Debates of Feb. 13th, 2024

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

[Rachael Thomas, Conservative, Lethbridge, AB]

Madam Speaker, the number of Canadians ending their lives through medical assistance in dying is accelerating at a rate that outpaces that in any other country. Canada's most recent annual report on medical assistance in dying, which I will call MAID from this point forward, shows that MAID deaths are actually up by 30% from just one year ago. This is not just a one-time occasion or occurrence. Rather, this is actually a trend. Year over year, we are seeing a rapid increase.

The matter at hand today, in the most literal sense, is a matter of life and death. Around the world, people are watching Canada and the debate taking place in this House. They are doing so with an overwhelming belief that what the current government is considering is, in fact, reckless. That is extending medical assistance in dying to those with a mental illness. This topic deserves our utmost attention today in this place and, my hope would be, beyond.

Last spring, the Liberals created legislation that would grant MAID to those struggling with a mental illness, starting on March 17, which is only a few weeks away. Thanks to the rallying cry of medical experts, those who struggle with a mental illness and concerned Canadians from far and wide, along with Conservative members of Parliament, the government has been forced into a position where they have actually had to hit the pause button. This is not permanent; it is only temporary, lasting for three years. We will then see this legislation back before the House, with the current government desiring to offer medical assistance in dying to those who struggle with a mental illness.

When considering whether a mental disorder is irremediable, Parliament has heard from clinicians, who stated that it is only predictable 50% of the time. In other words, 50% of the time, clinicians are able to say that the individual will not recover from the mental illness. The other 50% of the time, they actually get it wrong. It is not the same as a brain tumour, for example, that can be seen on a scan, where there is evidence that can be judged and physical circumstances that can be known. Mental illness does not operate that way. While doctors might be correct 50% of the time, this means that, with regard to a prognosis, they are also wrong 50% of the time. To be very frank, the toss of a coin feels like a rather sad, wrong way to make a life or death decision. That is really what we are talking about: the toss of a coin, where 50% of the time, they get heads, and 50% of the time, they get tails. That is how this decision would be made if we were to move forward with medical assistance in dying for those who have a mental illness. This is absolutely wrong. That Parliament would even consider it is deeply troubling.

Of course, we know that this has nothing to do with whether our physicians and our psychiatrists are functioning in an adequate manner. It has everything to do with the fact that mental illnesses are incredibly complex and difficult to understand.

It is important, as we engage in this debate, to consider what medical experts are saying. We heard from Physicians Together with Vulnerable Canadians, which reported, “Given that there is no medical evidence to reliably predict which patients with a mental illness will not get better, MAID for mental illness will end the lives of patients who would have recovered.”

The Canadian Centre for Suicide Prevention echoed this, reporting, “There is no consensus on the meaning of irremediability for any mental disorder.” Dr. Gaind, chief of psychiatry at Sunnybrook Hospital, raised the alarm; he said, we “cannot predict irremediability when it comes to mental illness”.

Dr. Zivot agreed, saying, “mental illness lacks a strict definition and therefore, by lack of definition, can never be grievous and irremediable”. He went on to say that “if MAID becomes a treatment option within mental health care, the bond of trust and the pledge between doctor and patient is destroyed”.

Those who live with a mental illness need hope, not death. They need us to believe in them when they are unable to believe in themselves.

It is incumbent upon us, as a society, to extend hope, to offer support and to give treatment, not death. When we consider extending medical assistance in dying to those who are suffering from mental illness, many Canadians are left extremely vulnerable. When an offer of death is extended to those who are struggling, we communicate a message that there is really no hope and no opportunity for recovery; we communicate that the best relief would be to exit this life. That lacks compassion. It is deeply troubling.

Laurel Walker has been very public about her story. She talks about her darkest days of living with a mental illness, about suicide being an ideation of hers, day after day. Then she talks about the fact that she had this glimmer of hope that somehow kept her alive. She warned Parliament that, if we were to go in this direction of legalizing medical assistance in dying for those who have a mental illness, we would be robbing them of that hope and sending this grave message that, really, death is their only option.

