Christine Moore

[Framework on Palliative Care in Canada Act, January 31st, 2017]

Mr. Speaker, I did not think I would have the chance to complete this speech, so I am pleased to use the eight minutes I have left to do that.

In the first part of my speech, I had noted some things that the bill’s sponsor could come back to in committee. I had also suggested that she include the first nations governments in the consultation, because that is crucial. Often, the cultural approach to death is not really incorporated. Given the federal government’s duty to the first nations communities, it is essential that they be at the discussion table to express their needs.

In addition, there are enormous needs for palliative care in indigenous communities, because there are virtually no projects. Often, the communities are too small, so the feeling is that resources cannot be allocated specifically to palliative care. A number of first nations communities have no long-term care facility. Elders are therefore cared for by their province’s health care system.

When we go out and meet with the people who provide palliative care, we see that they are interested in developing projects. I have been to the Maison du Boulot Blanc in Amos, right next to the community of Pikogan. It sometimes takes in people from the Pikogan indigenous community who need its services. The people who work there are very happy to do that, but they say themselves that it is not the same, that the community is much more involved and there are a lot of people who come to support the dying person.

They do what they can in terms of needs, but if there were some openness to allocating federal funds for specific projects for the first nations, they would very definitely be open to having a room set up and decorated based on the person’s needs. That would reflect the desired approach, which is to accommodate clients who need palliative care.

This is something that will have to be discussed in committee. I urge my colleague to give immediate thought to people from indigenous communities who might be interested in talking about their situations and how they could be involved in delivering palliative care.

Although the administration of palliative care itself falls under provincial jurisdiction, I believe that the federal government has a role to play in bringing all the stakeholders together to discuss best practices. It is not about taking a paternalistic approach and bringing everyone together to tell them to look at the best practices happening elsewhere. It is about creating room for dialogue, where everyone can share their successes and failures in order to move palliative care forward.

We often forget certain particularities associated with palliative care. Pediatric palliative care is extremely difficult. How do we support a child who is dying of cancer or some genetic disease? We have a lot to learn by sharing ideas on this.

For instance, it is important to ensure that children who need palliative care are not forced to choose between being close to home or in a pediatric care centre. They are often hospitalized for long periods and find themselves far from home. Parents sometimes decide to bring their child home when it is time for palliative care to begin. When we talk about a special client group, it is often those in remote areas who have a hard time getting the care they need.

It would be helpful, then, to be able to talk about our practices in order to overcome these challenges. If the various ministries, provinces, and agencies involved could share tools with the rest of the country, we would all be better off.

Other patients are often neglected. For example, how does one help a person with a fairly serious intellectual deficiency prepare for death?

I have had to do it over the course of my career and it is not easy. Caregivers do not always have all the tools they need. They are used to working in a context where the person understands death and what is happening to him or her. However, it is often more difficult to help someone outside that context. I therefore think it is important for caregivers to have that skill.

When it comes to palliative care, for example, some deaths will affect caregivers more than others. That is why it is also important to talk about the distress they experience. Regardless of where the caregiver works, some cases will cause a lot of pain and sorrow. It is also important to be able to talk about that aspect of palliative care so that caregivers do not carry that pain and sorrow with them throughout their careers and can resist breaking down at some point.

Take, for example, soldiers who are deployed overseas and who have to be there for someone who is dying because there is no other choice. Sometimes these experiences are traumatizing and become difficult to live with after many years in the field.

In my opinion, it would be worthwhile adding this other element to the bill on palliative care, that is, monitoring the distress of caregivers, because we are hearing more and more about this issue.

Working with death every day is difficult. I believe it would be beneficial to monitor the distress of caregivers, especially those working in palliative care centres and pediatric and neonatal departments, who do their best to save infants, but are sometimes confronted by the reality that there is no other option but to let them go. These life situations can be difficult, and it would be advisable to monitor this aspect of public health.

