44th Parl. 1st Sess.
February 15, 2023 02:00PM
Mr. Speaker, it is incredibly important that we provide the support. That should be the focus of the government. What it is undertaking with this process is not a requirement but a rapid and unnecessary expansion. Frankly, it devalues the human person and those who are living with any of the challenges the member opposite mentioned. It is incredibly important that we find ways to support those people to help them heal instead of finding ways to accelerate their deaths.
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Mr. Speaker, I thank my colleague for his speech.
I contend that the process we are going through right now calls for a dose of humility. I tend to believe the scientists. I prefer to put my faith in these exceptional people who have accumulated very high-level training. They have the distinct advantage of being able to contribute everything we need to ensure that the bill before us is as precise, detailed and scientific as possible.
I would like my colleague to comment on his faith in our scientists. I do not think anyone in the House would claim to possess the depth and breadth of knowledge it takes to decide what is good and what is not, what is acceptable and what is not. We have scientists to do that for us. Our job is to give them the right to work on this.
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Madam Speaker, I want to go back to some of the words of an expert I quoted. Dr. John Maher, who is a clinical psychiatrist and medical ethicist, said that “Psychiatrists don't know and can't know who will get better and live decades of good life.” We had another expert say that they “could be making an error 2% of the time or 95% of the time.”
It is so important to make sure that, in matters of life and death, we are correct 100% of the time. We have to stand up for life.
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Madam Speaker, it is with a heavy heart that I rise today to speak to this extremely important bill, Bill C-39, an act to amend an act to amend the Criminal Code on medical assistance in dying. Bill C-39 would delay by one year the inclusion of mental illness as a sole underlying condition for eligibility to access medical assistance in dying.
I am truly disturbed by where we find ourselves as a country today. We were once a beacon of light to the world, offering hope, opportunity, community and compassion to all. However, we are quickly becoming a place where the darkness of death threatens the light of our nation. We are offering death as a solution to despair and taking the easier, cheaper way out instead of the narrow, harder path. The narrow, compassionate path requires courage and hard work to create support for those who are struggling and desperate for hope.
When the government first introduced the medical assistance in dying regime in 2016, many sounded the alarm. They said it was a slippery slope that would open the door to abuse, and the vulnerable in society would pay the price with their lives. The government assured Canadians that this would never happen; there would be safeguards put in place with strict criteria, and the most vulnerable would always be protected. However, here we are today deliberating on extending assisted dying to those whose sole illness is one of mental health.
This is sadly ironic because during the last election campaign, the Liberals promised $4.5 billion in mental health funding, which we have yet to see. Our society has invested billions in embarking on awareness campaigns to bring dignity to those suffering from mental health issues. We have entire days dedicated to mental health. We have worked tirelessly in society to destigmatize mental health issues. We voted unanimously in this House for a mental health hotline, yet here we are contemplating how the government can legalize taking the life of a person who is lost in the depths of a mental illness.
I believe deep down inside that we are all disturbed by the idea that MAID can be extended to the mentally ill. I believe that members of this House and the government know in their hearts that it is wrong for a government to abandon the most vulnerable among us in their time of need. They know it is wrong to promise mental health supports and then offer assisted dying instead.
What is so sad is that they try to justify it by saying that it is only for those individuals whose mental health is incurable. However, drug addiction, alcohol addiction, the loss of a loved one, broken families, broken relationships, the loss of a job and the inability to support oneself are all real situations that many Canadians are now facing. They could all propel an individual to the darkest depths of their soul. When people find themselves in the depths of despair, lacking the support of friends and family, this precise moment is when it is important for governments to be the beacon of hope and provide support.
The Minister of Justice assures us that individuals who suffer from mental health issues and are suicidal will not be considered for MAID. That statement is a tautological paradox. A person who is in the depths of mental illness and wants to end their life is, by definition, suicidal. When a person cannot cope mentally, their government has abandoned them and they have no prospect of obtaining help, and they decide to take their life, they are not of sound mind.
They do not have the mental capacity to give meaningful consent to ending their life. They are in desperate need of help.
I say it another way: It is near impossible to separate those with suicidal ideations from those with irremediable mental health conditions. Ninety per cent of people who commit suicide today, in fact, have diagnosable mental disorders. That is why it is utterly unconscionable that, one year from now, we could offer death as treatment to those who are suffering from mental health issues.
This option will be abused in the future. MAID has already been abused, with few safeguards currently in place. There have been countless stories of abuse, including stories of elderly, disabled, marginalized and mentally ill Canadians, even veterans, who have fallen through the cracks of care and have become victims of Canada's permissive MAID regime. Here are some of the headlines across our country and across the world that comment on the MAID regime:
“‘Hunger Games style social Darwinism’: Why disability advocates are worried about new assisted suicide laws” is from Niagara This Week.
“Former paralympian tells MPs veterans department offered her assisted death” is from CBC News.
“Homeless, hopeless man to seek medically assisted death” is from Barrie Today.
“Normalizing Death as ‘treatment’ in Canada: Whose Suicides Do We Prevent, and Whose Do We Abet?” is from the World Medical Journal.
“What Euthanasia Has Done to Canada” is from the New York Times.
“‘Disturbing’: Experts troubled by Canada’s euthanasia laws” is from the Associated Press.
“Why is Canada euthanising the poor?” is from The Spectator in the U.K.