Dr. Sareen offered the same warning and shared that making MAID available for mental disorders would undermine suicide prevention efforts and lead to unnecessary deaths. He said:

When a society makes MAID available, the population believes it is a way to end suffering. In other jurisdictions that have had MAID available for mental disorders, not only are there deaths due to MAID, but there are also deaths related to non-MAID suicides.

In other words, we see an increase not only in medical assistance in dying rates but also in suicide in general. There is this lack of hope and this message conveyed by society that there is no future.

As Canadians, we can do better. I dare say we must do better. We cannot give up on people such as Laurel, who are fighting for their very lives. These folks are in desperate need of hope and help. They want treatment, not death.

Those struggling with their mental health deserve that element of support. Rather than looking to facilitate the deaths of fellow Canadians who are suffering, we must focus on how we can better provide the needed treatment. In an article, psychiatrist John Maher is quoted as expressing that “Mental illness is treatable, and death is not treatment.”

We know that the problem is rarely only mental illness. It is often within the larger context of social challenges as well, whether this is not having basic necessities, such as housing, or a social structural support that is not available to these folks. Again, we have a responsibility as a society to make sure that those things are available to these individuals. Death is not the answer.

To my fellow colleagues in this place, I would make the following plea: Let us not just simply push the temporary pause button, as if to say their life is worth something now but, in a few years, it may no longer be. It is as if to say that the flip of a coin might not be acceptable now, but maybe we will flip a coin in three years; that might be okay. Rather, let us commit to permanently valuing those who live with a mental illness, and let us make sure that they are forever offered the adequate health care supports that are needed. Death is not that.

Christie Pollock submitted testimony calling for great caution. She is a 30-year-old who has her own struggle. She talks about the hope that she is now able to offer, because she runs a support group. Then she talks about the fact that, if medical assistance in dying had been offered to her, she might not be here. She goes on to say that, sure, she has her struggles, and she is not healed, but she has found a mix of therapy and medication that is getting her through. Her days are filled with hope. It is not just hope for herself; she is also able to offer hope to others.

Madam Speaker and members of this House, this is where we should wish to land, where the people of this place offer hope to Canadians, not death.

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

Madam Speaker, I am not in too much disagreement with a lot of what the member had to say.

As a long-time doctor, I certainly know that one ought to be cautious, and I think our government has been pretty cautious. We first put a one-year pause on this; now we have a three-year pause. I hate to get political in this political place, but the reality is that one of the reasons we should hesitate to implement MAID for mental illness is a lack of mental health services. Our government has been fighting to increase those services.

Will the Conservative Party make the same commitment to providing adequate mental services for Canadians?

[Rachael Thomas, Conservative, Lethbridge, AB]

Madam Speaker, I would ask the hon. member to point to the supports his government has offered to those with mental illness. What we heard in this place, in Parliament, from witness after witness is that the supports are inadequate. People desperately need more support.

On this side of the House, I think of my hon. colleague, whose name I am not allowed to use, and his tremendous effort in advocating for support for those who live with a mental illness and his tremendous effort with bringing in a three-digit suicide line to help prevent suicide, and of course we know that is most often associated with a mental illness.

Not only are we going to make tremendous efforts when we are in government, but the reality is that we do not wait. We are already making a meaningful difference for Canadians.

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

Madam Speaker, I would like to take this opportunity to thank you for ruling the amendment in order.

The Bloc Québécois used this wording in order to recognize the fact that Quebec is a leader in this area, as proven by the unanimous motion recently adopted by the National Assembly. With this amendment, the Bloc Québécois wants to be able to move things along in Quebec.

Does my colleague care about the will of Quebec, whose values are quite different from those defended by the Conservatives?

Consequently, if the Conservative Party takes power within three years—which, according to the polls, is not impossible—do they intend to scrap the bill at the end of those three years?

[Rachael Thomas, Conservative, Lethbridge, AB]

Madam Speaker, as Conservatives, our desire is to be on the side of vulnerable Canadians and to be their greatest advocate. Our desire is to listen to the pleas of those who came before the House. That is our job. We have been elected to represent our constituents to the best of our ability, so when it came to hearing testimony on medical assistance in dying being extended to those with a mental illness, we leaned in, listened and did the hard work.

