culture of life and hope, rather than a culture of death and despair. I hope we make the right decision at this time.

[Jenica Atwin, Liberal, Parliamentary Secretary to the Minister of Indigenous Services]

Mr. Speaker, the member is a great speaker in the House. I certainly enjoyed the story about one of my constituents. That was really great, and I agree. I am an advocate for mental health access. Actually, I did vote against the previous bill as well in the previous Parliament.

I really want to highlight that it is so important to create the clear distinction between suicidal ideation, what happens when someone is dealing with depression and wants to take their life, and medical assistance in dying. It is really important to have that distinction made.

I wonder if the member could comment on that.

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

Mr. Speaker, my colleague is from a neighbouring riding of Fredericton, and it is always good to have good debate and discussion with her.

I want to assure her that the concerns we are hearing are that this pathway is being opened up and people do perceive that when someone is struggling in a season of difficulty, they may want to access, through the avenue of MAID, medical assistance in dying, for the sole purpose of mental illness.

We have to close that door. Obviously, I am glad our position is to make sure that door is closed completely and with finality, so that that access point is no longer available. Without those safeguards in place, I am afraid that more Canadians would choose that route as an avenue of coping with such devastating circumstances in their lives.

I will conclude with this point. I want to give honour to a colleague in the House, the member for Cariboo—Prince George, who fought very hard to get 988 established, to bring in a suicide crisis hotline in this country. To tell of the need for this kind of hope to be offered to Canadians, right now, the stats are upwards of 1,500 contacts a day, of people utilizing and calling or texting 988. That tells us there is a cry for hope in Canada. People want options, and the last option they should ever be given is to access MAID.

[Mario Simard, Bloc, Jonquière, QC]

Mr. Speaker, I sympathize with my colleague’s story about one of his constituents. However, using specific cases to try to advance ideological views is not how we move forward in a debate. Since this morning, I have been hearing the Conservatives talk about medical assistance in dying as if the process were like renting a movie on Netflix. This is not how it works.

Legislators are expected to stand back a bit and place the public good before their personal ideology. I know people who have sought medical assistance in dying. It is a medical procedure like many others that must be weighed. I would advise my colleague to place the common good before his ideological interests. Perhaps we would all grow if we worked this way.

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

Mr. Speaker, I thank the hon. member for sharing his thoughts. However, I will take exception to where he is taking that thought.

We cannot expect any parliamentarian who enters the House to separate what informs their decision-making process and the values they hold dear when it comes to debates in the House. If this is indeed the people's House, the House of Commons that represents the voices of the common people, no voice, world view, value set or concept should be dismissed out of hand. They should be welcomed and embraced. We should have wholesome discussions on these matters, especially a matter pertaining to life and death. No, I will not separate my values nor my world view from that discussion. They help inform the discussion.

[Mike Morrice, Green, Kitchener Centre, ON]

Mr. Speaker, in his speech, the member for Tobique—Mactaquac evoked the disability community, along with his concerns for their well-being when it comes to expanding medical assistance in dying for mental health.

The House could be pressing the Liberal government to actually address the legislated poverty that people with disabilities are facing. We could all be pressing to fund the Canada disability benefit. If the member claims to be concerned about the lives of people with disabilities, as I am sure he truthfully is, is he going to, and how will he, continue to press the government to fund the Canada disability benefit and end legislated poverty for people with disabilities?

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

Mr. Speaker, I quoted the CEO, Krista Carr of Inclusion Canada. They are raising alarm bells on this matter and this issue at this point. If we do not get this right, we will never get to the other access points.

It is absolutely critical that what we do in the House is the most fundamental basic thing, which is to make sure they have access to recovery and to hope. If we do not start there, we will never get to the other very important issues that need to be discussed and debated. Let us start with the fact that they need to make sure we are doing everything, as the people's representatives, to ensure their access to hope and to life.

[Yasir Naqvi, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I appreciate being recognized to speak to a very sensitive and emotional issue.

Today, I am pleased to be speaking to Bill C-62. This bill proposes extending the temporary exclusion from MAID for people whose sole underlying medical condition is mental illness.

We are proposing that the exclusion be extended by three years. To understand why an extension of this exclusion is so important right now, we need to look at how we got to this point in the legislative process.

