House of Commons Hansard #283 of the 44th Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was illness.

Topics

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12:30 p.m.

NDP

Lori Idlout NDP Nunavut, NU

Uqaqtittiji, I think that we all know that indigenous peoples have the fewest mental health resources. A huge part of that is because of Canada's colonial history.

One of the efforts we have been making is trying to get more indigenous healers and indigenous care workers incorporated into the non-insured health benefit system so they can be paid similarly to professionally or academically certified educated mental health professionals. I wonder whether the member agrees that making sure these workers are being funded as well would be a way of alleviating some of the pressures, and one of the better ways to make sure indigenous peoples are getting the mental health services they need.

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12:30 p.m.

Liberal

Chandra Arya Liberal Nepean, ON

Madam Speaker, I agree with the hon. member that rural and remote communities, including indigenous peoples, have difficulty accessing the quality health care that many of us in urban centres take for granted.

I also agree with the member that we need to look beyond the formal structure that is currently available in identifying the people with knowledge who can provide health care services. We should see whether we can bring people with the knowledge and expertise in traditional medicine or the various other knowledge systems available around the world into the system, where their knowledge and experience would be available not only to indigenous peoples but to all Canadians.

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12:35 p.m.

Conservative

Michael Cooper Conservative St. Albert—Edmonton, AB

Madam Speaker, I served on the special joint committee on MAID, and the overwhelming evidence from experts, including leading psychiatrists, is that there are fundamental political problems with MAID in cases where mental illness is the sole underlying condition. This includes the difficulty in predicting irremediability and in distinguishing a request that is rational from one motivated by suicidal ideation.

What evidence can the member cite to indicate that these fundamental political problems will be resolved in three short years?

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12:35 p.m.

Liberal

Chandra Arya Liberal Nepean, ON

Madam Speaker, especially on issues on which highly qualified experts and professionals are giving their opinions, sometimes it may not be possible for everyone in the room to agree on the right answer. That is why the government has invested in consultation. The bill did not come up on its own. It is not just an outcome of the thought process of some bureaucrats sitting in a government building here; it also includes a lot of consultations with Canadians, health care professionals and other experts. Their inputs have also been taken into consideration when formulating the legislation.

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February 15th, 2024 / 12:35 p.m.

Conservative

Michael Cooper Conservative St. Albert—Edmonton, AB

Madam Speaker, a survey released two weeks ago from the Ontario Psychiatric Association indicates that 78% of Ontario's psychiatrists oppose the expansion and do not believe that there are sufficient safeguards.

Can the hon. member speak to the government's decision not to add additional safeguards, and would he support additional legislative safeguards pursuant to the Criminal Code if in fact we move ahead with this in three years?

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12:35 p.m.

Liberal

Chandra Arya Liberal Nepean, ON

Madam Speaker, the short answer would be what I always say, which is that whenever we bring in legislation that fundamentally affects all Canadians, especially the kind of legislation that has never been thought of during the last 155 years, we need to take a real look at it, modify it and change it if required. I am sure there will be a time in the future when we can have a real look at the whole MAID legislation to see whether we can tweak it to better serve Canadians.

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12:35 p.m.

Conservative

Rob Moore Conservative Fundy Royal, NB

Madam Speaker, Canadians would be forgiven for thinking they have seen this movie before, because they have. It was only last year that we debated Bill C-39, which provided an extension of the coming into force of this dangerous legislation. Now we are debating Bill C-62, which was introduced two weeks ago thanks to consistent pressure from Conservatives, advocates, experts, organizations and individuals from across the country who want to help individuals live with mental illness, not help them end their lives.

How did we get here? We got here because we have a justice minister, a Prime Minister and a government that have ignored the science, the legal experts, the courts and the pleas of the most vulnerable. They have ignored Canadians. They have plowed ahead with legislation to expand medical assistance in dying to Canadians who deserve help, Canadians who are suffering from mental illness.

