Madam Speaker, it is always an honour to rise in this place on behalf of the great people of southwest and west central Saskatchewan.
Canadians sent us here to deal with many problems affecting them personally and impacting the country as a whole. There is no doubt that what we are debating right now is a very serious issue facing our society. I first want to thank my colleague the member for Cloverdale—Langley City for her leadership in bringing forward the right to recover act, Bill C-218. She has already brought hope to so many people and approached such a difficult topic with the compassion and the urgency that it deserves.
Not only has the member for Elgin—St. Thomas—London South seconded the bill, but along the way he has done a lot of work advocating for it. He had the courage to share his own personal story of battling years of severe depression and surviving suicide attempts. While telling his full story, which includes a challenging process of recovery, he shone a light on a struggle facing thousands of Canadians and their loved ones.
To give us more perspective, here are some of the latest numbers from the federal public health website. Each year in Canada, there are 4,750 deaths by suicide and 20,000 hospitalizations caused by self-harm. There are 100,000 reported suicide attempts, along with 250,000 people who make suicide plans and 840,000 people with serious thoughts of suicide. That means every single day there are 250 Canadians who make reported suicide attempts, 700 who make suicide plans and 2,300 who have serious suicidal thoughts. Let us allow all of that to sink in for a minute.
We often talk about having better awareness about mental health, but we also need to build on that by actively meeting people's needs and providing real protection for those who are vulnerable. With this bill, both of these MPs have moved us forward in that important goal.
At the moment, we are in a situation where the current law would allow access to MAID for people who have a desire to die solely on the basis of their mental illness. If we think about it for a second, we can start to imagine how that creates an opening in the medical system where it becomes easier for a suicidal person to end their life. In other words, it is pretty clear that we are really talking about assisted suicide.
As Canadians learn that this is happening, they are increasingly against the idea, but currently, if nothing changes, the Criminal Code would allow eligibility for assisted suicide on the basis of mental illness alone starting next spring. As disturbing as it is to think about, it is not too far in the future. However, Bill C-218 provides a simple solution. By a short amendment to the Criminal Code, it would stop the expansion of MAID for mental illness before it takes effect.
Just recently, the Special Joint Committee on Medical Assistance in Dying studied this exact issue and came to the same conclusion. Based on the consistent testimony of witnesses and experts, the committee's report officially recommended an amendment to the Criminal Code to exclude mental illness as the sole underlying medical condition for MAID. This recommendation reflects a consensus across party lines, and now that we have Bill C-218 in front of us, it just makes sense for us to proceed with it to achieve the final result we would like to see.
Earlier this year, I had the chance to work with the special joint committee as it carried out the study. That happened because I ended up filling in for one of the regular members, the member for Cariboo—Prince George—Omineca, who was supposed to be on that committee but had to spend some time away to recover from surgery he had on his knee.
I want to make a special mention of something here. It made perfect sense for him to participate in the study because he has been one of Canada's strongest advocates for mental health. He has worked tirelessly for years to make the 988 suicide prevention hotline a reality. After his motion passed unanimously in the House, it still took a few years before it finally launched, thanks in large part to his persistent efforts with introducing legislation, setting timelines and helping to keep up the pressure on the government to get the job done.
It needed so much time and effort to accomplish, even though it was a project that already had broad support across parties. It was worth doing because we know that 988 has made a real difference and has been saving people's lives.
We all support suicide prevention. We have a good idea of how important it is to be prepared so that we can respond with compassion and provide resources to people who are suicidal. On the other side of the equation, we also need to be extremely cautious of sending the wrong signals or messages, which could push a vulnerable group of people in a worse direction.
We had a representative from 988 appear as a witness in this study on assisted suicide for mental illness. She provided data to us based on her team's experience:
...on frontline signals from 988, up to 7% of interactions on the service refer to MAID. Critically, among those who reference MAID, 74% endorsed thoughts of suicide in the past two days, compared with 48% among other contacts. In short, interactions with our national suicide crisis line that reference MAID are associated with substantially higher suicidal ideation. That's not a theoretical concern; it's a real, measurable, elevated risk among people who mentioned MAID to Canada's suicide prevention service.
The same witness also went on to say:
My recommendation is straightforward. Do not expand MAID to cases where the sole underlying condition is a mental disorder. This recommendation aligns with the position of the International Association for Suicide Prevention that the overlap between MAID requests and suicide makes distinguishing between them impossible. MAID for mental illness will undermine suicide prevention by positioning MAID as a viable alternative to treatment.
This was one of the key concerns raised during the committee study. As this witness said, which was a point echoed by others, it is impossible to distinguish a desire for death inspired by mental illness from being suicidal.
Dr. Sandip Singh Gandham expressed, “I worry that in some cases, we may not be responding to an autonomous, enduring request for assisted dying, but rather to the voice of the illness itself.”
We also heard the story of Donna Duncan in B.C. Her daughter, Alicia, appeared as a witness and has been raising the alarm on her mother's case, which is directly related to the issue before us today. Donna was approved for and died by MAID in British Columbia in 2021, only hours after being released from a psychiatric unit and following a suicide attempt.
Donna was clearly suicidal and facing a mental health crisis, and all her blood tests came back normal. She had no terminal condition. She should not have been a candidate for MAID, yet the system deemed her eligible for track 1 MAID because, under the influence of a mental disorder, she was starving herself. In this case, the existing safeguards failed despite the family's best efforts and despite Donna's own admission that she did not want to die. She just felt deprived of proper care.
If a mistake was made in this case or any others, what is the remedy supposed to be? Death is irreversible. As the Duncan family found out, the only person authorized to access Donna's MAID assessment records is Donna herself, and Donna has died. Neither her family nor even the police can access the records, and neither the regulators nor the B.C Privacy Commissioner is prepared to override that. Realistically, then, how is anyone supposed to investigate whether the law was followed?
There are also concerns about new conflicts with providing patient care in the relationship that therapists have with clients. Are Canadian care providers there to fight relentlessly for every last person who can be helped or are they there to process people according to their requests and wishes, even if they could eventually recover in the future from their mental illness?
Dr. Jitender Sareen put his finger on this when he said, “This goes to the core psychiatric practice, which is grounded in assessing and treating hopelessness and preventing suicide.”
Is the psychiatrist there to help prevent suicide or enable it? What does it do to a psychiatrist's ability to do the former if the patient knows all the time that all they have to do to have their life ended is refuse to co-operate on therapeutic help that might work?
In that context, if MAID is available as an option, it becomes a factor on its own, which can undermine the effectiveness of therapy. Along with the general problem of recognizing suicidality for what it is, medical and psychiatric professionals also share deep concerns with the idea of irremediability and predicting patient outcomes while considering all the complexity of treatments for mental illnesses.
Dr. Karin Neufeld testified about a middle-aged patient of hers who had been suffering from a major depressive illness since childhood. He was seeking a referral for MAID and would have qualified, but after undergoing treatment with this particular therapist, he has now recovered the will to live. We have heard about similar cases as well.
Across Canada, people struggling with a mental illness are contemplating MAID not because they want to die, but because they are not getting proper support. They come from all walks of life. In this area, we heard about particular concerns related to indigenous communities and people with disabilities.
Our approach to allowing assisted suicide for mental illness is something that medical professionals, psychiatrists, advocacy groups and the United Nations have called on us to rethink. Parliament has itself pushed the deadline back multiple times and our special committee has now recommended indefinitely suspending it. We should listen to Canadians and listen to the committee and finally reverse this expansion. Let us pass Bill C-218.