Medical Assistance in Dying committee  Thank you, Mr. Chair. I'd like to thank the witnesses for their insightful testimony. Ms. Chalifoux, you said that advance requests should not be restricted to cases of neurocognitive disease because that would exclude all other types of medical problems, such as strokes. For the former, the assumption is that a person received a diagnosis and is still capable of making a decision, but this decision cannot be reviewed afterwards because the person's capacity to give informed consent will have disappeared.

Medical Assistance in Dying committee  Thank you, Mr. Chair. My question is for Dr. L'Espérance. Unfortunately, we don't yet have access to your brief. However, I read the brief from your association, which you tabled in the National Assembly last month, and in which you had made a proposal to have criteria and requirements for advance directives.

Medical Assistance in Dying committee  As it stands, the wording of the act says that if a person cannot provide advanced directives, they choose medical assistance in dying and, in a sense, die prematurely.

Medical Assistance in Dying committee  Thank you, Dr. L'Espérance.

Medical Assistance in Dying committee  That's not my question. If the patient has dementia, he cannot ask for advance requests. It's too late. He cannot consent to it. However, if he was competent, why are you opposed that later on, when he reaches the stage he had indicated when he was competent, we follow the instructions?

Medical Assistance in Dying committee  So you'll go judge in that situation?

Medical Assistance in Dying committee  Thank you, Mr. Chair. My question is for Dr. Cohen-Almagor. I understand, Doctor, that you are opposed to advance requests out of concerns about potential abusers. That said, is there a way, if we put up a system here in Canada with a lot of safeguards, including an intermittent check before the administration of MAID and including that if the patient is showing some resistance, we won't proceed, that these safeguards will address some of your concerns or maybe all of your concerns?

Medical Assistance in Dying committee  Doctor, I'm sorry to interrupt. If you say that you're not opposed to advance requests when you're competent, what is the difference between asking for MAID at one point and asking for it in advance? You're talking about the same thing.

Medical Assistance in Dying committee  Thank you, Mr. Chair. My question is for Dr. Buchman. You work with the more vulnerable in society, those who are often isolated and have been left out by society in general. When they come to you, it's because they need palliative care or they want to receive MAID. You are a MAID assessor.

Medical Assistance in Dying committee  Thank you, Mr. Chair. Dr. Viens, please keep in mind that I have three minutes, so I will keep my comments brief and I would ask you to do the same, although I realize you have many years of experience. You brought up an argument often cited by MAID opponents: that the data provided by Health Canada were not reliable.

Medical Assistance in Dying committee  Thank you, Mr. Chair. I would just like to make one little comment. I sense that we want to work quickly. I am finding it a bit hard to proceed this way without having the documents from the people testifying before us. Today, several witnesses referred to what they had said in their briefs, which we have not seen.

Medical Assistance in Dying committee  That's not exact. In Belgium it went down in 2019.

Medical Assistance in Dying committee  Thank you, Mr. Chair. My question is for Professor Gaind. If I understood correctly, he is opposed to offering medical assistance in dying to people whose only problem is a mental health problem, with no comorbidity. In his opinion, there is nothing to justify expanding that.

Medical Assistance in Dying committee  Thank you, Mr. Chair. My question is for Dr. Naud. You may have heard the testimony of Dr. Pageau, in the previous group of witnesses, who seems to make a distinction between not preventing death from happening—which is how he sees advance medical directives—and causing death—which is how he sees advance requests for access to medical assistance in dying.

Medical Assistance in Dying committee  Thank you, Mr. Chair. My question is for Dr. Pageau. Dr. Pageau, since you work in geriatrics, your youngest clients are my age. In the case of a person who has made advance medical directives and who, by definition, is no longer able to make decisions for themself, substituted consent is given.