Furthermore, we went out and listened to Canadians beyond this place, sitting down with them in our constituency offices and meeting with them during town hall meetings. Our leader also went on tour across the country, leaning in and hearing the concerns of Canadians, and this came up as one that Canadians do not want. They do not want medical assistance in dying to be extended to those who have a mental illness. Instead, they want to see greater support for those who struggle. They want to see a better medical system put in place. They want to see better health care provisions put in place. They want to see greater support from society as a whole.

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, I appreciate very much the passion the member shared in her intervention.

I wonder if the member could share with us what she thinks would happen after March 17 if we do not meet this deadline, this really important deadline, which we need to avoid so we can make sure what she has been talking about is protected. Could she explain to us what she thinks would happen with the March 17 deadline if we were not able to meet it without the amendments being made?

[Rachael Thomas, Conservative, Lethbridge, AB]

Madam Speaker, I cannot help but point out the obvious. She is a member of the NDP, which is currently in a coalition with the Liberal government, so in part, it is actually her doing that we are here in this place having this discussion at the eleventh hour.

I would encourage her to perhaps work with her party to act differently and to actually act on behalf of Canadians. That said, she is going to have to enter into a conversation with her coalition government to ask it what is going to happen on March 17.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, at the outset, I would like to say that I am splitting my time with my hon. colleague from Calgary Rocky Ridge.

This is a weighty issue. Over the course of this debate, I have listened intently to all of our colleagues. I am brought back to when we debated this as new members of Parliament in 2016. I said, at that time, that this is perhaps one of the most important pieces of legislation that our generation would be debating and discussing. I also said, at that time, that there is nothing that prepares someone, as a new member of Parliament, to debate and make choices about that piece of legislation.

I consulted so many of my constituents, as well as friends of mine in the faith community. I consulted my pastor. I was conflicted as to how I was going to vote. I said at that time, too, that it was troubling for me because we were in the eleventh hour on such an important piece of legislation, and here we are again at the eleventh hour on a piece of legislation that is, quite frankly, literally life and death.

I want to make something clear. In the time since MAID became law, I have sat with families who have had loved ones who have chosen MAID. Our family very recently had a loved one who chose MAID, and we are currently dealing with all of the emotions that go along with that. It has been a tough few months for our family, but I now have a greater understanding, I believe, of the complexities of this issue. I do understand both sides of the argument better than I did in 2016.

Nevertheless, I firmly believe that expanding MAID to the mentally ill is giving up on people who could be saved. I have spent my eight and a half years of being elected fighting for those who do not have a voice, fighting for mental health awareness, passing bills with respect to post-traumatic stress disorder, and fighting for us, as a nation, to adopt the simple three-digit suicide hotline 988. I have to ask why.

Why did I fight so hard if all we are going to do is pass a piece of legislation so somebody who is struggling with a mental illness or mental health issues can choose medically assisted death or suicide? It is deeply troubling for me to see how far we have fallen to where we can perpetuate one's addiction, but we cannot get them into recovery. We have fallen so far to where we are saying it is okay if someone is struggling, as we will offer assistance in death if they are struggling with a mental illness. We are giving up on people.

I am disappointed in how we, as a Parliament, have taken the easy way out. Expanding assisted suicide to include people whose sole condition is mental illness will result in the deaths of Canadians who could have gotten better. We have 12 Canadians who die by suicide every day. A further 200 attempt suicide. That is 73,000 Canadians a year who attempt suicide, and those are just the numbers we know of.

What are we saying? My colleagues spoke very passionately about the statistics and the feedback from experts about mental illness and the irremediability of it. It is like a coin flip as to whether somebody can recover from it or not.

In preparing for this debate, I was reminded of a young man long ago who had enough of the abuse and dysfunction he was growing up with. He had lost a brother in a horrific car crash. He wanted to die and attempted suicide, but was found and saved by a loved one. That same gentleman tried it again, but for the bitterness of the metal of the weapon he chose to use, I dare to think what could have happened.

I think about if that young man, so many years ago, was successful in wanting to die by suicide. That young man would not have married his high school sweetheart, had four amazing children and a beautiful granddaughter, and travelled the world so many times to see and experience things that some will only ever be able to experience through the wonders of the Internet. I think about that young man taking a chance in 2014 to run for office. I think about that young man who was elected in 2015 to represent his hometown riding of Cariboo—Prince George and how he would have missed out on all those opportunities.

