Debates of Feb. 15th, 2024

Criminal Code

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

Madam Speaker, I think my colleague shares my concern that we are now 30-some days away from an arbitrary deadline that was imposed. We passed a national palliative care motion that I brought in 2016, and nothing was done. In 2019, we brought forward the national suicide prevention strategy that was based on the work in Nunavut. Everybody signed off, and nothing was done.

Now we are being told that we should be making it easier for people who are suffering with mental illness, people who are on the streets, people using opioids, people who are hopeless, and that we should be fast-tracking that rather than putting in place the protections needed to protect people.

What are my hon. colleague's thoughts are on that?

[Ed Fast, Conservative, Abbotsford, BC]

Madam Speaker, I want to thank my colleague for his work at the Special Joint Committee on Medical Assistance in Dying, where we did excellent work in coming up with a recommendation, which unfortunately the government did not choose to follow in its entirety. We had called for an indefinite pause. Unfortunately, the government felt an arbitrary three years was sufficient.

To answer his question, I have great concern the government's promises to deliver improved palliative care supports to the provinces and to deliver improved mental health supports to them have not been fulfilled. Now people are asking for death because they are not getting those supports. That truly is sad.

[Michael Barrett, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

Madam Speaker, we come here to debate the most serious of issues, and we are faced with one of those issues today.

I want to start by being very up front. I do not think that a pause is appropriate for the expansion of medical assistance in dying to those whose sole underlying medical condition is mental illness. There must be an abolition of the expansion to those who are most vulnerable and to those who are suffering.

We have heard that the Liberal government is pushing this off to avoid political consequences in the next election, and it is shameful. However, it does present an opportunity, because a Conservative government would not allow the expansion of doctor-assisted death to people for whom our country should be offering hope and help.

The concrete solutions that have been put forward by Conservative members have been heard in the House, including by my hon. colleague from Cariboo—Prince George with the 988 suicide prevention hotline, which he shamed the government into taking action on. While it took that shame for the Liberals to act, it does offer some help to those who desperately need it.

The hon. member for Abbotsford spoke just before I did. His Bill C-314 would have scrapped doctor-assisted death for those whose sole underlying medical condition was mental illness, but the government rejected that. With respect to the provinces and territories, which are constitutionally obligated to deliver on health care, the majority of their heads of government have had to call for the government to stop this reckless march forward.

While I will vote in favour of a pause, I cannot abide anyone believing that I am okay with this continuing three years from now.

This debate is following the Liberals' pulling the emergency brake on the reckless expansion of MAID just a year ago. Given the chance, there would be a wide expansion of MAID, and not just to those who are suffering from mental illness and addiction. This expansion of doctor-assisted suicide cannot be carried out safely or justly. It is difficult, if not impossible, to determine the irremediability of a mental disorder in individual cases, meaning we cannot say, with the certainty that is required in a matter that truly is life or death, whether a person suffering from mental illness will get better.

In appearing before the Special Joint Committee on Medical Assistance in Dying, on which I sat as a vice-chair, Dr. Jitender Sareen, a physician in the department of psychiatry at the University of Manitoba, testified, said:

We strongly recommend an extended pause on expanding MAID to include mental disorders as the sole underlying medical condition in Canada, because we're simply not ready. In our experience, people recover from long periods—“long” meaning decades—of suffering with depression, anxiety, schizophrenia and addictions with appropriate evidence-based treatments. We strongly believe that making MAID available for mental disorders will facilitate unnecessary deaths in Canada and negatively impact suicide prevention efforts. The clinical role is to instill hope, not to lead patients toward death.

Dr. Sareen went on to say:

Unlike physical conditions that drive MAID requests, we do not understand the biological basis of mental disorders and addictions, but we know that they can resolve over time. The real discrimination and lack of equity is not providing care for people with mental disorders and addictions.

I could not agree more with the doctor.

We have a moral obligation in our society to ensure that every person is treated with the inherent dignity and value with which they are created, everyone. They do not get that when we offer them death instead of help and hope, treatment and care.

