Debates of Feb. 15th, 2024

Criminal Code

[Gerald Soroka, Conservative, Yellowhead, AB]

Mr. Speaker, I have to admit that this has been one of my big things. Even when I was a mayor, I talked about the mental health of Canadians.

We can solve a lot of societal problems if we have a better handle on mental health. In order to do that, we have to fund appropriately and properly. One of the big challenges, when we start looking at mental health, is that it is probably going to take at least a 20-year period before we start seeing some real benefits to society. Unfortunately, governments are only elected every four years; therefore, they are not willing to put in the real money that is needed. They often use a band-aid approach.

We need to start looking at a long-range plan to enhance and assist our mental health in Canada.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, we often hear the argument that investments must be made in mental health to prevent mental illness and severe mental disorders.

I did not hear his leader say that he was going to put more on the table in terms of health transfers. Will the Conservatives propose a substantial increase in health transfers?

[Gerald Soroka, Conservative, Yellowhead, AB]

Mr. Speaker, there is a big misconception in this House about the opposition. We are not going to come forward and start laying out our plan for the next election, as to everything we are going to do.

Believe it or not, the Liberals would steal everything we are proposing. That is why, I have to admit, we are not going to lay everything out.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, if I understand this correctly, from what I just heard, the most important thing for this member is political opportunity and gain, not to advance the best interests of Canadians.

I have news for that member. He was not elected to come here and spend—

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, I rise on a point of order. The member opposite is, of course, breaking a number of rules all at once, as he does. He is far afield of the topic, number one. Number two—

[The Deputy Speaker, Conservative, Chris d'Entremont]

That sounds like debate.

The hon. member for Kingston and the Islands.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, he was not elected to come here and then develop plans for four years to run on four years later. He was elected by his constituents to come here and try to put forward policies to make their lives better.

The idea, when members are in opposition, is not to just stay there and do absolutely nothing, hoping that they get a turn to be on this side of the House. What they need to do is actually start trying to influence policy and make it better.

Can the member not understand that?

[Gerald Soroka, Conservative, Yellowhead, AB]

Mr. Speaker, that very delusional member does not understand what the role of the government is. It is to make sure that the government provides what Canadians need and want.

Unfortunately, Canadians are finding that the Liberal government is failing on so many fronts. That is why the member is being desperate tonight and is trying to say that it is our problem, not theirs. Members can trust me: When we form government, we will fix a lot of the issues that the Liberal government has put upon Canadians. During our election, we will allow everything to come out in our platform. I look forward to releasing that when there is an election in the future.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Mr. Speaker, I for one cannot wait for the next election. I hope it comes sooner rather than later.

On the important subject here, with respect to the postponement of this legislation, postponing medical assistance in dying for mental health-related issues for three years, does the member believe that it should be stopped permanently?

[Gerald Soroka, Conservative, Yellowhead, AB]

Mr. Speaker, there is a very big concern when we are dealing with mental health. How do we determine that someone who has a mental health condition is in a stable mental health state and make sure they understand everything they are doing? This is not like someone going to buy a vehicle who is not sure they really like the colour or whatever else. This is something that is irremediable.

Definitely, we need to reexamine this and make sure we have a logical approach to mental health.

[Marc Dalton, Conservative, Pitt Meadows—Maple Ridge, BC]

Mr. Speaker, today's debate concerns extending the pause for assisted death for people with mental illness and disabilities as the sole underlying condition. The Liberals' original bill last year included this expansion. However, public and professional backlash toward their measures caused them to hold back for one year. That deadline is fast approaching. The one-year extension expires in March, at which time MAID will be accessible to very vulnerable people unless there is a change in legislation.

This expansion is terrible legislation for Canadians, but it is on par for the Liberal-NDP government. As someone who has taught Canadian history, I am sorry to say that I cannot think of a worse government in Canadian history.

Why does the Liberal government pursue such harmful policies across the board? The Liberal environmental plan is a war against our natural resource sector, which is the foundation of Canadians' wealth and prosperity and provides the finances for health care, infrastructure and services that are important to Canadians. The Liberal catch-and-release policies have unleashed crime and chaos in our cities. Their soft-on-drugs approach has resulted in 40,000 overdose deaths. Record numbers of people died last year in B.C., some of whom I knew.

However, today we are debating Canada’s MAID regime under the Liberals and NDP. The number of people who died from MAID in 2022 amounts to 4.1% of all deaths in Canada. Canada is second only to the Netherlands, which implemented MAID in 2002. Euthanasia became legal in Canada in 2016.