As members know, former Bill C-7 was enacted in response to the Quebec Superior Court Truchon ruling. The ruling found that the original MAID legislation, which required a person's natural death to be reasonably foreseeable, contravened the Charter of Rights and Freedoms.

The former Bill C-7 received royal assent and became law on March 17, 2021. This law included a temporary two-year exclusion of eligibility for individuals suffering solely from mental illness, which meant that such persons would become eligible to receive MAID starting March 17, 2023, if they met all other eligibility criteria. The intent of this two-year delay was to allow an expert panel to undertake an independent review and to provide recommendations respecting any protocols, guidance and safeguards that should apply to requests for MAID by persons with a mental illness.

I will be sharing my time with the member for Richmond Hill.

On May 13, 2022, the “Final Report of the Expert Panel on MAiD and Mental Illness” was tabled in Parliament and released publicly. The expert panel noted that MAID clinicians are already assessing very complex cases and concluded that certain assessment challenges, such as determining incurability or assessing decision-making capacity, are not unique to MAID requests from persons with a mental disorder, nor are they applicable to every requester who has a mental disorder. The expert panel also concluded that the existing MAID eligibility criteria and safeguards in the legislation provide an adequate structure for MAID where a mental disorder is the sole underlying medical condition, as long as they are interpreted and applied appropriately.

The expert panel's recommendations provide guidance to support complex MAID assessments. In its final report, the expert panel made 19 recommendations, laying out a broad set of principles that could structure the practice of MAID not only for persons with a mental disorder but also for those with other conditions where concerns may arise related to incurability, irreversibility, decision-making capacity, suicidality and/or the impact of structural vulnerability, regardless of the person's diagnosis.

The government supports the insights and general advice emerging from the panel's work. Let me take a few minutes to highlight some of the key achievements.

The expert panel report recommended the development of national practice standards on MAID for mental disorders and other complex cases. Practice standards help regulatory bodies evaluate the appropriateness of the clinical decisions of health professionals who assess and provide MAID. They also provide clarity to MAID clinicians regarding their professional obligations. In March 2023, a model practice standard for MAID was released along with a companion document of advice to the profession, which provides a series of questions and answers that elaborate upon specific clinical questions raised by the model standard.

That is not all we have done to help prepare a safe approach to providing medical assistance in dying across Canada.

We are providing $4.9 million to the Canadian Association of MAiD Assessors and Providers to develop and deliver an accredited, Canadian-made curriculum to support practitioners. This consists of seven training modules that address various topics related to the assessment and provision of MAID, including guidance in how to assess capacity and vulnerability, how to navigate more complex cases and how to assess MAID requests with mental illness as the sole underlying condition. The MAID curriculum was launched in August 2023. Over 1,100 clinicians have registered for it.

From when MAID legislation was enacted in 2016 to the end of 2022, over 44,000 Canadians received MAID. The vast majority of these individuals were at the end of their life. In fact, numbers from 2022 show that 96.5% of individuals accessing MAID were terminally ill, and two-thirds had a cancer diagnosis. Many more requested MAID but were ruled ineligible based on the strict eligibility criteria and safeguards, withdrew their requests or died before receiving MAID. This is not unexpected.

The government recognizes that public reporting is critical to ensuring transparency and public trust in the legislation. Both the original MAID legislation of 2016 and the amended law passed in 2021 set out obligations for the collection of data and public reporting on important aspects of MAID. As of January 1, 2023, we have expanded our collection of information on MAID.

I would like to take this opportunity to highlight the achievements of the provinces and territories, as well as key partners in the system, such as health care professionals, who are working to safely implement MAID within their health care systems.

We have come a long way, but we have heard clearly that there is more work to be done. More preparations are required within the provincial and territorial health care systems to support the wraparound activities that may be necessary for the management and assessment of MAID requests where mental illness is the driver.

We also know that some Canadians and members of the medical community are concerned about expanding eligibility for MAID to people suffering solely from mental disorders.

We will continue the work with the provinces, territories and key health system partners to support the safe implementation and delivery of Canada's framework for MAID, while protecting those who may be vulnerable. The expert panel also recommended consultations with first nations, Inuit and Métis people. We recognize the importance of meaningful engagement and ongoing dialogue with indigenous peoples to support the culturally safe implementation of MAID.