I think about that every day when we talk about suicide and doing whatever we can to get the message across that we should always choose life, that hope is always possible. Whatever it is that somebody is going through, it may seem so dark, but light is just a short hand away. That young man is me and, for the first time, I am sharing this. I think about that all the time when we do what we do here in the House, when we are fighting for those who do not have a voice. If somebody had not told me that life is worth living and asked to let them help me at that time, there are so many things I would have missed out on.

I appreciate the debate that we have had in the House, but I am saying that today we should be fighting every minute for those who are struggling, to tell them that hope is always possible and life is worth living. I will continue to fight for that as long as I am elected.

[Joël Lightbound, Liberal, Louis-Hébert, QC]

Madam Speaker, the member is a colleague I have always enjoyed working with. I remember one of the very first files I was asked to work on as Parliamentary Secretary to the Minister of Health back in 2017 was his private member's bill, Bill C-211, on post-traumatic stress disorder, so I know it means a great deal to him, and I appreciate his speech.

I voted with our colleague from the other side to completely abandon the idea of opening MAID to people solely affected by mental illness. I have been convinced, through the discussions I have had with psychiatrists from across the country, that we are not ready nor is it desirable to go down that path for various reasons. One of them is that it is hard to say for certain that a mental illness is irremediable, but another aspect that moved me is that, if someone were to have access to that, theoretically, we would need to exhaust all possible treatment options. As we know, in this country, treatment options are sometimes, depending on the regions, hard to access, so I would like to have his comments on that.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, my hon. colleague is absolutely right. We do not treat mental illness in parity with physical illness. If I have a broken arm, we can see that injury and will offer all our assistance to it, but if I am struggling with mental illness or mental health challenges, it is an invisible illness and an invisible injury, and we do not do enough as a nation to put those supports in place. That is why I said we are giving up on Canadians when we take the easy way out. We need to put more resources in place so that people can get the help they need when they need it, wherever they need it and for as long as they need it.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I have great deal of compassion for my colleague and want to thank him for so generously sharing his life experience. He says he speaks for those who have no voice, and he is living proof that suicidal ideation is reversible.

I wonder if he could dig a bit deeper and acknowledge that there are people who have no voice, who have yet to find a psychiatric treatment that eases their suffering and who struggle with mental disorders? What solutions does he have for them after 30 years of treatment?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, I have sat with many people who have struggled for their lives with mental illness and mental health challenges. The greatest issue many of them have is that they do not have adequate access to help and that they constantly are waiting for help. I think we need to first go down the path of doing everything in our power to remove the barriers for care so that we can help those who feel helpless and we can provide hope in their times of despair. I believe life is always worth fighting for. When somebody is struggling, I will always tell them that life is worth fighting for. We do whatever we can to fight for them.

[Blaine Calkins, Conservative, Red Deer—Lacombe, AB]

Madam Speaker, I want to thank my colleague from Cariboo—Prince George for his excellent work in bringing the 988 number, which is now finally implemented and seeing great use. I want to thank my colleague for always being a passionate advocate, not only for his constituents, and for always doing the right thing. I can say that I am going to rest easier tonight knowing that there is somebody who is never going to give up on me. I really do appreciate that from my colleague, and I want to thank him for joining me. We will never give up on those who feel like giving up.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, that is my motto. It is “never give up”. In our darkest days and our darkest moments it is easy to find a permanent solution to a temporary problem, and that is suicide. I believe with every fibre in my body that life is worth fighting for. We just have to be able to have those moments of clarity. Sometimes it is hard to find those moments of clarity. Sometimes it is hard to see the light through the trees, but it is there. I am living proof of it.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Madam Speaker, it is quite difficult to follow the incredible words we just heard from the member for Cariboo—Prince George. Nevertheless, I am going to give it a try.

I am here tonight of course to speak to Bill C-62 and the self-inflicted debacle that has been unfolding in Parliament since it passed its radical expansion of legal medical assistance in dying to include persons for whom the sole underlying health condition is mental illness.