Compare the number of Canadians who died by MAID in 2022, the last statistic I am aware of, which is 13,241 people, with the number in California, which has a population similar to Canada's of 40 million, and which implemented MAID in 2016 also. They had 853 deaths. That is quite a discrepancy. Is that because suddenly, or maybe not so suddenly, the government has been promoting it?

I think of Canadian Forces veteran, Christine Gauthier, a five-time world champion at the paralympics, who testified that when she requested help from the Department of Veterans Affairs, she was offered MAID. They wrote a letter to her, saying that if she was so desperate for help, they could offer her MAID. I think that is disgraceful and incomprehensible. Six other veterans that we are aware of were also offered medically assisted death. Those are the ones we know of.

It is easier in Canada to get MAID than it is to get palliative care. That is disgraceful. It is easier to get MAID in Canada, and the wait time is less, than to get psychiatric help. That is disgraceful. It is easier to get MAID than to get supports. Andrew Robbins from Hamilton told The Globe and Mail that he was seeking medically assisted death to escape the cycle of poverty and health problems. Under the NDP-Liberal government everything is getting more expensive. People are struggling to pay their rent, pay for gas and pay for groceries. He stated, “I know one thing. I would be better off dead than on the streets. My wife would be better off too.” That is a shame.

The bill before us delays the implementation of MAID being extended to people with mental illness and those with disabilities who are not facing imminent death.

Over 200 organizations representing persons with disabilities across Canada actively opposed and urged the government to appeal this decision. Not a single national disabilities rights organization expressed support for the repeal of RFND, or reasonably foreseeable natural death. They say that MAID for people with disabilities stigmatizes and dehumanizes persons with disabilities and the international human rights obligations. United Nations representatives also agree.

This legislation is so contrary to what our country has stood for. I think of B.C. native Rick Hansen, a paraplegic who did the Man in Motion World Tour in a wheelchair. His message is, “You can do it. You can be productive in spite of your disabilities. You can enjoy a full life despite these challenges.”

Terry Fox, also from British Columbia, lost his leg to cancer. He decided to run across Canada for cancer research. He had to stop in Thunder Bay, because the cancer had returned, but still the Terry Fox Run continues and has raised hundreds of millions of dollars. He is a national hero. He is an inspiration not to give up.

Then there is Nicholas James Vujicic. He is not a Canadian, but he was born with a rare disease and without arms and legs. He has only a six-inch foot coming out of his torso. He founded an organization called Life Without Limbs. He has spoken to millions of people and is very inspirational, saying that no matter our circumstances, we have something to give and to live for in helping others.

This is the message we should be promoting, especially to people who have become disabled.

I am disturbed that the Liberals merely want to postpone this legislation, which would open wide the door for people still struggling with mental illnesses to access medically assisted death.

The chairs of psychiatry for all of Canada's 17 medical schools called on the Liberals to hold off. They say it is extremely difficult to predict whether a person will get better or will recover, as my colleague mentioned, and that physicians get it wrong 50% of the time. As my colleague from St. Albert—Edmonton said, it is like flipping a coin with people's lives.

Suicidal thoughts are often a symptom of mental disorders, and it is hard to distinguish between the two. People can get better with supports, and a great many do.

In the early 1980s, I went through a clinical depression. It was a very dark and painful time, and suicidal thoughts bombarded me. I had medical care, and I had friends with me, and I totally recovered. Now it is only a distant memory, and all the pain, all the despair and all the darkness have faded, so there is hope.

Most people with opioid addictions also struggle with mental illness. Is this the direction the government is prepared to take us in? It seems sinister. Liberals and the NDP provide addicts free hard drugs. There is a high likelihood that this will kill them sooner or later, as we are seeing from statistics, but if they do not like their life as an addict, in three years, if we have a Liberal government, state-sanctioned suicide could be available to them.

Conservatives believe in supporting the most vulnerable. We believe in treatment and recovery and not safe injection sites. We believe in palliative care at the end of life and supports for our most vulnerable. The member for Cariboo—Prince George initiated the 811 suicide prevention line.

Finally, Conservatives believe that this bill, which would expand MAID to people with disabilities, needs to be struck down, because it could be brought back in three years.

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

Mr. Speaker, on a point of order, I would like to correct my hon. colleague. I note, in his zest for this intervention, he misread the number. It is not 811; it is 988.

[The Deputy Speaker, Conservative, Chris d'Entremont]

It is not a point of order, but it was a good clarification.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Mr. Speaker, it was not that long ago that “made in Canada” was a phrase we were proud of.

We have teenagers who, sometimes for the very first time in their lives, are encountering adversity. It is a psychological crisis to them. They react in such a way that they are actually trying to commit suicide. It is often said that an attempt at suicide is a cry for help. They end up in the hospital for a time.