Psychiatrists and even the Prime Minister's so-called expert panel cannot know if someone is going to recover from mental illness, and this under a government where wait times for psychiatric treatment can be over half of a decade. If the government goes ahead with this, people who would have gotten better will not get the chance, because they will have been killed at the hand of the government.

Further, it is difficult for a clinician to distinguish between a rational request for medical assistance in dying where mental illness is the sole underlying medical condition and one motivated by suicidal ideation. On the question of suicidality, Dr. Sareen said:

...there is no clear operational definition differentiating between when someone is asking for MAID and when someone is asking for suicide when they're not dying. Internationally, this is the differentiation. If somebody is dying, then it can be considered MAID. When they're not dying, it is considered suicide.

On the same question, Dr. Tarek Rajji stated, “There is no clear way to separate suicidal ideation or a suicide plan from requests for MAID.”

With the line being blurred between suicidal ideation and so-called rational requests for medical assistance in dying, evidence from jurisdictions that have assisted suicide for mental disorders, both suicides and medically facilitated death go up.

We cannot move forward with this dangerous game that the government is playing, the plan of moving full steam ahead no matter what the cost. The minister said that the Liberals had the moral imperative to move ahead with an assisted suicide regime. Hopelessness and misery, that is their imperative. A moral imperative? It is immoral.

This is the same government that has degraded life in the country to the point where an entire generation of people is giving up hope. Two million Canadians are lined up at food banks a month and once former middle-class families are living in their cars. People are being offered MAID instead of a wheelchair, after serving our country and going to veterans affairs for help. People are being offered MAID at routine doctor appointments. People are seeking MAID because they cannot afford housing. People are seeking MAID because they cannot get the psychiatric care they need. This is blind ideology ahead of evidence. It is death on demand for any reason.

Depression, anxiety, schizophrenia, personality disorders and addictions will all become justifications for death under the Liberal government if this plan is allowed to be carried forward. A new generation of addicts will have been created, by normalizing and legalizing opioids that are being peddled to our children. The MAID regime seems like it will become the government's plan for addictions. Rather than offering treatment and a chance to get better to people who are suffering, they are being offered death.

There is hope yet, if we pass this bill, that we could stop the expansion of MAID to people who are suffering. We can make a commitment, as the representatives of Canadians, to deliver on the health, help, hope and treatment that Canadians deserve, that every human person deserves. Dignity, respect, hope and life, that is what we are going to have to vote to protect.

I am proud to stand and vote in support of life.

[Chandra Arya, Liberal, Nepean, ON]

Madam Speaker, as an advanced democratic country, Canada sometimes brings in legislation on issues that have never been dealt with before. Sometimes Canada is one of the first countries in the world to deal with these types of issues.

When we bring in legislation that fundamentally affects every single Canadian, sometimes we have to look at it again to see how we can serve Canadians, whether we are stepping on the toes of the fundamental rights of Canadians.

Earlier the hon. member for Abbotsford said that there was no national consensus. I would like to ask the member whether he agrees with me that due to the different religious beliefs, different religious faiths and philosophies, we cannot have national unanimity on issues like this.

[Michael Barrett, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

Madam Speaker, I do not believe that this is a question of religion. I think it is simply a question of humanity and how we care for the most vulnerable among us. This is an imperative that we have as parliamentarians. Ensuring that we care for the least of us, those who are most in need of our help, is the highest calling we can answer. To allow MAID for folks whose only medical condition is mental illness would be an abdication of that. Allowing state-sanctioned death, or doctor-assisted suicide in that case, is an abdication of our responsibilities to the most vulnerable, regardless of one's beliefs or creed.

[Simon-Pierre Savard-Tremblay, Bloc, Saint-Hyacinthe—Bagot, QC]

Madam Speaker, Voltaire said that fanaticism pretends to be the child of religion.