I will remind members of the House and my constituents that I supported and still support the principles of the 2016 bill, which was a necessary response to a 2015 Supreme Court ruling that struck down the blanket prohibition against MAID. That bill was not perfect, but it was a reasonable response to the Supreme Court's decision and was certainly better than the free-for-all on MAID that would have surely followed had there been no law.

It is my view that people who are suffering intolerably from a terminal disease without any hope of recovery or any prospect for improvement and are spiralling into a certain death as a result of illness or disease ought to be able to seek medical assistance in dying as long as they are not coerced, have received an option of proper palliative care, are not proactively offered MAID as an alternative to treatment, and most importantly, as long as the patient is a mentally competent adult.

Part of the criteria laid out in the original 2016 law was the reasonable foreseeability of death of the applicant. This clause was a problem from the start. It was challenged in court and struck down by the Quebec Superior Court. The Truchon case presented the Liberals with a decision point. The decisions the government has made since then have all been wrong.

The first thing the Liberals could have done, but did not, was defend their own existing law and appeal the Truchon decision to the Supreme Court. If they believed that their 2016 law was charter compliant, like they claimed it was during the debate in 2016, they should have stepped up and defended it. Not doing so was their first mistake.

The second mistake was that the then minister of justice was so eager to expand the law, they used the Truchon case as an opportunity to open up and expand access to medical assistance in dying and tabled Bill C-7 in the fall of 2020. That was their second mistake.

As I said before, I support MAID for competent adults who are grievously and irremediably ill and suffering cruelly from intolerable pain and anguish in the late stages of a terminal illness. I have consistently said there are important conditions for my support for legal access to MAID: the availability of quality palliative care as an option; the existence of robust safeguards for the vulnerable, especially minors, the disabled and the mentally ill; conscience protection for practitioners who oppose MAID; and any expansion of the availability of eligibility for MAID be well thought out, carefully considered and not rushed.

For these reasons, I voted to send Bill C-7 to committee, but voted against it at third reading because it failed on at least two, maybe three of my four conditions for support. I concluded that access to palliative care is not adequate in Canada. I have also become alarmed by the cracks in what should be the protections for vulnerable Canadians, as we have experienced in my own family. It was my view, even before the Senate amendment, that Bill C-7 was flawed and unworthy of support.

Then the House made a terrible decision when it passed the amendment that came back from the Senate. It was rightly opposed by all of my Conservative colleagues, who knew then that medical professionals cannot, with the certainty required for what is literally a life-and-death decision, determine irremediability of a patient in a case of mental illness. Conservatives opposed it, but it was passed nevertheless, and this expansion, which was not necessary to conform to any court decision, was to come into effect last year. The government had to introduce emergency legislation this time last year to give the medical system more time for this extraordinary change. That was the next mistake it made.

The Liberals could have used that opportunity to deal with this once and for all and simply strike this portion of what was then Bill C-7. However, they did not do it and here we are, another year later, and this country is no more ready for this expansion than it was this time last year. Here we are again in an eleventh-hour panic to kick this further down the road until after the next election; the next mistake.

Now, the Liberals could have tabled a bill that would have removed this from the bill that passed in 2021, but they have chosen not to and so said that the next government will have to deal this. However, the good news is that a Conservative government, which will surely be formed after the next election, will not recklessly expand the application of MAID to include vulnerable Canadians whose sole underlying health condition is a mental illness.

MAID is for people who cannot get better. It is for people who have no reason to hope that they can get better because they are in an irreversible, terminal state. It is for people capable of making a rational decision and not as a means of potentially fulfilling suicidal ideation.

The impossibility of creating a regime that could determine appropriate MAID for mentally ill but otherwise healthy people who are not in the final stages of a terminal illness seemed intuitive to me, but, of course, I am not a medical professional. However, I can also point to the clear message that was sent from the joint committee that studied this. Its recommendation to Parliament was very simple: Do not do it. It was the shortest list of recommendations I have ever read in a parliamentary report. It just said: Do not do it. That was the recommendation based on months and months of testimony from experts.

My recommendation to this government is to listen to the committee and strike it from the bill that passed. This time last year, the Liberals could have done that, but they kicked it ahead until this year, and nothing has changed. We find ourselves here where a full 80% of members of the Ontario Psychiatric Association do not believe that Canada can safely implement MAID for mental illness. Here we are just pushing this back a couple of years.