Working in partnership with indigenous communities, we have developed an extensive plan for indigenous engagement. Our approach involves both indigenous-led community engagement and federally supported activities, such as an online tool, which has already been launched, and knowledge-exchange round tables, which will be taking place this February to April. We are working closely with indigenous partners to design a process with them at their pace.

I recognize that there is a lot of hard work being done in order to show that MAID is accessible to people who need it, with appropriate safeguards in place. However, we need to make sure that we do not rush into that decision. This is why it is really important that we extend the application of this particular bill, as it relates to people with mental disorders, by at least three years; as a result, all provinces and territories can have the appropriate training and assessment tools ready.

A year ago, we extended the exclusion period for one year, until this March. As we approach that date, we have heard unanimously from all provinces and territories that their health care systems are at various stages of readiness, and there is more to be done.

The decisions we are making about MAID are not easy to make, nor should they be.

These are life-and-death decisions and we must get this right.

In Bill C‑62, the government has put forward a three-year extension of the exclusion from eligibility for MAID for people suffering solely from mental illness.

I urge all members of this House to support Bill C-62.

[Ed Fast, Conservative, Abbotsford, BC]

Mr. Speaker, I would begin by reminding my colleague across the way that the provinces and territories sent a letter to the then minister of justice asking for an indefinite pause on MAID for the mentally ill, not just a three-year extension. I would also remind him that the large majority of Canadians oppose the expansion of MAID to the mentally ill. Similarly, a large number of mental health professionals across our country oppose the expansion.

Given all those circumstances, why does the member support a three-year extension rather than an indefinite pause on this policy?

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Mr. Speaker, I thank the member opposite for his remarks and question. I want to remind the member that, back in 2016, when the first MAID legislation came, I was serving at the provincial level. In fact, I was the attorney general for the Province of Ontario. I had the opportunity to work closely with the federal government, along with the provincial minister of health at that time, on the appropriate and proper implementation of the MAID legislation that was passed by this House. This was hard work that required a lot of appropriate training, curriculum, readiness and safeguards to ensure that MAID was practised in the province according to the law.

That is the path forward as we look at people with mental disorders. We need to make sure that provinces and territories are ready, as they are asking for time. We are confident that, if we provide an extension for three years, they will have the appropriate tools, curriculum and training necessary in order to deliver this service in the most appropriate manner.

[Sébastien Lemire, Bloc, Abitibi—Témiscamingue, QC]

Mr. Speaker, I would like to thank my colleague for his speech, and especially the bits in French.

However, I am still amazed to learn that during the course of this debate, which is not that old, the Special Joint Committee on Medical Assistance in Dying agreed on recommendations. These recommendations are found in the Bloc Québécois amendment we are debating today. I believe this amendment is very simple. It mentions that the bill “take into account provincial medical assistance in dying frameworks for advance requests from persons who have an illness that could deprive them of the capacity to consent to care”. I think this is just common sense.

Can we not vote on this amendment first and then make some progress so that people who need it can have access to medical assistance in dying in a free and informed manner?

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

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

Partnership with provinces, including Quebec, is extremely important in order for the legislation around MAID to be applied properly. As we know, delivery of health care is a provincial responsibility. It is really important that our provinces have all the tools and the time necessary to administer MAID in an appropriate manner.

That is why the work that is happening around setting of curriculum, training and the tools that regulatory bodies need to ensure that the training and curriculum is being met, as well as that the safeguards are being complied with, is important. This is also why the three-year extension under Bill C-62 is absolutely necessary.

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

Mr. Speaker, as the parliamentary secretary well knows, we really only have two sitting weeks left for this bill to reach the Governor General's desk. We are already pretty much halfway through one of those two. I think that the House of Commons is going to do its duty and pass the bill this week, but there are reports in the media of senators openly defying the intent of this bill and threatening to block it.

What steps is the government taking to ensure that the Senate does not thwart the will of the democratically elected House and that it makes sure the bill reaches the Governor General's desk in time?

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Mr. Speaker, I want to thank the member opposite for his question and the members of this House for the hard work they are doing to ensure that this particular piece of legislation passes through this place as quickly as possible, so it can get to the Senate and become law by March 17.