We have seen, with veterans, how some of them who seem to be near the end of life have been encouraged to use MAID.

Is there anything in this legislation that would explicitly prevent medical workers from suggesting MAID to people who attempt suicide but thankfully are not deceased as a consequence of it?

[Marc Dalton, Conservative, Pitt Meadows—Maple Ridge, BC]

Mr. Speaker, it is quite unfortunate, but even under the old regime, there were many people who were not facing imminent death but still received MAID. I believe the Liberal member for Thunder Bay actually talked about some of the zealous doctors who prescribe it. I am aware that this has happened, so to the member's question, there is nothing that I am aware of that would prevent this.

The member talked about youth. I have family members who have gone through drug issues and mental health issues and have come out the other side and now are supporting people in a similar situation.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Mr. Speaker, I have had the same question through the whole debate today, and that is, as I have said before, that we all know that access to mental health supports varies by one's residence, by one's income and by one's ethnicity. People have trouble accessing mental health services.

Would the hon. member support making mental health services fully part of the Canada Health Act, so that we can equalize access to mental health services in the country?

[Marc Dalton, Conservative, Pitt Meadows—Maple Ridge, BC]

Mr. Speaker, we do not have the supports we need for people with mental health challenges.

The member mentioned ethnicities. I am indigenous. I am Métis. I know that a lot of indigenous, first nations and Métis groups are very concerned, because the number of suicide attempts among adults is at least double the rate in the rest of Canada's population. Among youth, it is six times higher.

It is a very vulnerable population, and this is a concern, especially for indigenous Canadians.

[Marty Morantz, Conservative, Charleswood—St. James—Assiniboia—Headingley, MB]

Mr. Speaker, this amendment was brought in by the Senate, the other place, in the first place. It was not in the original legislation. It came back here; the Liberals decided it was a good idea, and it got put through the House without any time limit. It was supposed to be law, and then they extended it for a year. They are now trying to extend it for three years. They are relying on the same people who brought in this idea of MAID for mental illness to postpone it for three years.

Does the member think that this is going to be an easy ride through the Senate, or are the senators who brought this in in the first place going to give it a hard ride?

[Marc Dalton, Conservative, Pitt Meadows—Maple Ridge, BC]

Mr. Speaker, that is a real concern, especially because we have a deadline in March to get it passed here and then through the Senate.

[Daniel Blaikie, NDP, Elmwood—Transcona, MB]

Mr. Speaker, given the March deadline and the potential for trouble in getting this expeditiously through the Senate, is the member glad that we are wrapping up debate in the House of Commons so quickly, so that we have time to try to get it done before the deadline?

[Marc Dalton, Conservative, Pitt Meadows—Maple Ridge, BC]

Mr. Speaker, I think it is an extremely important discussion. I know it is moving forward. It does need to go to the other chamber.

[The Deputy Speaker, Conservative, Chris d'Entremont]

It is my duty, pursuant to Standing Order 38, to inform the House that the questions to be raised tonight at the time of adjournment are as follows: the hon. member for Calgary Rocky Ridge, Automotive Industry; the hon. member for St. Albert—Edmonton, Public Services and Procurement; and the hon. member for Calgary Nose Hill, Carbon Pricing.

[Annie Koutrakis, Liberal, Parliamentary Secretary to the Minister of Tourism and Minister responsible for the Economic Development Agency of Canada for the Regions of Quebec]

Mr. Speaker, I would like to inform you that I will be sharing my time with the member for Lambton—Kent—Middlesex.

I am pleased to rise in the House today in support of Bill C‑62. The bill proposes to extend the temporary exclusion of mental illness as a an eligibility criteria for medical assistance in dying for three years, until March 17, 2027.

Today, I will speak to the importance of allowing some time before lifting this exclusion so that the provinces, territories and their health care partners can use it to better prepare for this critical stage in the evolution of medical assistance in dying, or MAID, as we call it in Canada.

The current legal framework for MAID is set out in the federal Criminal Code. However, the provinces and territories are responsible for delivering health care, which includes implementing MAID. Even before the original legislation authorizing MAID was added to the Criminal Code in 2016, we were working closely with the provinces and territories to support MAID's safe implementation. These important relationships are all built around the mutual goal of ensuring quality health care for Canadians.

The expert panel on MAID and mental illness and the Special Joint Committee on Medical Assistance in Dying both emphasized the importance of clear standards of practice and consistent implementation of guidelines across the country, training doctors and nurse practitioners, case review, vigilance in supporting best practices and confidence in the appropriate application of the law.

The provincial and territorial governments and their stakeholders, such as health professional organizations, regulatory bodies and practitioners, are actively planning to make people whose sole underlying medical condition is mental illness eligible for MAID.