I think we have proof of that again today, unfortunately. Our colleague stated the Conservatives' position on freedom of choice, on medical assistance in dying and on providing relief to people who are suffering. The Conservatives want to abolish medical assistance in dying. That is what we just heard.

The Liberals claim their position is different, but I cannot tell the difference. They are going to put the decision off for three years, but by then, the Conservatives will be in power and can decide to abolish it. Then there is the NDP, which is applauding that.

Is the real coalition basically just the Ottawa coalition?

[Michael Barrett, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

Madam Speaker, we have an epidemic in this country of people who are suffering from addiction. We have people who are suffering from mental illness. I am not going to be shamed by anyone who wants to call me a fanatic for saying that we need to protect the vulnerable.

If there are members in this place, and I abhor the thought, who would rather have the government kill people than give them the treatment they deserve, have it abandon its responsibility, then I genuinely hope we do not elect anyone to this place who represents Canadians who believe that. I certainly do not. I believe in helping the most in need.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

The member for Saint-Hyacinthe—Bagot on a point of order.

[Simon-Pierre Savard-Tremblay, Bloc, Saint-Hyacinthe—Bagot, QC]

Madam Speaker, I will not stand for anyone saying that I am telling the government to kill people. I demand an immediate apology.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

That is a point of debate.

The hon. member for Saint-Hyacinthe—Bagot on another point of order.

[Simon-Pierre Savard-Tremblay, Bloc, Saint-Hyacinthe—Bagot, QC]

Madam Speaker, it is not a point of debate. Words have meaning. Saying that I am encouraging the government to kill people has no place in a debate. The member can say he disagrees with me, but he cannot say that.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I will check the record and get back to the House if necessary.

The hon. member for Timmins—James Bay.

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

Madam Speaker, I would challenge the member. The government is not killing people, but it is failing to put in place protections for people. There is a difference, and our language does matter, but we need to have a strong support for everyone. To simply say that people are being killed does not help our conversation. I would ask my colleague to reflect on that.

[Michael Barrett, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

Madam Speaker, through action or inaction, the result is the same. By failing to help the vulnerable, by failing to offer those supports, we are condemning those people. The government is condemning those people to death. To take a positive action and offer them suicide in place of help and treatment, well, we can take a look at a thesaurus and decide whether or not that is to be described as the government killing them, but it is not reaching out a hand in help, and that is exactly what government should do.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I am still looking into what was said a while ago, but I do want to remind members to be very careful with some of the wording they are using because it is not quite proper to be using that type of language in the House.

Resuming debate, the hon. member for Joliette has the floor.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Speaker, I would first like to ask for unanimous consent to share my time with my colleague and friend, the member for Montcalm, who is a leading expert on this subject.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Does the hon. member have unanimous consent to share his time?

[Some hon. members]

Agreed.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Speaker, medical assistance in dying is a topic as crucial as it is sensitive. By choosing to delay debate for three years, the Liberal government is aligning itself with the Conservatives, with the blessing of the NDP, to ensure this debate will never happen again. That is highly irresponsible.

The Bloc Québécois was in favour of a one-year delay, but three years pushes it to after the next election. In other words, we will not be discussing this issue for a very long time. Meanwhile, Quebec has passed a law that allows advance requests. Specifically, it covers people suffering from neurodegenerative diseases such as Alzheimer’s and Parkinson’s. However, Quebec’s law is blocked until the Criminal Code is amended by the House. The entire National Assembly of Quebec has asked Ottawa to amend the Criminal Code accordingly. Although the Quebec law allows advance requests, the Criminal Code does not. This leaves doctors open to prosecution.

That is why we presented an amendment addressing this issue. Again, the Liberal government, the Conservatives and the New Democrats chose to oppose it. Again, Quebeckers are reminded that we cannot decide for ourselves, even when there is consensus, and that our neighbour will decide for us. Furthermore, the government did all this by imposing a super gag order, with the NDP's support. It wanted to muzzle the House and put off debate well into the future while rejecting Quebec’s unanimous request. So much for democracy here.