I am confident that the Senate will fulfill its responsibility appropriately and will pass this legislation. I know the minister, along with the Attorney General, will be speaking to the senators and answering their questions. I hope this will satisfy them in terms of the validity of the bill and the need to pass it by March 17.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Mr. Speaker, it is with a sense of profound responsibility and pride that I address the House today regarding the government's proposed bill, Bill C-62, aimed at extending the temporary suspension of eligibility for medical assistance in dying, MAID, for individuals suffering exclusively from mental illness, for an additional three years. This discussion is not just about policy but about the very essence of compassion, dignity and the complexity of human suffering.

The concept of MAID resonates deeply within the Canadian societal fabric, touching upon the core values of autonomy and the right to end intolerable suffering. In Richmond Hill, as in communities across our nation, I have engaged with constituents, health care professionals and advocacy groups. These conversations have revealed a spectrum of beliefs and underscored the critical importance of adopting this issue with sensitivity, respect and an unwavering commitment to the well-being of all Canadians.

Since MAID was introduced, our office organized three community council meetings to deeply engage on this topic. We also partnered with the Canadian Mental Health Association, among many other professional associations, to enhance the dialogue with our constituents. Following the special joint committee's report, we convened our latest community council to gather our constituents' views and insights. Their response was clear and united in support of the delay. This active involvement with our community underlines the importance of careful reflection and thorough examination in addressing this issue.

The proposed extension under Bill C-62 is not merely a procedural delay. It is a crucial break that would let us look more closely into how mental illnesses and the final choice to end a life interact with each other. Mental health issues are complex and different for everyone, making it hard to fit them into our usual ideas about illness that leads to death. We need to look at each situation individually, taking the person's pain seriously while making sure there are strong protections in place to prevent hasty choices.

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 and report annually on MAID assessment and delivery. The formal monitoring system is important to inform our understanding of who applies for MAID in Canada, the medical conditions prompting requests, and trends in MAID activity since the 2016 legislation. As such, we have been working in collaboration with the provinces and territories and with health care professionals to establish a robust monitoring system. It is important to emphasize that this is a significant collaborative commitment.

As members know, on March 17, 2021, revised federal legislation was passed, expanding MAID eligibility to persons whose natural death is not reasonably foreseeable, providing they meet the remaining eligibility criteria.

Since the passing of the new legislation, the vast majority of MAID deaths, that is 96.5%, involved individuals whose death was reasonably foreseeable. Of course, two-thirds had a cancer diagnosis. In 2022, just 3.5% of total MAID deaths, which is 463 deaths, were attributed to individuals whose death was not reasonably foreseeable, representing less than 0.2% of all deaths in Canada. Of those 463 deaths, nearly 50% reported that the main underlying medical condition was neurological, such as ALS or Parkinson’s disease, while the remaining cases involved a variety of other complex conditions, including multiple comorbidities, cardiovascular disease, organ failure and respiratory illnesses.

Although the current sample is small, 2022 data also shows that where death was not reasonably foreseeable, 64% of individuals were approved for MAID, compared to 83% of individuals in cases where death was foreseeable. Each MAID request where the person’s natural death is not reasonably foreseeable is complex and unique, and early indications show that approvals for MAID in this stream are much lower than when the person’s death is reasonably foreseeable.

The decision-making process for MAID, especially in the context of mental illness, is fraught with complexity. It necessitates a meticulous evaluation of the individual's condition, an exploration of all viable treatment options and a profound understanding of the person's lived experience. This process is not undertaken lightly. It is grounded in empathy, clinical expertise and a rigorous adherence to ethical standards.

I also previously engaged in discussions on this matter in 2016 and again in February 2023. Today marks my third address to the House on this subject, which holds personal significance for me and, undoubtedly, affects numerous households in Richmond Hill and beyond.

I wish to highlight the government's consistent commitment to thorough and collaborative investigation, in concert with provincial, territorial and societal stakeholders, to ensure that MAID is administered with rigorous safeguards to protect the vulnerable while respecting the rights and dignities of applicants.

In pursuit of these objectives, the government enacted Bill C-39 last year, extending the moratorium on MAID for those with mental disorders as their sole medical condition until March of this year. This extension was pivotal in facilitating the safe provision of MAID, allowing for the broader dissemination and adoption of essential resources among medical and nursing professionals and ensuring the readiness of our health care infrastructure.

Moreover, this period provided the government with a crucial window to review the conclusive report by the Special Joint Committee on Medical Assistance in Dying. The one-year extension has proven invaluable, enabling the special joint committee to conduct a review in October 2023 concerning Canada's preparedness to accommodate MAID requests for mental disorders.

