Medical Assistance in Dying committee  Yes, they're part of the functioning of the brain. This is why I think, again, we have this dichotomy between dementia and, say, depression. We understand exactly what dementia is about. We're not quite sure what depression is, but we do know they're both disorders of the brain.

Medical Assistance in Dying committee  As with all patients about whom I'm not certain, I'd get a second opinion. There's nothing that says you have to have only two assessors. I don't do a lot of assessments. The assessments I get involved with involve cases in which there are two assessors and they can't decide on an issue when it involves a psychiatric illness.

Medical Assistance in Dying committee  Thank you for that question. Not only do I disagree with it, I think it's preposterous. People who call suicide hotlines may be in a situational adjustment—they've broken up with a loved one in their family or they've been fired from their job. These are not the kinds of patients who we're thinking about at all for MAID.

Medical Assistance in Dying committee  Thank you. This is one of my passions in life. I think we're all facing, unfortunately, a wave of dementia that's going to affect most of the people in this room and on this conference call. With respect to the other issue, competent minors and psychiatric patients, there are small numbers of patients.

Medical Assistance in Dying committee  That's a very interesting question as well. I have to tell you that, when people ask me what I do for a living, I tell them I'm a medical doctor first and a psychiatrist second. The seat of all psychiatric illness is the human brain, which the last time I looked was part of the body and part of the human experience.

Medical Assistance in Dying committee  Yes. I don't want to be overly enthused or state things that are not true for me, but I think all psychiatrists in Canada have a vigorous training and licensing system. I think any psychiatrist who wants to is competent to do all of those things. We have to assess competency on a case-by-case basis on a regular basis.

Medical Assistance in Dying committee  There's no doubt that a competency assessment is part and parcel of every MAID assessment. Doctors do this all the time because we can't do a single service with a patient—we can't do surgery or do psychotherapy or give medications—without permission, and the person must be competent.

Medical Assistance in Dying committee  Thank you for that question. There are certainly forms of mental illness that are incurable and terminal, and I'm referring here to the dementias. Alzheimer's and Lewy body dementia are all going to kill people eventually, so that's certainly one category of psychiatric illness for which there is no debate about that.

Medical Assistance in Dying committee  Thank you for that question. It comes back to the point I made, which has come up repeatedly in the court decisions, that it's the whole person you look at, not the diagnosis. When I first saw cases in the Benelux countries with personality disorder, I thought that this was terrible and that there must have been a mistake.

Medical Assistance in Dying committee  These are people with chronic illnesses who have been suffering for many years, and incidentally I agree entirely with all the recommendations in the final report of the expert panel. I had nothing to do with this expert panel. I came at it as an interested party and I read it. I have no problems with any of those recommendations.

Medical Assistance in Dying committee  There's no doubt a great inequality in access to services for many people with psychiatric illness. They are disadvantaged with respect to getting the kinds of treatment they need, but that is becoming true in all other parts of medicine as well. In my province, almost one million people don't have a family doctor, so we're facing a crisis in terms of access to health care.

Medical Assistance in Dying committee  Thank you, Mr. Arseneault, for that question. I'm sorry I cannot answer you in French. I'll do my best in English. I think the detailed answer is in this report, which you have received already, the report of the expert panel on MAID and mental illness. I'm not going to be able to go over that in five minutes, but I want to reassure you again, as I mentioned previously, that in court this has been tried, not with a bunch of opinions but with cross-examination demanding hard evidence.

Medical Assistance in Dying committee  Again, at the risk of being repetitive, I want to go back to the court decisions. The court decisions are where facts are established and rulings are made. The honourable gentleman's opinions were tested in court and found not to hold any water, so the court clearly found, when they heard all the evidence from a whole bunch of experts, including psychiatrists, people for and against, that psychiatrists are clearly able to distinguish between people who are suicidal and people who are seeking MAID.

Medical Assistance in Dying committee  My name is Derryck Smith. I am a practising psychiatrist. I was head of children's and women's psychiatry in Vancouver for 30 years, and I have been personally involved in two cases involving psychiatric illness and MAID, both of whom have received MAID, incidentally. You've heard a [Technical difficulty—Editor].

Medical Assistance in Dying committee  I don't know. I'll try again.