Madam Speaker, we are debating Bill C‑218, which seeks to specifically exclude patients with a mental disorder from being able to request an assessment of their condition to determine whether or not they are eligible for medical assistance in dying. Some of these patients have had a mental disorder for decades, 20 or 30 years. They have tried everything, all available treatments, have been treated for decades without significant improvement in their condition and have endured stigma and discrimination their entire lives. These are people whose decision-making capacity is established according to the rules, people for whom psychiatry can only offer a life indefinitely housed in palliative care with no cure. These people's suffering has become intolerable, but Bill C‑218 tells them to try again for their own good, because their only option is repeated treatment. They are told to suffer so that, maybe one day, they will be cured.
In June 2022, the Special Joint Committee on Medical Assistance in Dying recommended that MAID be expanded to include mental disorders. The only two reservations it had were about how prepared clinics were to ensure safe and appropriate implementation, as well as the very short time frame leading up to the March 2023 deadline. Those reservations can be found in the conclusion of the June 2022 interim report of the Special Joint Committee on Medical Assistance in Dying.
However, in its latest report in 2026, the Special Joint Committee did a complete 180° and questioned the merits of expansion, despite proof that such a position is discriminatory; despite proof that the groundwork had been laid, according to the Canadian Association of MAiD Assessors and Providers, the psychiatric associations of Canada and Quebec, the Department of Health and the Department of Justice; and despite the establishment of practice standards by the task group that the Liberal government funded to define the practice standards and required training for assessors and providers.
I find it troubling to stand here before legislators who support a blanket, definitive exclusion from MAID for patients with mental disorders, even though the exclusion is discriminatory and unconstitutional, yet who lack the courage to refer the matter to the Supreme Court to spare suffering patients from having to bear that burden. It speaks to ideological rigidness, unfortunate partisan politics and a flagrant lack of compassion. It is unbearable to hear constant claims that issues with accessing care and structural vulnerabilities supposedly lead patients to choose MAID over treatment, despite evidence to the contrary and without proposing a substantial increase in health transfers.
In terms of structural vulnerabilities, Health Canada data, annual reports on MAID in Canada, and a scientific study by James Downar and Kieran Quinn, entitled “Is Structural Marginalization Driving Medical Assistance in Dying (MAiD) in Canada?”, have concluded that structural vulnerabilities do not play a significant role in MAID requests.
When it comes to MAID, it was not the House but the Supreme Court that did the work. Back in 2015, it forced the House of Commons to amend the Criminal Code to respond to requests from patients whose constitutional rights were being violated. The Bloc Québécois believes that the Carter decision and the Baudouin ruling justify opening up MAID to people with a mental disorder whose chronic suffering has become intolerable.
On what grounds should the government undermine or restrict the right to self-determination of a person with a mental disorder, as long as their decision-making capacity is not affected? On what grounds should chronic suffering that has become intolerable be considered reasonable? On what grounds would discrimination be reasonable?
The role of the state is not to claim it knows better than a person facing unbearable suffering what is right for them in a matter as personal as their own death. The role of the state is to ensure that the conditions are in place for that person to make a free and informed choice.
The right to self-determination, free and informed consent, informed decision making and the exercise of a patient's decision-making capacity, when this has been established in accordance with best practices, all run counter to the medical paternalism that still seems all too present in psychiatry.
We must ask ourselves the following: On what grounds should certain patients with a mental disorder whose suffering has become intolerable and has been established as chronic, and whose medical records demonstrate beyond any shadow of a doubt that all available treatments have been administered without resulting in a permanent improvement or significant relief from intolerable suffering, be discriminated against or forced to continue suffering?
Some psychiatrists argue that it is impossible to determine that a mental disorder is irreversible. They question whether a psychiatrist can establish a prognosis or even diagnosis of incurability. However, all of these issues are clearly explained in the expert panel's report, which proposes guidelines and precautions to be taken for the safe and appropriate provision of medical assistance in dying for people with mental disorders. I urge everyone to consult it.
Madam Speaker, the members opposite are really bothering me because they are laughing and talking. If they do not want to listen to me, they are free to go outside. I ask that you intervene and stop the clock.