I do not need to tell the House about some of the shocking headlines we have seen over the last year. Veterans suffering with PTSD are being told by employees of Veterans Affairs that they could consider MAID. Individuals without housing are considering MAID for economic reasons. Individuals, as we heard at our justice committee when we studied Bill C-7, who did not wish to have MAID were consistently pressured to considered it.

On this side of the aisle, Conservatives have chosen the path of hope rather than harm, and we will continue to do so, but across the way, just this week, we heard a government minister say it is not a matter of if this expansion takes place; it is a matter of when.

I mentioned ignoring the law. When we were at the justice committee studying Bill C-7, we consistently heard the government say that we have to do this because the courts told us we have to. Nothing could be further from the truth. First of all, there was a court decision, which the government did not appeal. That decision in no way directed the full expansion of accessibility to MAID to those suffering from mental illness. In fact, it was not in the original legislation.

What happened with Bill C-7, which we studied at justice committee, in no way, shape or form involved expansion of MAID to those suffering from mental illness. However, when the bill got to the unelected Senate, it was amended to include this provision, which we had not even studied. The minister at the time assured us his bill was charter-compliant. The previous justice minister was at committee.

I am holding today a letter signed by 32 leading experts on the law, professors from faculties of law around the country. The letter says, “We disagree as law professors that providing access to MAID for persons whose sole underlying medical condition is mental illness,” which is what we are talking about today, “is constitutionally required, and that Carter...created or confirmed a constitutional right to suicide, as [the Minister of Justice] has repeatedly stated. Our Supreme Court has never confirmed that there is a broad constitutional right to obtain help with suicide via health-care provider ending-of-life.”

Those are powerful words. If I had time, I would read the names of the 32 professors who signed the letter. People would recognize many of them. They would certainly recognize the different universities they represent.

With the letter in hand, I said to the minister of justice, “Minister, you have come here saying that, constitutionally, you have to do this, but these 32 experts are saying you do not. Who is right, you or these experts?". The minister said, “I'm right.”

That is the attitude we have seen consistently with the government as it has plowed ahead in spite of the evidence, in spite of the concerns and in spite of the pleas from disability groups, mental health experts and psychiatrists.

I have a brief from the Society of Canadian Psychiatry, which makes a number of conclusions. I do not have time to read them all, but I want to touch on a couple of the conclusions:

At this time, it is impossible to predict in any legitimate way that mental illness in individual cases is irremediable. A significant number of individuals receiving MAID for sole mental illness would have improved and recovered.

This is a finding of the Society of Canadian Psychiatry. I have already spoken about this a bit, but even they can see this. They go on to say:

The political process leading to the planned expansion of MAID for mental illness has not followed a robust and fulsome process, has not reflected the range of opinions and evidence-based concerns on the issue, and has been selectively guided by expansion activists.

If that does not send a shiver down one's spine, I do not know what would. When we are talking about Canadians at their most vulnerable place, they should be able to count on us. How many of us participate in, for example, Bell Let's Talk Day every year? We say to people, if they are suffering with mental illness, to reach out, that we are here to help and that they should talk to someone they trust and access mental health support. Now, in spite of all this, we have psychiatrists saying the government is moving in the wrong direction.

I turn to their recommendations:

The Board of the Society of Canadian Psychiatry recommends that the planned 2024 MAID for mental illness expansion be paused—

It's not for a year, not for three years and not for five years, but:

—indefinitely, without qualification and presupposition that such implementation can safely be introduced at any arbitrary pre-determined date.

What are we led to believe when a government will not listen to legal experts when it comes to the criminal law and will not listen to psychiatrists when it comes to mental illness? It begs the question of who it is listening to and why.

This is the second time, and Conservatives have warned all along that there would be a dangerous, slippery slope. Canada has leapt ahead of all other nations. Some nations were ahead of the curve on this compared to Canada. Now they look at us and ask what happened that we would even be discussing providing assisted death to someone who comes to Veterans Affairs or to one of the number of hospitals across our country, looking for help, and instead is offered medical assistance in dying.