Here we are reviewing a bill that seeks to delay choices involving mental disorders and that says nothing about neurodegenerative diseases and advance requests, unlike Quebec’s law. All this is happening three years after Bill C-7 was passed. Regardless of what other parties choose to do, we continue and will continue to ask that the Criminal Code be aligned with Quebec’s Act Respecting End-of-Life Care by allowing advance requests.

Can I ask for a bit more compassion in the House? Is it so complicated to change the Criminal Code to give effect to the Quebec law with respect to advance requests for people suffering from serious and incurable neurocognitive disorders?

In an attempt to convince my colleagues of the importance of Quebec's request and the urgency of the issue, I would like to read a very moving letter sent by one of my constituents. She talks about what her mom, Jacinthe Arnault, went through. Here is what the letter says:

At age 56, my mother, Jacinthe Arnaud, a clinical nurse, was diagnosed with early-onset Alzheimer's. Nothing in her family history could have predicted that this huge black cloud would darken the rest of her life. The second thing she told me in 2019 after being diagnosed was:

“Promise me you won't let me die in a long-term care home. Promise me, Cath, that you'll let me go with dignity.” Back then, the MAID legislation did not allow for people with cognitive impairments to access this type of care.

I scrambled to learn about the subject, to talk with MPs, to contribute to the improvement of the legislation at the National Assembly and to get informed about what was being done in other countries. What I found was that we were in a dead end—even if my mother repeated her request week after week, I could not see how I could grant her the end she was hoping for. In 2021, when the “imminent death” requirement was taken out of the legislation, there was a glimmer of hope. Fortunately—or unfortunately—my mother wasn't 100% aware of her condition and wasn't ready to let us go and choose to die, at the risk of losing her chance to die with dignity.

The disease progressed very quickly, much faster than the legislative work to expand MAID. In early 2022, we had to watch over my mother almost constantly as her cognitive abilities, her memory and even her motor skills became more and more impaired. She still had enough clear-mindedness to ask her geriatrician for MAID. We started the procedure. It was very stressful not to know whether my mom would change her mind right until the very end, not because she didn't want MAID anymore, but because the disease would have made her unable to understand her condition and where she was headed.

Do you know that the legislation imposes a 90-day waiting time before MAID can be granted to patients with cognitive impairments? As a nurse myself, and seeing my mother get worse and worse every day, I could not see how she would still have a clear mind after 90 days. After several discussions with the prescribing physician, we were able to move up the date.

Why was my mother's credibility called into question? Why do patients with cognitive impairments have to wait before receiving MAID, but not patients with other incurable diseases? Requesting in advance to die with dignity is a very personal and legitimate choice, according to my mother and me. It is a decision that should, in a perfect world, be made quickly after diagnoses of this nature. Considering that neurodegenerative diseases evolve very differently from one patient to the next, wouldn't it be logical to allow these patients to request a dignified death in advance?

Not knowing if she would be allowed to die put my mother under incredible stress. And let me tell you, as a mother of two young children, I too was under a tremendous amount of stress, not knowing if my mother would pass away or if I would have to institutionalize her within a few months, which would have been a very difficult choice to make, considering the wishes she had so forcefully expressed.

During the last years of her career, my mother worked in the hemodialysis department at the Joliette hospital. She wanted to keep helping others. On May 4, 2022, she died in an operating room at the Joliette hospital, with her by her loved ones at her side. She saved three people. Both of her kidneys and her lungs live on somewhere in Canada. We're extremely proud of that.

I'm so proud of her and of us.

I wish with all my heart that ADVANCE requests for MAID were allowed. All these people who are sick now and who would like to die with dignity are depending on the legislation to be changed quickly.

Best wishes,

Catherine Joly

I thank Ms. Joly for her letter from the bottom of my heart. I agree with her, because I also hope with all my heart that advance requests for MAID will become an option. As she says, it is a matter of dignity. As she points out, everything depends on how quickly the legislation can be changed. Quebec has changed its legislation. The one step left is to harmonize it with the Criminal Code.