On January 29, 2024, the committee tabled its third report, which outlined recommendations regarding Canada's readiness for the safe execution of MAID under these circumstances. Following the committee's recommendations, the government, via Bill C-62, seeks to extend the pause on MAID for those with only a mental disorder until March 17, 2027. This aims to give our health care system enough time to prepare for MAID under these conditions.

We have held detailed talks with health care experts and the public, which showed a clear need for more time to maintain the integrity of this process. This time would also help in creating and sharing specialized training for health care workers, developing detailed policies and encouraging discussions on this important matter. The goal is to create a system that acknowledges mental illness complexities, protects those at risk, respects individual rights and dignity, as well as the Constitution, and ensures the proper safeguards.

In conclusion, we know that the MAID regime has provided relief from suffering for thousands of Canadians so far, the vast majority of whom are already at the end of life, and that individuals living with intolerable suffering will continue to explore MAID as an option in the future.

We have made a commitment to transparency and accountability across all levels of government to support public confidence in the MAID regime. I am also confident that we are honouring that commitment by providing Canadians with accurate and reliable information on MAID as it continues to evolve in this country.

As I stand before you, Mr. Speaker, acknowledging the profound impact of this issue on myself, the constituents of Richmond Hill and countless other Canadians, I am confident that this bill would facilitate the careful and considered approach required to address this sensitive matter appropriately.

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

Mr. Speaker, on the situation we find ourselves in this week, and last year with Bill C-39, we can draw a direct line back to the Senate amendment that was placed on Bill C-7. The government did a complete 180. It came out with a charter statement explaining why it was excluding mental disorders, and it then went and accepted the Senate amendment.

Bill C-39 last year had to punt the ball down the road by a year. Now we have Bill C-62 trying to do that by another three years. It feels like everything we have been doing has been trying to play catch-up to that change in the law. The law was changed before we had done the work.

Does my hon. colleague regret voting for that Senate amendment, given all he knows now and all of the catch-up we have been trying to do on this very important and sensitive issue?

[Majid Jowhari, Liberal, Richmond Hill, ON]

Mr. Speaker, through you, I would like to thank my colleague across, not only for the work he has done as part of the special committee, but also for the point of view he is raising.

We have to remember that, at that time, we were looking at the bill from a constitutional aspect as well, so when we looked at it we addressed many issues. We put the policies, the procedures, the constitutional concept of it and the rights of Canadians into perspective. I believe that was the right decision to make.

However, since then we have had the opportunity to look at the next phase, which is the implementation and the rollout of that. As we started to address working with the provinces and the professionals, we realized there was a lot more opportunity for collaboration as far as readiness and safeguards are concerned, and that we needed more time. We were hoping that one year would give us that, but once again it became clear that we needed more time. Therefore, the extension we are talking about is finding that fine balance between making sure that all Canadians can exercise their constitutional right and making sure we have the safeguards in place to ensure that no missteps are taken.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Mr. Speaker, I am not sure what the constitutional right to MAID is that the member across referred to.

He wants more time to discover this legislation. The difficulty of course is the concept of irremediability. The Liberal government can take the next thousand years to consider this legislation, but it is clear from experts across this country that the issue of irremediability with respect to mental illness is not going to be resolved. How is he going to resolve that with the voters who are going to send him packing in the next election?

[Majid Jowhari, Liberal, Richmond Hill, ON]

Mr. Speaker, let me address the last part first. I have had the honour and privilege of representing Richmond Hill over the last three terms and am counting on people and my hard work to be able to be re-elected so that I can come back here to continue representing them. Let us leave it at that.

What is key is that the issue of irremediability is a very complex issue, and it takes time to understand each case. We need to make sure all the safeguards are put into place to ensure that we do not cause any undue risk and harm.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Mr. Speaker, we are talking about a bill that is very sensitive for many different reasons. This bill affects us all for one reason or another. There is a motion calling for a distinction between neurodegenerative disease and mental illness.

I wonder if my colleague could tell us what he thinks about the possibility of moving faster on legislation that covers neurodegenerative disease so that people with Alzheimer's can decide, while they are still lucid, if and when they want to end things, because it is still a choice.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Mr. Speaker, I have had the pleasure of working with my colleague on a number of committees, and I thank her for her point of view.