I want to set the record straight that the Liberal government has not, in any way, been bound by the courts to expand MAID to those whose sole underlying condition is mental illness. This was a path it chose to take. We need to take this time to reflect on that path, to turn back and to give people hope.

We all know individuals who have been touched by mental illness in the health care system. We know the wait times can be extraordinary for people to get help. We also know the government has contributed to those wait times. After eight years, people are suffering.

I would urge members to support this bill and then to look at ways to provide support for those suffering with mental illness, not to offer them assistance in death.

I move:

That the question be now put.

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12:45 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

The motion is in order.

Questions and comments, the hon. member for Timmins—James Bay.

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12:45 p.m.

NDP

Charlie Angus NDP Timmins—James Bay, ON

Madam Speaker, I want to follow up on something my colleague pointed out that people in Canada really need to understand.

Because the federal government failed to challenge the Truchon decision, the legislation came back to the House. Parliament went through it, and it was to be approved in the Senate, yet unaccountable, unelected people in the Senate who did no due diligence decided arbitrarily that they would expand MAID to include people who were desperate, isolated and alone with mental illness. They threw it back to the House without any work being done, and the Liberals accepted it. Now we are scrambling, 30 days away from the deadline.

I would ask my hon. colleague what it says about the fundamental failings of democracy that unelected, unaccountable people in the Senate, who cannot even be fired, could make such a profound change in legislation that would affect so many lives without any oversight, due to a failure of the government to say they are way over the line, this is not their purview and this is the work that Parliament does.

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12:50 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

It has happened a couple of times today that members of the Senate have been mentioned or adjectives have been used regarding the Senate. I want to remind members that the House rules say that no member shall use offensive words against either House or any member thereof. Members should be careful with the words they are using and not mention members from the other House directly, because they are not here to defend themselves.

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12:50 p.m.

NDP

Charlie Angus NDP Timmins—James Bay, ON

Madam Speaker, I am very concerned that you are rewriting rules in Parliament. Is the issue that I used the word “unelected”? Is that not parliamentary? Is “unaccountable” not parliamentary? It has been used in the House.

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12:50 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

We need to be very careful with the words we use. We should ensure that we are not causing disorder. The comments being made are on both sides of the House, and I would ask members to please be careful with the words they use.

The hon. member for Abbotsford.

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12:50 p.m.

Conservative

Ed Fast Conservative Abbotsford, BC

On the same point, Madam Speaker, I would ask that you get clarity on this and come back to the House. I do not believe the terms “unelected” and “unaccountable” are offensive. They are appropriate, because they reflect the fact that the Senate is not elected.

If it is a matter of naming senators, that may be a different issue, but using terms that most of us would acknowledge accurately reflect what the Senate represents is fair, especially in this chamber, where we are supposed to be free to express our thoughts and feelings about the issues of the day.

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12:50 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

I will read part of the ruling that was given in the House not that long ago. House of Commons Procedure and Practice, third edition, has the following, on page 620:

Although the Chair has been known to show considerable leeway at times in recent years, it is generally understood that disrespectful reflections on Parliament as a whole, or on the House or the Senate individually, are not permitted...and it is out of order to question a Senator’s integrity

I would again ask members to please be mindful of that.

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12:50 p.m.

NDP

Charlie Angus NDP Timmins—James Bay, ON

Madam Speaker, I would ask you to review the debates today, which I think have been very respectful. You mentioned disorder. Did anyone speaking about unelected or unaccountable senators cause disorder where it was raised?

You are putting yourself in a discussion where I think there has been very respectful conversation. Talking about the fundamental problem with the other House is germane to the issue at hand. It is why we are here today. It is why this debate has to happen. If we cannot talk about that, then we are not doing our job for Canadians.

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12:50 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

I appreciate the additional input. I will certainly look further into this and get back to the House, if need be.