I want to share with the House the words of one of my constituents who met with me in November. She said in a letter to me, which I got before I met her, that, “Twenty-three years ago, age nineteen...I made the desperate decision to try and escape what appeared to me to be a dark world.... While taking a course in Pharmacology, I calculated the quantity of poison needed to arrest the heart of an adult male, multiplied it by three, and chose to ingest it.... I felt compassion for the suffering of others and the weight of constant, terrible news...though I formerly had the capacity to deal with this, the ingestion of a single pill coerced upon me by a well-intending physician inadvertently plummeted my thoughts into despair.”

What she told me later was that the side effect of the medication that she had been prescribed caused her to immediately become suicidal, and her survival was described as miraculous by the professionals who attended her.

She is now a wife and a mother and lives a productive, meaningful life. She is convinced that had MAID been available to her earlier in her life, she would have sought it and potentially have been granted it. She told me that the sufferings earlier in her life may well have been thought to be irremediable and thus would have made her eligible.

So, this government has failed to defend its original law. It failed to focus the new law on the narrow constraints of the Truchon decision. It used the Truchon decision in Quebec as an excuse for a reckless expansion of MAID. When it was obvious that it made a mistake, its members dithered instead of acting decisively and they are dithering now by pushing this two more years down the road. That is not leadership. This is just bizarre enthusiasm for the most radical expansion of MAID possible, which has now run amok.

So, I do support swift passage of the bill. Given the extensive debate that has already taken place, I was prepared to let it pass unanimously, but here we are. I had an opportunity to get some of my thoughts on the record, and I am happy to take questions.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, I was encouraged when the member indicated that he supports the swift passage of the legislation and ultimately the motion. I take it that is because he realizes the consequence of the House not having the bill passed before the deadline. I am wondering if he could give an indication of whether that is his personal opinion or if that is the Conservative Party's position.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Madam Speaker, Conservatives know that we cannot allow this bill to fail and thus stumble into a wild, unprepared territory where those whose sole underlying health condition is mental illness are permitted to access MAID, when it is so clear that the country is not ready for it.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, my colleague is claiming that Bill C-14 resulted in good legislation with its reasonably foreseeable natural death criterion. However, that did not even address the Carter ruling, since Ms. Carter did not have a condition that made her terminally ill. The Supreme Court ordered Parliament to regulate situations like those of Ms. Carter and Ms. Taylor. Limiting medical assistance in dying to people who are terminally ill completely ignores people like Ms. Gladu and Mr. Truchon, who had to go to court to assert their constitutional right. People have had to go on hunger strikes to meet the reasonably foreseeable natural death criterion.

Is that what my colleague calls compassion?

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Madam Speaker, it is possible that my colleague misunderstood me. What I said in my speech was that I voted for Bill C-14 because it was a reasonable response to what had to be addressed, which was the Carter decision. The reasonable foreseeability of death was a problem clause, and I thought so at the time. I thought it was awkward and perhaps not the best way to put it, so it was not a shock to me that it ended up being challenged on that basis. I think my colleague may have been overestimating my enthusiasm for Bill C-14, but I did support it, because something had to be done.

However, this reckless expansion that came after the Senate amendments to Bill C-7 goes way beyond this. No court was calling upon Parliament or forcing Parliament to expand the eligibility of MAID to those whose sole underlying health condition is mental illness.

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

Madam Speaker, the New Democrats actually also voted against what I thought was an ill-advised Senate amendment to Bill C-7. There is plenty of blame to be thrown around. I understand that. I have done more than my fair share this week against the Liberals, but the fact of the matter is that we are at a moment right now when time is critical. We have about a week and a half left, in terms of sitting weeks, until the March 17 deadline. It is imperative that this bill gets passed through the House this week, so that it can go to the Senate.

I am glad to hear the member's support for that measure, but I am curious as to why, when we had a vote on time management of this motion, which is programming the bill, the Conservatives voted against it, knowing that it could have actually jeopardized the time we had available to us this week to get Bill C-62 passed.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Madam Speaker, there is no danger of Bill C-62's not passing this House. I think perhaps there has been some failure of the combined party leadership negotiations to come up with an arrangement that would have expedited this.

