Mr. Speaker, it is always an honour to stand in this House and speak for the constituents of Bow River. This is a deeply held and personal issue for so many people across the country. I am often skeptical of government intervention in the economy, on the farm and in the private lives of Canadians. I believe the government should respect the freedom of people in their own decisions.
I also believe Parliament has the duty to protect life, especially when the law puts vulnerable people at risk of irreversible harm. That duty brings us to Bill C-41 with respect to medical assistance in dying, and to a straightforward request to split the bill, pass the permanent exclusion where mental illness is the sole underlying medical condition and give the issue of advance requests the separate scrutiny that it deserves.
On October 7, the Liberals voted against Bill C-218. Introduced by my colleague, the member for Cloverdale—Langley City, that bill would have permanently prevented MAID eligibility where a person's sole underlying medical condition was a mental illness. Twenty days later, the government has now introduced Bill C-41 with provisions to maintain that exclusion, but attached them to a separate proposal on advance requests. They have deliberately turned this into a moral paradox. The Liberals rejected the Conservative solution, then returned with the protection we had sought tied to a much broader change in the law, a change that would expand the availability of MAID. The first part of this bill is necessary because we cannot ensure that someone suffering from a mental illness is competent to make a final and binding decision to engage in MAID. This bill then goes on in the second part to do just that and enable MAID when a person is unable to give competent consent or competent refusal by design. The Liberals owe Canadians an explanation. If we agree that people whose sole underlying condition is mental illness must be protected, why make that protection dependent on settling a separate debate?
Conservatives are united on the way forward. Let us split the legislation. We are prepared to work with the government to pass the mental illness provisions through all stages of this House without delay and send them to the upper house. The current exclusion expires on March 17, 2027. Unless Parliament acts, the scheduled expansion will take effect. The Liberals have already delayed the expansion of MAID for mental illness more than once, which is exactly why they should not rush a separate and complex change through Parliament at the same time. They are going to make the same mistakes. There is no corresponding federal deadline requiring Parliament to authorize advance requests. The government should not use the deadline on the issue of mental illness to rush a different and complex change through this House.
The Special Joint Committee on Medical Assistance in Dying recommended that people whose sole underlying medical condition is a mental illness be excluded indefinitely. Our proposal would have provided a lasting protection without another expiry date. The committee heard warnings about two fundamental problems that remain unresolved. First, doctors and nurse practitioners warned that they cannot reliably determine when there is no possible recovery from a mental illness. Put plainly, they cannot reliably predict that a person will never improve. Severe, prolonged suffering does not itself settle that question. Second, witnesses warned that clinicians cannot reliably distinguish a request for MAID from a desire for suicide in this context. There are different clinical views on these questions. When the consequence of an error is death, Parliament must take those warnings seriously. A person whose condition could have improved with treatment must never lose that chance because the law moved ahead of the evidence.
The committee also heard serious concerns about whether existing safeguards and oversight are working in practice. Before Parliament extends the law further, Canadians deserve answers about how those protections are enforced and what happens when they fail. Bill C-41 acknowledges significant unresolved concerns about the safe provision of MAID on the basis of mental illness. Ministers should act on that acknowledgement and work with us to put this protection into law, now. People living with mental illness deserve to have their suffering taken seriously. They deserve care that is available when they need it and a country that remains committed to their recovery.
I recognize that this debate raises questions about autonomy and equality. The Canadian Civil Liberties Association has raised those concerns about the exclusion. Those arguments deserve a serious response. Section 7 of the charter protects life, liberty and security of the person. Section 15 guarantees legal equality, including protection against discrimination. Parliament must consider all of those rights. Protecting people from the irreversible consequences of a mistaken assessment is a legitimate and necessary responsibility of government. We can respect the dignity of people living with mental illness while insisting that the law protect their chance to recover.
The second part of Bill C-41 raises a very different question. Herein is the paradox. It would permit an adult to make an advance request after a diagnosis of a serious incurable illness expected to permanently take away their capacity to consent. This is important on the “expected” part, which I will get to in a moment. By the time MAID was administered, that person would no longer be able to give informed consent to the procedure. Families facing dementia and other devastating conditions deserve a careful hearing, and so do people who fear that a past request could be acted on in circumstances that they never understood or anticipated.
The bill contains safeguards, including two independent assessments and rules about refusal and resistance. Parliament must examine whether those rules can reliably protect someone who is no longer lucid. A clear refusal would prevent MAID under that request. Where a practitioner is unsure whether a reaction means refusal or resistance, the bill would require a pause of at least 30 clear days.
The legislation proposed already anticipates uncertainty in the practitioner. How would that uncertainty be resolved after the waiting period? Who would review the decision? How would the conditions distinguish an involuntary reaction from a person trying to resist? More importantly, the real question here is can the practitioner understand what a person is trying to communicate at the last moment? I submit this is the crux of the problem. It is not so much whether the patient is able to communicate. Is the practitioner equipped to understand what they are communicating?
We have all heard examples of locked-in syndrome, where there is complete consciousness and lucidity, but the inability to move or communicate. How would suffering be assessed when a person cannot really describe it? What would happen when a request is many years old and the treatment circumstances or preferences have changed?
These questions concern the moment when someone is least able to speak for themselves. They require evidence, clear legal rules and enforceable accountability. When ambiguity exists, we must err on the side of caution and prevent advance requests.
The advance request provisions would also depend on provincial legislation. Alberta and other provinces must be heard on their responsibilities, on the safeguards they would administer and on how the federal framework would operate in practice.
Doctors, legal experts, families, veterans and people living with disabilities must have a meaningful opportunity to testify. Members of Parliament should be able to assess the proposal to allow MAID by advance request on its own merits, separately from the urgent mental illness protection.
As Remembrance Day approaches, we should reflect on our particular responsibility to veterans. Veterans Affairs' own investigation confirmed four incidents in which a single employee inappropriately raised MAID with veterans. That was shameful. It was a shameful failure toward people who served our country. The government must ensure it never happens again.
Veterans living with trauma, chronic pain or physical injuries deserve timely treatment and comprehensive support. When a veteran needs help, Canada's response must demonstrate that their life and service matter.
That responsibility extends to every vulnerable Canadian. People must have meaningful access to health care, mental health support services, disability supports and palliative care. If someone feels MAID is their only realistic option because adequate care is unavailable, Parliament has a duty to confront that failure. A list of services on paper means little to a person who cannot actually get them.
We have common ground before us. The government now proposes to prevent the expansion of MAID for mental illness. Conservatives are ready to pass that protection immediately. Members of the House may reach different conclusions about advance requests after hearing the evidence. The government should give them the opportunity to consider that question separately with the care it demands.
The Liberals keep asking for co-operation. The Minister of Justice can put aside petty politics and work with us today. Separate the two measures. Let us pass the protection on which we agree. Parliament can examine the rest. Canadians living with mental illness should not have to watch their protection evaporate.
Conservatives will continue to fight to ensure vulnerable Canadians are met with help to live, not a pathway to state-facilitated death. Split the bill, pass the exclusion and give advance requests to the study they need.