Earlier today the hon. member used some adjectives that were not becoming of the language that should be used when it comes to specific senators, so I would ask him and all members to please refrain from doing so.

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12:50 p.m.

Conservative

Dan Albas Conservative Central Okanagan—Similkameen—Nicola, BC

Madam Speaker, I listened to our critic for justice. He has done yeoman service on committee and in this place on this subject, and I know it is very dear to him—

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12:50 p.m.

NDP

Carol Hughes NDP Algoma—Manitoulin—Kapuskasing, ON

The hon. member for Timmins—James Bay is rising on a point of order.

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12:50 p.m.

NDP

Charlie Angus NDP Timmins—James Bay, ON

Madam Speaker, I asked a question. I think I should be allowed to have an answer, even if I mentioned unelected and unaccountable senators. I should not be denied an answer from my colleague.

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12:55 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

I apologize for that. I jumped one step there.

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12:55 p.m.

Conservative

Rob Moore Conservative Fundy Royal, NB

Madam Speaker, my hon. colleague is quite right. The government and the minister have been all too eager to lose. When they had a constitutional responsibility to defend their laws, they did not appeal decisions that would protect vulnerable Canadians, and when the then minister appeared at the justice committee on Bill C-7, which expanded medical assistance in dying, he assured us it was quite constitutional. Then, the next day, he was back, assuring us that without the expansion to those suffering from mental illness, it would be unconstitutional, so this was a minister who was all too eager to lead his government, and the government members did not stand up and push back.

Now we are in the situation we are in. We have already extended the coming into force for a year, and now we are debating a bill to extend it by three years. That is a clear indication that the government got it wrong, and we are going to do what needs to be done to protect Canadians.

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12:55 p.m.

Conservative

Dan Albas Conservative Central Okanagan—Similkameen—Nicola, BC

Madam Speaker, the member in his speech today questioned the government's judgment on a lot of these issues. As a long-standing member of this place, I was hoping he would comment a bit further, because it seems to me that the Liberal government in particular somehow believes that if we create a law that changes the way institutions such as our health care system work, and there are not sufficient practical resources or understanding of those changes in law, it has very real repercussions.

I fully supported the bill from my colleague from Abbotsford, because I believe this is an issue that we need some finality on.

Could the member maybe comment on those two items?

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12:55 p.m.

Conservative

Rob Moore Conservative Fundy Royal, NB

Madam Speaker, my colleague is quite right. With Bill C-7, but for the passage of Bill C-62, the impact would be profound on our health care system, on individuals suffering with mental illness and on the message we send Canadians suffering with mental illness. I can say only that the government has moved forward in this dangerous direction while ignoring at every turn the advice of experts, including, as I quoted extensively, the Society of Canadian Psychiatry, medical experts and legal experts, about the merits of moving forward. It is our job to debate these things, to consider them and to hear from experts. Unfortunately, because the government dropped the ball, it is up to us to pass the legislation before us to protect Canadians suffering with mental illness.

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12:55 p.m.

Conservative

Tom Kmiec Conservative Calgary Shepard, AB

Madam Speaker, I am glad to be joining debate on Bill C-62. Off the top, I will mention that I will be voting for it. Like the shadow minister for justice on the Conservative side said, this is about protecting the vulnerable. Though the federal government has dropped the ball in this latest iteration of its legislation, these three years, I hope, will be taken to basically fix the mistakes that were made all the way back to Bill C-14. I want to talk a little about what brought us to this moment, and then refer to some constituents of mine who have emailed me over the last few months on the issue of assisted suicide.

I will also mention that I am sharing my time with the member for Mission—Matsqui—Fraser Canyon. I am sure he will add more to this debate.

To go back to the beginning, not too far to the beginning because I could get into Genesis, the Carter decision is what kicked off multiple debates that I have now been a part of. I have now seen this debate go from Bill C-14 to Bill C-7 to Bill C-62, and the attempts by my hon. colleague from Abbotsford, who, I think, tried to do right by vulnerable Canadians all across Canada to make sure that we would not see an expansion of the MAID provisions to those who are still suffering with mental health conditions.