I am not concerned about the bill's not passing. The programming motion is there. I certainly never had any intention to deliberately delay the passage of this bill. That is not what any Conservative has attempted or is attempting to do.

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

Madam Speaker, let me start by saying that I am sharing my time with the member for Sarnia—Lambton, which, I have to say, is a little bizarre.

I support this legislation, a further three-year hold on allowing MAID for mental illness, and, in addition, imposing a requirement in two years' time to reform the MAID committee to re-examine this question.

I know there are a lot of people out there who are worried about MAID for mental illness. People are worried about their parents. People are worried about their siblings, and I can most appreciate that people are worried about their children. I have six kids and I, frankly, would be worried if we were to implement this legislation as is, because I do not think there are adequate safeguards. Everyone who is a parent realizes that our children will inevitably, at some time, go through difficult times.

I also know that there are many psychiatrists out there who are worried about this, and the majority of psychiatrists are against this. They are worried that their patients, who would otherwise probably get better, would instead resort to MAID. To all these people, I think their concerns are totally justified. I do not think there are adequate safeguards in place at the moment.

Let me step back a bit and look at the approach of those who are advocating for MAID for mental illness to start right now. For them, it is all about personal autonomy: “It is my body, my choice. Who are you to second-guess whether I want to live or not?” This is not the state dictating to people what to do with their own bodies. It is not criminalizing either suicide or attempted suicide. This is a question of what role, if any, the state should have in assisting people to commit suicide.

I am going to get back to the question: Is MAID for mental illness really the same as suicide? The question of whether the state should be assisting people in committing suicide is closely akin to the question of whether the state should help to prevent people from committing suicide. This is something that I have a bit of experience with, because for a lot of years, as an emergency room doctor, I would see people who were suicidal, and it would be my role, if I thought they were suicidal, to keep them in the hospital, even against their will. People would ask me why I should have this power. They would ask, “Is it not my right to decide what to do with my own body?”

In thinking about it, I thought, well, the state has two legitimate interests in trying to prevent people from killing themselves. One is to protect people from themselves, because when they are in the depths of depression they do not realize that things will get better. That is partly why they are so depressed and why they want to kill themselves. However, the vast majority of people do get better.

The other legitimate reason for the state to intervene is to protect the loved ones. The person who dies is dead; they are not suffering any more pain. The people who continue to feel the pain are those who have lost their loved one. In addition, they often spend the rest of their lives thinking about whether this had anything to do with something they could or could not have done.

I know there are people who are going to say this is different: MAID for mental illness is different from assisting suicide, and the people they are talking about with respect to MAID for mental illness are people who are chronically, desperately ill, who have tried all forms of treatment and for whom nothing has been effective. They say that it is really cruel and unconstitutional not to help those people. I disagree.

First of all, the Canadian law, unlike the Dutch law, is very permissive as to who meets the requirements. There is absolutely no requirement that the person has tried all forms of therapy and they have failed. In fact, they do not have to have tried any form of treatment at all, because the legislation would require only that there are no other treatments acceptable to the patient. I know, from being a doctor, that people are going to refuse all treatment. They are going to refuse medications. I know those who support MAID for mental illness are going to say, “Okay, it is not in the legislation, but it is up to the medical profession, the doctors, to impose these requirements, like trying all forms of treatment, even if the law does not.”

I hate to say it, but as a doctor I do not have the same faith in my own medical profession, and the reason for that is that we ought to have learned from what has happened with MAID for other forms of physical disability. There are a lot of zealous MAID practitioners out there who absolutely believe that personal autonomy is paramount and do not think we ought to be questioning why somebody decides to take their own life.

Let me give some examples from the media. The Fifth Estate, a very good show, talked about a 23-year-old diabetic person who was losing sight in one eye, who applied for and was granted MAID. Another story was of a 54-year-old man with back problems, but his real problem seemed to be that he was afraid of losing his apartment and ending up on the street. He too applied for and was granted MAID.