The point is that it is those complexities that have necessitated, now that we are at the point of rolling out this legislation, that we really take a step back and look at the spectrum of diseases and the challenges that exist to be able to ensure that the right safeguards are in place. Yes, all of those need to be taken into account.

I am hoping that, over the next three years, working in collaboration with the provinces and with professionals, as well as with those with lived experience, we will be able to answer some of those key questions.

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

Mr. Speaker, I would like to inform you that I will be sharing my speaking time with the hon. member for Shefford.

I rise today to speak about a topic I am passionate about. I am a social worker. I spent my career supporting seniors who wished to live at home, as well as seniors living in long-term care centres. I could say that I will be giving a speech, but it is more like a first-hand account, because this morning, quite frankly, I could not believe my ears. I could not believe the outrageous remarks I was hearing on the issue of medical assistance in dying.

I would like to remind the House that the Bloc Québécois has a humanist vision of medical assistance in dying. Our focus is on the importance of the individual's right to dignity, to free and informed consent and, most of all, to self-determination. That means that I am the best person to decide what will happen to me, because I am making a free and informed choice.

I want to tell the House a story, but I should mention that it is not a very pleasant one. As I said, I am a social worker, and I have kept up my membership in my professional association, because I think that is very important. Today, I am addressing my colleagues as both a member of Parliament and a social worker.

I worked with an elderly lady in a long-term care home. She had multiple sclerosis. She had been living there for years. Slowly, little by little, she lost her autonomy, until all she could do was move her head, swallow, and move two fingers. It was just enough to operate her wheelchair. She asked for medical assistance in dying.

As a social worker, it was my job to professionally assess whether her request was free and informed and whether she was asking for care in a free and informed way. I did my duty. I went to university, so I have clinical knowledge that enabled me to examine her condition, professionally evaluate her and use my clinical judgment to assess the request from this woman who had been suffering for years, confined to her bed.

Imagine what it is like for someone who has to stay in bed all day long, having people turn them over so they do not get bedsores. Imagine what it feels like for someone who can no longer go to the bathroom, who is incontinent, who can no longer scratch their own forehead and has to ring for an attendant to come scratch it for them because it is itchy.

The woman I am talking about made a request for medical assistance in dying. Her request was denied because the members of the multidisciplinary team concluded that this person was not in a condition to make a truly free decision, that she was depressed and that it was not the right time for her to take that step.

When I hear our Conservative friends say all someone has to do is ask and they will get an injection the next day and die, I can tell my colleagues that, as a health professional and a social worker, it is tough to listen to that. As a member of Parliament, I am ashamed, because it is bad to spread misinformation. Just because someone asks for medical assistance in dying does not mean they will get it. There are tons of people around these patients who assess their state of mind and their disease. Together, they decide whether that person can request medical assistance in dying and receive it. We live in a democratic country. People can submit requests. That does not mean anything goes and requests will automatically be granted. This morning, I decided I had better listen to the speeches from my office, because I would have had trouble facing the members who were saying outrageous things.

The same goes for people with disabilities. It seems like some members believe that people with disabilities are not smart, that they cannot make decisions and that they need to be guided. I am sorry, maybe I am getting emotional, but I have profound respect for human beings, and human beings are capable of making decisions about themselves.

I want to reiterate that just because someone requests MAID does not mean they will receive it. The professionals surrounding these people are not naive. They are educated people: doctors, nurses, social workers and occupational therapists. Care providers are professionals.

MAID is a lengthy process in Quebec. Sometimes, people make the request too late. They lose their ability to consent again to the process, and they miss their chance. They suffer because they lost the cognitive capacity to consent one more time to medical assistance in dying.

We agree that today we are discussing a very sensitive and complex issue. There are some members in the House who are really lowering the level of the discussion and debate. Frankly, I feel sick about this, and I repeat that I am ashamed of what I heard this morning.

The Bloc Québécois’s proposal is balanced. We know that Quebec passed a law and wants to allow people to make advance requests. What does that mean? If the hon. member for Rosemont—La Petite-Patrie received a diagnosis of early dementia or Alzheimer’s around the age of 45, he could decide that he did not want to die in a long-term care home, hunched over and completely dependent on others. He would then decide to draft his advance requests and trust those around him so that he could receive medical assistance in dying when all the criteria he described were met. In Quebec we are ready to do that.