The great thing about Hansard is that I was able to go all the way back and review what I had said on Bill C-14. I spent quite a bit of time complaining that the reasonably foreseeable clause would be knocked down by a court. It was knocked down by a court in the Truchon decision, because all our deaths are reasonably foreseeable; that is what living is all about. At the time, I had said that all of us who are born are born with one foot in our grave. One is assured one will die; one does not know just what it is, but it is reasonably foreseeable. I am just repeating it now. I know that it is morbid, but it is the truth. A lot of what we are dealing with here are issues of life and death and how one's death will happen. Therefore, at the time, this reasonably foreseeable clause would get knocked down, and it was knocked down in the Truchon decision.

My issues, just generally, are that, in a perfect world, this would not be necessary because people would not suffer. However, because this world is not perfect, people do suffer. People suffer in deep and different ways. Members know that I had a disabled daughter who passed away a few years ago. Had she lived longer, and I know at least one little girl in Calgary who has lived much longer with the same conditions my daughter had, she would be one of those vulnerable Canadians who would be facing the possibility that her physician, her specialist, might push for and might offer MAID.

I say “offer MAID”, but it seems so weird to say “offer MAID”, to offer something that I do not consider to be a medical service and to rush one's death sooner. Although we all die, as I said many Parliaments ago, the act of dying is not one that one does alone; it is done as a family, as a group of friends and with those loved ones around.

It is not something that happens in solitude. There are others who will miss one when one is gone. I know that it is difficult in a moment of suffering and a moment of great pain, or chronic pain, to believe it, to know it. A lot of the emails, the correspondence and the meetings I have had were with people who are worried about the assisted suicide MAID provisions, which the government has ineffectually dealt with through successive pieces of legislation. I think it was a grave error not to appeal the Truchon decision. I really do. I think it was a mistake. I said it to constituents at the time.

I have a Yiddish proverb, because I always do. They are great proverbs, and everybody should live by them and should know more of them. I just wish I could pronounce them in Yiddish: The truth never dies, but it is made to live as a beggar. This legislation is a beggar. This legislation should have been a permanent fix to the issues.

I think that Conservatives have suggested, both in committee and outside of committee, what some of those fixes would be. Although I disagree with an acronym, I will use RFND, reasonably foreseeable natural death. It should be limited to those who are terminally ill, where their death is foreseeable within the next six months, where there is a prognosis from a medical professional saying that one will indeed pass away.

For those most terrible conditions, I am thinking of a lot of cancers. My grandfather passed away from brain cancer in Canada, which brought my family to Canada. His death was very much reasonably foreseeable when it was terminal. There are others who have mental health conditions, which are caused by a physical condition. The mental health condition alone should not be the reason to seek assisted suicide.

Different Conservatives have mentioned, and I very much agree with this, that patients should be the ones requesting it. These are all things the government could have legislated into law. These are things that experts have said, and I want to read some of what the experts said in different committees.

Professor Trudo Lemmens and Mary Shariff persuasively rebutted a bunch of arguments that were made in Truchon. They noted again that reasonably foreseeable natural death applied to “all” persons, “not only to persons with disabilities”. “The judge in Truchon failed to appreciate how such a restriction reflects a constitutional duty to protect the equal value of the lives of all Canadians.”

I have read the Carter decision twice now. As many in the House know, this is something I take pride in saying that I am not a lawyer. I am not burdened with a legal education. I know the member for Fundy Royal is disappointed and that the member for St. Albert—Edmonton will be disappointed too, so I come to this as a layperson. Even the Carter decision did not say he had a right to die. It goes back to this idea, like I have said, that all of our deaths are reasonably foreseeable. It will happen; it is unavoidable in life.