I would like to thank my colleague and the House once again for letting me finish my speech. I look forward to my colleagues' comments.

[Statistics Act, January 30th, 2017]

Mr. Speaker, another thing that my constituents often mention about the census is access to a paper copy. In the past, there were people available to help those who are somewhat less educated or who have trouble reading or understanding the questionnaire.

Is it not important to ensure that this service continues to be available to people who need it? Paper copies of the census must be made available, and people who want a paper copy should not have to wait on the phone for an hour and a half to get one. It is also important that those who call are able to speak to someone in the official language of their choice, and staff must be available to help people who, for whatever reason, need assistance filling out the form.

[Statistics Act, January 30th, 2017]

Mr. Speaker, since we are talking about statistics in general and the census, I would like to talk about a problem I am seeing in my riding. I wonder whether my colleague is facing a similar problem.

The census is done in the summertime, in early spring, in May. Along with the census there is also an agricultural census, and all agricultural businesses must participate. This happens at the worst time of year, since that is when farmers need to be sowing their fields and getting ready for summer.

Does the member think that that is the best time to encourage census participation? Since we are talking about the census and statistics, should we not try to find a solution that allows farmers to participate more fully, and make sure that it does not happen at a time that is really difficult for them, since it only makes life harder?

[Petitions, December 14th, 2016]

Mr. Speaker, I am pleased to present a petition signed mainly by people from the region of Temiscaming in my riding. They believe that community television and access to local media is important. They are asking the government and the CRTC to take action on this matter.

[New Year's Eve in La Sarre, December 13th, 2016]

Mr. Speaker, before we leave for the holidays, I would like to take the time to invite you and your gang, and all Canadians, to a wicked New Year's Eve party.

In fact, everyone is invited to attend a traditional Canadian New Year's Eve celebration at the Nicol Auto arena in La Sarre.

Saddle your horses and get dressed up because there will be a lot of people at mass. One hundred years is a really big deal.

Everyone should come on down and grab a seat because our fiddlers and harmonica players will be providing the music, and there could be some good tunes from our surprise guests.

Mr. Beaulieu, a really nice guy, will also be regaling us with his stories.

When the time comes to bring in the new year, a fancy cocktail will be served. Naturally, it is not a good idea to get tipsy because the reverend will not be very far away.

If you happen to miss this party, all is not lost. The 100th anniversary celebrations will continue in the summer of 2017.

[December 12th, 2016]

Mr. Speaker, I have the good fortune of representing a riding where cheesemakers have set up shop over the last two decades and work hard to make quality products. These include Fromage au village, Les fromages Fromabitibi and La vache à Maillotte. They are being threatened, just like the dairy producers that are going to suffer major financial losses, by this free-trade agreement.

At this time, however, there is a good deal of talk of climate change and doing more for the environment. Does my hon. colleague not find this a little illogical?

From the environmental standpoint, it would be logical to consume local products so far as possible; yet we are importing greater quantities of products from across the ocean, perishable products that cease to exist once they are consumed.

I would like to hear my colleague’s comments on this.

[December 12th, 2016]

Mr. Speaker, I would like my hon. colleague to comment on the provinces’ role in the free trade agreement negotiation.

He said that Canada could be sued, or it could also be sued as the result of decisions taken by provinces. They could go in their own direction and may not necessarily agree with the free trade agreement, and as a result there could be lawsuits.

I think it is important to respect the fact that provinces can make their own decisions in their areas of jurisdiction, but these things could happen. This has been seen in cases of proposed moratoriums and other free trade agreements.

[Telecommunications, December 7th, 2016]

Mr. Speaker, based on the response to my question from last Friday, clearly, people who have been waiting for 20 years for cellular service are going to have to wait even longer, because this government has absolutely no plan.

It is not just the remote countryside that lacks service. Sometimes just five minutes away from the main city, there are dead zones, as though the technology did not exist.

