Mr. Speaker, I am thankful for the opportunity to speak to this critical issue.
All of us know in the House that there is an urgent need for action. There are many challenging parts to this issue. There are no easy answers.
I think it is important that we do not wrap this particular issue exclusively in just the broader question of the challenges facing aboriginal communities. There are many challenges facing first nations communities. However, we also need to have a specific strategy to address suicide, because suicide is a challenge like no other.
We have all been moved by the tragedy in Attawapiskat, and the broader context in terms of suicide within aboriginal communities is horrifying. Suicide rates in aboriginal communities have been shockingly and persistently high. Not only are the numbers high, but while the overall Canadian suicide rate has declined, these rates have continued to rise in aboriginal communities.
Existing numbers may in fact under-report the levels of suicide in aboriginal communities. In many cases, suicides may appear as accidental death, and aboriginal communities have significantly higher rates of accidental death as well as suicide.
I spent some time today reading a report prepared for the Aboriginal Healing Foundation called “Suicide Among Aboriginal People in Canada”. I would certainly recommend the reading of this report to all members in this place.
There are a few points in particular from this report that I would like to highlight, because I think they may help us chart a way forward.
First of all, the report highlights the significant need for more study, specifically about suicide within aboriginal communities. There is a need to dig deeper into the specific dynamics, problems, and potential solutions that apply here in Canada.
I know my Conservative colleagues recently proposed a study at the aboriginal affairs committee specifically on the staggering rate of suicides among Canada's indigenous people. Our colleagues in other parties disagreed and preferred instead a study focused on general health issues. It is not to suggest that is not important, but I think we need to recognize suicide as a specific and distinct kind of challenge.
It was interesting for me to read in this report that there is significant variation across different aboriginal communities. This is important. It gives us an opportunity to study communities where things are working and to try to facilitate connections between communities with significant challenges and communities that may already have some solutions. Let us explore the possibility of facilitating partnerships between communities and also studying the significant variation between communities.
The report highlights how suicide can spread in small communities with close interconnections. The report reads as follows:
In small Aboriginal communities where many people are related, and where many people face similar histories of personal and collective adversity, the impact of suicide may be especially widespread and severe.
Later on, the report tells us this:
Early interventions with families and communities to support the healthy development of infants and children may reduce the prevalence of personality disorders and other mental health problems, which are more difficult to address in adolescents or adults.
Therefore, we know the importance of that early intervention.
The report highlights strategies that make a difference: restricting access to the means of suicide, providing education on coping skills, training youth as peer councillors, training those who come into regular contact with youth, mobilizing the creation of community-based suicide programs, and ensuring that mass media portrays suicide and other community problems appropriately.
Through all of this, I think we all recognize that there is a role for government but that government policy is not the central factor. The report I referred to highlights that we need to explore and support local solutions to strengthen individuals, families, and whole communities. Certainly I would again underline the emphasis on the need for further study.
There is one final and perhaps somewhat distinct point that I want to make about these tragic suicides. Very soon in this place, we are going to be debating legislation on physician-assisted suicide. I know that we will all have an opportunity to debate this latter point, but I do want members to think about that debate in light of this one and of this situation. The young people who took their lives I am sure felt that they faced serious and irremediable suffering. Indeed, anyone who commits suicide likely feels themselves to be experiencing serious and irremediable suffering.
Most systems of morality or law rely on absolute moral or legal rules. When morality or law is seen as situational, it becomes more fluid, more subject to individual situational justification. That is why moral rules like “thou shalt not kill” are important. Any time modifications are introduced to previously understood absolute moral rules, they may induce a relaxation in the social taboo beyond the parameters of the proposed modification.
For example, Oregon legalized assisted suicide in 1997 and the Centers for Disease Control and Prevention report showed suicides within men and women ages 35 to 64 increased by 49% in Oregon between 1999 and 2010, compared to a 28% U.S. national increase overall. It seems to be that when clear immutable behavioural standards are removed, behaviour changes.
Certainly, whatever we do on that issue we particularly need to make sure that we are listening to the voices and concerns raised by indigenous Canadians.
I want to quote at some length from comments that Dr. Alika Lafontaine, the president of the Indigenous Physicians Association of Canada, made before the special joint committee. He said:
In reviewing these hearings, I feel obliged to identify the absence of the major national indigenous organizations. I believe there has not been meaningful consultations with indigenous peoples, although meaningful mainstream Canadian consultations have been carried out by many other organizations that have presented here. You are all aware of the widening health disparities among indigenous peoples and the rest of Canada. When considering the overrepresentation of indigenous peoples in nearly every category who may qualify and pursue medically assisted dying, it should be strongly considered that you may be ignoring the largest proportional demographic that is eligible to pursue this service. I hope the apparent absence of indigenous consultation is remedied prior to any final decisions regarding indigenous patients and medically assisted dying.
He went on to say:
My personal experience with indigenous patients and their concerns regarding medically assisted dying are very different from my experience with mainstream Canadian patients. One reason is that medically assisted dying has existed in our communities for more than a century.
When residential schools exposed children to nutritional deprivation and medical experimentation, that was medically assisted dying.
When child and family services apprehend indigenous children at an alarmingly high rate—if not the highest rate of all demographics—with medical decisions made by the crown, and an inconsistent quality of standards that contribute to children dying in care or going missing, that is medically assisted dying. When the trauma of residential schools is perpetuated intergenerationally and we do nothing to stem the tide of abuse, addiction, and suicide that overwhelms our indigenous communities through insufficient mental health intervention, except in crisis, that is medically assisted dying.
When indigenous peoples have programs designed without their input, then are chastised for poor engagement in mainstream health care, that is medically assisted dying.
When there is no monitoring, tracking, or enforcement of standard practice that every other Canadian can expect when receiving medical care, that is medically assisted dying. If an indigenous person dies and no one tracks it, does anyone care?
What we are pleading for in indigenous communities is not medically assisted dying. That already exists in more ways than can be counted. What we are pleading for is medically assisted life.
Those are the remarks of Dr. Lafontaine. I think we need to listen to them. We need to take his concerns seriously. Going forward, let us leverage the collegiality we have seen tonight to build a better country for everyone.