These two experts said that the judge in Truchon made a mistake. This concept, this expertise, was then repeated in observations made by 72 disability rights organizations that penned a letter to the then justice minister. They said that reasonably foreseeable natural deaths are the ones where there is terminal illness that is coming up very quickly, and that this idea is an equalizing effect, guaranteeing a common thread among persons accessing MAID, assisted suicide, namely that they are dying within a very short time window. That is how I think this legislation should work. I am not saying there should be no MAID.

The Carter decision stands as a Supreme Court decision in Canada, so there has to be a provision of it in a method. It should be rare and should be restricted to the very few people for whom it was originally intended. I feel that Bill C-14 to Bill C-7 to the situation we are in today do not address that. That is why we have this legislation that is a beggar. It is not in the original form that it should be. The truth lies in abiding by what Carter decided.

Another one reads, “From a disability rights perspective, there is a grave concern that, if assisted dying is made available...regardless of whether they are close to death, a social assumption might follow (or be subtly reinforced) that it is better to be dead than to live with a disability.” That is a terrible message to send to persons with disabilities. I am thinking of my daughter, had she lived. That would have been a terrible message to send to her.

All three of my living kids have a chronic kidney condition. My boys will likely need a kidney transplants. What a terrible thing to tell them, that they are a burden on the medical situation and that maybe they should seek faster death. Is that what specialists are going to tell them when they are adults? I will not be in the room, but they will be in the room. Will that be pushed onto them? For those who are on dialysis, it is hard on their bodies to go three to four days a week to get dialysis in a hospital setting. I am not speaking of peritoneal dialysis that can be done in the home.

There have been lots of experts. The member for Fundy Royal explained a lot of what has been said on the issue. The government keeps erring in the wrong direction with more expansive legislation to allow more people to access something that was not the original intention of Carter. We should abide by Carter, as I mentioned before.

I have had constituents write to me. I just want to make sure that I read some of their thoughts into the record. Leanna wrote, “Please Halt the expansion of MAID to include those facing mental illness.” Catherine wrote, “As a parent who has seen my own children experience mental health challenges while in their teen years and early twenties, I am writing to express my deep concern about people with mental illness alone becoming eligible for medical assistance in dying. The move towards this will put countless vulnerable people at risk.”

Joe, in my riding, is a regular writer. I respond to most of his emails. I will send this to Joe just to make sure he knows I read his emails. His second and third points read, “By offering MAID for mental illness governments may put less money into treating mental illness.... Canadians may wish for MAID because of despair. They have not have been offered treatment for their mental illness.”

Cameron talked about a friend of his who is a nurse working in a mental health unit in Calgary. Mental health for him is all about seeing the intrinsic value of every human being, as celebrating the person not for what they contribute but for the beauty of their existence. He feels that once we stop seeing the dignity of one person, we will doubt our own worth and validity.

I know my time is running short, so I will not belabour this. I have heard comments from some members of the House who have tried to impugn a person's faith, religion or philosophical affiliations with whatever beliefs; although, all of us come to the House with our different beliefs. Some of them are sacred. Some of them are secular. It really does not matter where they come from, but all of us try to ascribe value to life, what that life is and what autonomy should be like.

To those members, I note that I did abstain from one vote that was specifically on advance directives because I have a constituent, Jim, who communicated with me over email that he and his spouse saw the experience of his mother, who passed away from Alzheimer's, and how terrible it was. In situations like that, it is incumbent upon the government to find a way to meet the requirements of the original Carter decision so that Jim and his spouse, when that time comes, can have their wishes met.

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1:05 p.m.

Liberal

Francis Scarpaleggia Liberal Lac-Saint-Louis, QC

Mr. Speaker, in issues like this, there is always this tension between the right of the individual and the impacts that individual has on the “culture”, for lack of a better word, and on others in the society when exercising that right. This was brought up by one of the psychiatrists who appeared before the committee when he said that one of the concerns he has with MDSUMC is a possible contagion effect. I do not know if courts would actually consider this because it is so difficult to prove. Anyway, it is just something I think about a lot, and I wonder whether the member has any thoughts on that.