Furthermore, the Special Joint Committee on Medical Assistance in Dying, which analyzed the issue for a year, reached the same conclusion, namely that it makes sense. A person who is mentally sound, who has been assessed and wants to make their advance request should be able to do so and, above all, to obtain it.

The bill we have here is very timid. It lacks ambition and political courage. We are abandoning people who, at this very moment, would like to use advance requests because they are suffering from a form of dementia, a kind of incurable neurocognitive disease. They see the end coming, and it is terrible, because it comes with atrocious suffering and complete loss of autonomy.

If I received a diagnosis of early onset dementia and no longer recognized my children and my grandchildren, if I was aggressive, if I defecated in my underwear and did not stop walking all day long because I kept wandering and had no life left, I would want my children to say that I met all the requirements and to ask that they let me go because I would be ready and those were my wishes. In Quebec, this has been recognized. Unfortunately, because this government will not listen to Quebec, it will not allow practitioners, doctors, nurses and social workers to do their work. They could face legal action launched by the family or by a third party. What is going to happen? People in Quebec are really going to suffer because here, in the House, people lack courage and do not want to support the one province that is ready to move to another level. When it comes to advance requests, we are ready.

We in the Bloc Québécois nonetheless agreed that we had not necessarily fully explored the issue of mental disorders and that we needed an extra year to reflect and lay the groundwork. However, three years is too long. Society is moving ahead faster than legislators. Members of the House need to understand they are abandoning people who will suffer.

My grandmother was religious. At age 91, she was suffering terribly and was about to die. She refused morphine because, in her religion, those who suffer go to heaven. She refused care, and she suffered. It was a choice. We respected her choice to suffer so she could go straight to heaven, even though we knew full well she would. She believed she had to suffer. We respected that. She refused all morphine injections. Today, we have made progress. People have the right to choose how they want to leave this earth. I repeat, just because people ask for medical assistance in dying does not mean they will receive it.

Today, I am making a plea from my heart. For everyone who will need it, let us listen to the consensus of Quebec society. Let us listen to Quebeckers, who are saying that Canada can take the time to reflect, but that Quebec is ready and wants permission to do it properly and legally.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

Mr. Speaker, I would like to thank my colleague for her plea from the heart, her speech. She mentioned me at one point. I hope I do not receive that diagnosis anytime soon. I generally agree with her on this issue.

I did not follow all the formalities and procedures surrounding this matter. That said, I agree that there is consensus in Quebec concerning advance requests with defined criteria, loved ones who can care for the patient and health professionals who can provide support.

I quite agree with my colleague that the federal government should show some openness, sit down and talk with Quebec to find a solution, maybe even a reasonable accommodation, so we can respect the consensus of Quebec society, which seems to be heading in the same direction in this matter.

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

Mr. Speaker, I am pleased to hear from my colleague who understands the consensus in Quebec. Now, I will ask him to convince his political party to support the Bloc Québécois amendment, which proposes amending the Criminal Code so that service providers cannot be prosecuted for providing MAID to people who made advance requests and obtained that service. I encourage him to speak up and to be a leader in his party to convince his colleagues.

Just because the other health ministers from the other provinces and territories are not ready does not mean that Quebec is obligated to move as slowly as them. Quebec is ready to help people who are suffering who want MAID and who request it.

I will say it again. I do not know if there are any anglophone MPs here who are wearing their earpieces, but just because a person requests medical assistance in dying does not mean that they will get it.

[Damien Kurek, Conservative, Battle River—Crowfoot, AB]

Mr. Speaker, I find aspects of the debate we have had here today to be very troubling because there are increasing examples, and I hear of them in my constituency office and from reports in the media, but the member suggests that somehow the debate is settled. Therefore, anybody who would raise valid questions is somehow not entitled to ask those questions. That is simply not how our democracy works. It is troubling that that would be the trend some members of the Bloc Québécois, and even some Liberals today, are following when we have heard a host of very concerning things.

Even at the special committee, which has been referenced, Quebec's college of physicians suggested that infants could be euthanized if they were born with a disability. There are concerns about members of the military, veterans, who have been offered MAID instead of treatment. There is a whole host of questions that need to be answered. It is time to give hope in this country and not simply the opportunity for somebody to end their life in the most final way imaginable.