I sincerely hope that Ms. Joly's words have helped convince my colleagues about how important it is to make this change and make it quickly. I thank her.

[Chandra Arya, Liberal, Nepean, ON]

Madam Speaker, Canada is one of the most advanced democracies in the world. That is why we bring in legislation, some of which is quite unique. In Canadian history, over all 155 years, this is the first time legislation like this has been brought forward.

Whenever we bring forward legislation that fundamentally affects every single Canadian's life, is it not important that we relook at it, modify it if required, take a pause, check to make sure everything is okay and patiently advance it instead of rushing it through? I would like the hon. member's views on that.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Speaker, I would like to say two things. First, there is unanimous consensus in Quebec. All parties in the Quebec National Assembly voted to pass a law, but it has no force or effect because it is being blocked. Quebec is asking that its law be aligned with the Criminal Code so it can come into effect in Quebec alone. That is what we are asking. It is not complicated. The government tells us this is very important, but it chose to do nothing and kick it down the road, even though we need to act quickly.

Second, the decision to delay all debate in the House for three years brings us to after the election. Projections indicate that the Liberals will not form a majority government. In all likelihood we will never discuss this again, we will never come back to this debate. I think that is irresponsible.

We first dealt with Bill C-7 in 2021. That is already three years ago. What has the government done in three years? It came up with the current bill, which says they will ensure the debate will never be over. We think that is irresponsible. I beg the government to at least try to harmonize the Criminal Code with the unanimous will of Quebec. It is a matter of dignity. My society and my nation are ready. However, they are being blocked by their neighbour, who is choosing not to act. I am asking them to act.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Madam Speaker, the hon. member read a letter from a constituent. Conservatives also receive letters that speak in a different way about the dignity they look for and how they want their lives to be treated based on MAID and the new law that will be put in place.

If the hon. member's emphasis is on the humanitarian and compassionate side of this, would it not apply to every Canadian rather than just narrowing it to Quebec? I understand and respect that he represents a Quebec riding, but we need to look at something that applies to all Canadians. I think that is the purpose behind what we are debating today.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Speaker, from my perspective and that of my party, the substance of Bill C-62 is to ensure that we never discuss this again. By choosing to extend the exclusion by three years, there could well be a Conservative government─possibly a majority government─in power. I would be amazed if that government chose to follow up and move in the same direction.

Let me remind my hon. colleague that Canada is a federation that includes several nations. The Quebec nation has a unanimous position on advance requests but cannot implement it because the federal government refuses to amend the Criminal Code.

We understand that the rest of Canada may have other debates. That is the idea of a federation, to bridge different cultures and perspectives. There is unanimity in Quebec. We are not asking for a unilateral approach or for the Quebec model to apply from coast to coast, but for Ottawa to stop blocking what Quebec has unanimously decided.

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

Madam Speaker, I simply want to remind my colleague that, yesterday, I voted in favour of the amendment for advance requests because there is a political and social consensus in Quebec society. I think that the message for the federal government is to find a compromise and a solution so as not to prevent Quebec from moving forward.

However, we must also not block the bill, because there is no medical or scientific consensus on the issue of mental health as the sole underlying condition. I think that it is important to meet the March 17 deadline and to ensure that we can reflect together on this issue because there is no medical or scientific consensus.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Speaker, I recognize that the member voted with the Bloc Québécois for advance requests, but I deplore the fact that he was the only one from his party to do so. This demonstrates the rift that exists between Quebec and the rest of Canada on this issue. It is deplorable. I deplore the fact that the member could not convince his entire caucus to vote with us.

I recognize the importance of taking the time to talk about such important issues. However, we have been at this for three years, and the government has not done anything.

Extending the deadline by three years is a hypocritical way of ensuring that we never talk about it again, because that takes us past the next election. It is irresponsible.