As it has been recognized in all areas, significant progress has been made in that regard. However, the provinces and territories are dealing with different challenges within their jurisdictions. They are also at different stages when it comes to implementing these key elements and, consequently, in how prepared they are for the lifting of the exclusion.

For example, an independent task force of clinical, regulatory and legal experts has developed a model practice standard that physician and nursing regulatory bodies can adopt or adapt as part of the development or ongoing review of MAID standards. In addition to the model standard, the task force has also published a companion document entitled “Advice to the Profession”.

Practice standards are developed and adopted by bodies responsible for ensuring that specific groups of health care professionals operate within the highest standards of clinical practice and medical ethics. While some provincial and territorial regulatory bodies have successfully included MAID practice standards in their guidance documents for clinicians, others are still in the process of reviewing and updating their existing standards.

To facilitate the safe implementation of the MAID framework, Health Canada helped develop a nationally accredited bilingual maid curriculum to support a standardized pan-Canadian approach to care. The Canadian Association of MAID Assessors and Providers, known as CAMAP, has created a training program that has been recognized and accredited by the appropriate professional bodies.

The MAID curriculum uses a series of training modules to advise and support clinicians in assessing persons who request MAID, including those with mental illness or complex chronic conditions or who are impacted by any vulnerability.

To assist in the practical application of the legislative framework for medical assistance in dying, the curriculum will help achieve a safe and consistent approach to care across Canada. This will ensure that health care professionals have access to high-quality training on medical assistance in dying.

To date, more than 1,100 clinicians have registered for the program, which is impressive given that the program was only launched in August 2023. However, that is only a portion of the workforce. More time will make it possible for more doctors and nurse practitioners to sign up for and participate in the training so they can absorb the theory and put it into practice as professionals.

Let us talk a bit about the medical assistance in dying review and case study. In Canada, the medical and nursing professions have a self-regulating process. The above-mentioned provincial and territorial regulatory bodies are tasked with protecting the public with respect to all health care, and medical assistance in dying is no exception.

In addition to the existing health care practitioners' regulatory governing bodies, several provinces have established formal oversight mechanisms specific to MAID. In Ontario, for example, the chief coroner reviews every case of medical assistance in dying, as does Quebec's commission on end-of-life care. Both organizations have strict policies on when and what information must be provided by clinicians, and the Quebec commission publishes annual reports.

While provinces with formal MAID oversight processes account for over 90% of all MAID cases in Canada, other provinces do not have a formal MAID quality assurance and oversight process to complement the existing complaint-based oversight processes put in place by professional regulatory bodies. Work is planned to explore case review models to ensure oversight and best practices through a federal-provincial-territorial working group to support consistency across jurisdictions.

All the provinces and territories were united in their call to extend the exclusion in order to have more time to prepare their clinicians and their health care systems that also manage the requests having to do with mental illness, which also deserves having the necessary support measures implemented. The provincial and territorial governments need to ensure not only that the practitioners are trained in providing medical assistance in dying safely, but also that the necessary supports are accessible to clinicians and their patients throughout the entire assessment process.

The Special Joint Committee on Medical Assistance in Dying and the expert panel both underscored the importance of interdisciplinary engagement and knowledge of the available resources and treatments. Specialists and practitioners also expressed the need to bring in support mechanisms for providers conducting the assessments and the people who request medical assistance in dying, regardless of their eligibility.

Although some administrations have strong coordination services to manage requests and provide auxiliary services, others are taking a decentralized approach, which can result in less coordination between services and disciplines. The availability of the support services necessary for practitioners and patients also varies by region. For example, we heard about difficulties accessing health care services in general in rural and remote areas of the country. The additional delay will make it possible to better support the patients and clinicians involved in medical assistance in dying.

This government is committed to supporting and protecting Canadians with mental illness who may be vulnerable, while respecting their autonomy and personal choices.

We think that the three-year extension proposed in Bill C‑62 will give the time needed to work on these important aspects so that this can be implemented in a safe and secure way.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, I have a question for the government about its so-called “MAID policy”. Its members have said repeatedly, especially as it relates to mental health challenges, that their MAID policy would aim to exclude those who are suicidal, but I want to understand something from the government: Is not any person who requests MAID suicidal, simply by definition, since they are requesting MAID?

[Annie Koutrakis, Liberal, Vimy, QC]

Mr. Speaker, I think it is irresponsible and untrue, honestly, to claim that MAID has anything to do with suicide. The Government of Canada recognizes the importance for all Canadians to have access to critical mental health resources and suicide prevention services. I am a member of the special MAID committee, and not one witness I heard when I was there said that this is suicidal.