CTV documented the story of a 51-year-old woman, who applied for and actually received MAID for multiple chemical sensitivities. Another story was of a 31-year-old woman approved for MAID for needing a wheelchair. I do not think she actually really needed it, but she usually used a wheelchair and had multiple environmental allergies. Again, her problem was mostly that she could not find adequate housing. Again, this person was approved for MAID.

To those who have such faith in the medical profession that they say we are going to create the safeguards, they are perhaps a little naive. I would sincerely worry if we were to implement this legislation with the safeguards in it right now. I have six children, and I know, almost inevitably, that life is such that they are going to go through difficult times, such as the breakup of a relationship or hard financial times. I would be worried they would see one of these zealous practitioners who believe in personal autonomy, who would say, “Who am I to question your suffering?”

Part of the problem is that the current legislation would not require the MAID practitioner to talk either to the family or to the treating doctor, so they are not going to find out that the depression was the result of the breakup of a relationship or the person's not taking their medication.

I also want to briefly talk about the problem with allowing MAID for mental illness and the question of irremediability. Part of the problem with allowing it for people who are depressed is the fact they cannot see that things are going to get better, but people are going to say that surely there are people out there who are not going to get better, which is the requirement of the legislation: One needs to have an irremediable illness.

The problem, though, is that doctors are not really good at predicting who is not going to get better, especially with respect to mental illness. With things like cancer, it is different.

A recently published study that looked at clinicians' ability to determine irremediability for treatment-resistant depression concluded, “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 assessment.

For me, as a long-time doctor, it is almost mind-boggling that there are practitioners out there, psychiatrists, who are not particularly bothered by the fact that they cannot be sure somebody's condition is irremediable. It would be absolutely terrible to take someone's life when they could actually get better.

Lastly, let me address the assertion of some proponents of MAID that it is inevitable that if this was to go to the Supreme Court, it would find it to be unconstitutional, because it discriminates against people who have mental illness rather than physical illness. I do not think it is at all inevitable. Yes, a court would probably find this to be a violation of section 15 or section 7, but the real question, as in a lot of constitutional questions, is the section 1 analysis. Does it constitute a reasonable limitation “prescribed by law as can be demonstrably justified in a free and democratic society”?

I think that is highly questionable, but never mind my opinion. There was a letter written by 32 law professors to the relevant ministers a year ago, stating the same thing, which is that it was not clear this would be found unconstitutional.

I am not going to say I do not think we should ever allow MAID for mental illnesses. I, in fact, know someone to whom perhaps the only humane thing would have been to offer it. However, we are very far at the moment from being in a position in which I would be willing to advocate for MAID for mental illness.

Let us vote for this legislation. Let us re-examine it in two years' time.

[Blaine Calkins, Conservative, Red Deer—Lacombe, AB]

Madam Speaker, I am encouraged by my colleague across the way's position on this particular issue and his knowledge as a medical practitioner, but for goodness' sake, it was a year ago we were dealing with this issue. The government controls the agenda; he is a member of the government caucus.

Why, instead of just punting this issue and kicking the ball down the road, did the government not put a fork in this with a piece of legislation that would stop us from having to deal with this for the foreseeable future? Did he advocate for that in his caucus? Why is Parliament going to have to deal with this again in a handful of years?

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

Madam Speaker, as the member knows, I am not free to discuss what I did or did not say in caucus. However, we did delay this for one year and a further three years. Obviously there are the considerations of what the Senate is going to do and what the courts are going to do. The issue will come back. Yes, I would have liked to have seen the pause be indefinite, but it is what it is. Let us go one step at a time, and I think in the end we are going to come to the right conclusion.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I have high regard for my colleague. We are both members of the Standing Committee on Health.

However, I am a bit shocked this evening. I say this quite honestly and without being condescending, but, if I were to return to teaching and present a speech to show how much sophistry there can be in one speech, I would take his. It is a perfect example.

On one hand, he says he knows what he is talking about because he is a doctor, and we should believe him. On the other hand, because he is a doctor, he tells us we should not trust doctors. Then who should we trust? He tells us he is a doctor, he knows what he is talking about, but he is concerned for his children. Then he gives examples of people feeling suicidal when we know full well, and it has been established beyond a shadow of a doubt, that suicidal states can be reversed.

What is he afraid of?