When will the government start listening to people from rural communities? They have solutions at the ready.

[Criminal Code, December 6th, 2016]

Mr. Speaker, according to a 1998 survey on fetal alcohol disorder around the world, the prevalence of FASD is about 2 cases per 1,000 births.

However, in Canada, there are 9 cases per 1,000 births, which translates to about 3,000 infants a year. The prevalence is much higher in this country.

The prevalence may be higher here because the consumption of alcohol is legal in Canada and not frowned upon. For example, there are more cases here than in countries where alcohol is illegal, frowned upon, or much less available. I think that this is an important issue that we must consider. It may be specific to Canada, and our legal system should take it into account.

Some of the diagnostic guidelines are very specific. In particular, there can be prenatal or postnatal growth deficiency, which can be identified through weight-to-height ratios. There are also defects such as facial distortions, which are fairly technical, but are characteristic of the disorder. There will be evidence of deficiencies in three of the central nervous system domains such as cognition, brain structure, and communication. It is also evident in school performance, especially memory and executive functioning.

Some of these symptoms will be obvious at birth, while others may be more difficult to see at that time. These individuals must therefore be monitored to determine whether they actually do have fetal alcohol disorder. For example, a baby who has a high birth weight but then later fails to thrive may have fetal alcohol disorder.

Craniofacial deformities may not always be a sign of this disorder. If a delivery was particularly difficult and the doctor had to use forceps or vacuum extractor, the doctor will likely wait before providing a diagnosis. Obviously, cognitive problems are also difficult to assess in a newborn.

In my opinion, it is important to monitor these individuals. Since they are also at a higher risk of becoming involved in criminal activity, it is important that their disorder be taken into account by the corrections system at sentencing. However, it is also important that the condition be considered in determining what assistance that person can be given, from childhood through adolescence, to ensure that they receive the psychosocial support they need and that they are monitored by a social worker. That is why I think it is worth implementing this bill.

Since we know that there is a high incidence of fetal alcohol disorder in indigenous communities, it would be worthwhile to implement specific programs there to help people with this disorder. We need to ensure that these young people are carefully monitored because we know that they are at increased risk for delinquency.

It is important to take fetal alcohol disorder into account in the corrections system, in sentencing, and in the justice system. However, I think it is also important to take it into account in general, to help prevent these individuals from ending up in our prisons. We should incorporate that aspect into our discussion about the bill.

[Criminal Code, December 6th, 2016]

Mr. Speaker, I am pleased to have a chance to finish the speech that I was just getting started on. In my speech, I talked about how, in the conversation around fetal alcohol disorder, it can be hard for mothers to admit to drinking alcohol during pregnancy. They are often embarrassed to admit it, especially if they have said that they stopped drinking when they found out they were pregnant.

Unfortunately, scientific research tells us that consuming alcohol can be most harmful to the fetus in the first trimester. By that time, the damage is already done.

Scientists started talking about fetal alcohol syndrome in 1968. The first case was described by a French pediatrician, Paul Lemoine, but it was not until 1973 that the syndrome was officially recognized. That means that some people over the age of 43 may have the syndrome, but may not have been diagnosed at birth because the condition was not recognized then.

Individuals aged 43 and up might have this problem, be in the prison system, have a criminal record, and be misunderstood because of this health condition. What is more, sometimes it can be a challenge to look to the past to determine whether it is a case of fetal alcohol disorder because that requires a record of drinking during pregnancy. The mother may already be deceased making it impossible to establish whether alcohol was consumed during the pregnancy or not.

This is important to note because there is a clear link between fetal alcohol disorder and criminal behaviour. An estimated 60% of people with fetal alcohol disorder will have run-ins with the law in their lifetime. That is a very high number. Sixty percent is more than one in two people and that creates problems. These are persons who are more easily influenced by the ill-intentioned people around them. These are persons who struggle with judgment, which makes them more susceptible to being lured by others into a life of crime. There are many effects—