The government needs to read those headlines and generally consider the totality of the evidence. It is clear that there is no way to safely expand MAID to mental illness.
The government heard the evidence presented at the Special Joint Committee on Medical Assistance in Dying. Experts said that it is “difficult, if not impossible” to determine whether someone is suffering from a mental illness and whether they will get better.
Our country is in a mental health crisis. Record numbers of Canadians are struggling with mental health issues that have been exacerbated by COVID.
To push forward with expansion at all is an abdication by this government of its responsibility to provide sufficient social, financial, mental health and suicide prevention supports to our most vulnerable. It is to abandon anyone who is suffering from mental illness.
The darkest hour is just before the dawn. To those suffering with mental illness, we must be the hope of the dawn in the dark night of despair.
We have the resources to wrap our arms around every person in Canada suffering from mental health issues and to embrace and enfold them in the promise of a brighter future, investing in life and dignity for all Canadians.
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Madam Speaker, I have three questions for the hon. member.
First, does she understand that someone who does not have the capacity to make a decision regarding MAID is ineligible for MAID?
Second, does she understand that in order for someone to be eligible for MAID, they must be informed of available and appropriate means to relieve their suffering, including counselling services, mental health and disability support services, community services and palliative care, as well as being offered consultations with professionals who provide these services?
Third, is she aware that in order for someone to be eligible for MAID, they and the practitioners must have discussed reasonable and available means to relieve the person's suffering and agree that the person has seriously considered those means?
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Madam Speaker, I hope my hon. friend is aware of the simple fact that those who are suffering from mental illness, those who are in the darkest part of their life and whose government has abandoned them, do not have the capacity to choose MAID, because they are in desperate need of help that their government needs to provide. Those individuals need life and help over assisted dying.
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Mr. Speaker, I listened to my colleague. I do not agree with her principles at all. She said that it was an easy choice. Medical assistance in dying is not an easy choice. On the contrary, it is a question of dignity.
For the past five years, the Bloc Québécois has been participating in consultations on medical assistance in dying. It is a right to die with dignity, of one's free will and with the least possible amount of suffering. Therefore, I disagree. When people say they want to support very ill individuals, support might mean offering them assistance in dying while surrounded by their loved ones.
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Madam Speaker, I did not speak today about individuals who are on artificial means and at the end of life. I did not speak about individuals who had living will directives. What I spoke about was the extension of MAID to those who are mentally incapable and the abdication of the government in providing the necessary supports to help those who are most vulnerable make the decision to continue a life in dignity.
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Madam Speaker, one of the ways we can help people who are suffering and who may at some point consider medical assistance in dying is by supporting the establishment of a Canada disability benefit and supporting the level of income that this benefit would deliver to be something that raises people out of poverty. New Democrats have suggested, for instance, that the level of that benefit should be set at $2,200 a month to ensure that people living with a disability actually have the means to live with dignity, to afford a roof over their head and to afford to feed themselves and their families. Is this something the member supports?
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Madam Speaker, Conservatives support supporting our most vulnerable, and we believe that among those are individuals who are suffering from mental health issues. They deserve all of the supports needed to help them get through this dark time in their lives.
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Madam Speaker, I would like to follow up on the question from the member for Elmwood—Transcona, because there are many members in this place who are talking about people deserving a dignified life, and people with disabilities certainly deserve that. There is an important call for the governing party to fund the Canada disability benefit. Does the member for Haldimand—Norfolk join us in that call?
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Madam Speaker, I thank my hon. colleague for his concern and compassion over the most vulnerable. The most pressing thing right now in order to make sure MAID is not extended to those with mental health issues is to make sure the Liberals live up to their promise of caring for those with mental health issues, and that is not through providing assisted dying.
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Madam Speaker, I am proud to rise on behalf of my compassionate and caring residents of Renfrew—Nipissing—Pembroke. Like the majority of Canadians, my constituents strongly oppose state-sponsored suicide for those living with mental illness. That is why I will support the legislation to delay this from happening. This bill to delay providing assisted suicide is critical. It is a matter of life or death that this expansion be delayed.
Many Canadians are wondering, “How did we get here?” To describe this process as a slippery slope is to understate how greasy this rapid descent has been. How did we go from the Supreme Court reversing a precedent granting the right to die to those with incurable illnesses causing intolerable suffering and whose deaths are reasonably foreseeable to the point where the Quebec College of Physicians and Surgeons is advocating for the killing of newborn babies? How did we get here?
Obviously, first and foremost, the decision by the Supreme Court was to overturn the previous Supreme Court decisions and allow for a limited exception to the Criminal Code. The court found that the prohibition on assisted suicide is intended to protect vulnerable persons from being induced to die by suicide. The court ruled that the total ban on assisted suicide was overly broad because it also applied to non-vulnerable people and prevented them from receiving the assistance of a willing physician. The court said that it was up to Parliament to strike the right balance between Canadians suffering grievous and irremediable illness who want access to physician-assisted dying and those who may be put at risk by its legalization.
Then, Parliament debated legislation and Bill C-14 was passed in 2016. People whose deaths were reasonably foreseeable, meaning they were dying, and who were suffering intolerable pain could seek medical assistance. Despite widespread reservations, many Canadians view medical assistance in dying as compassionate.
Then, one judge said this was a violation of equality rights. The judge ruled that someone whose death was not reasonably foreseeable but who was suffering intolerable pain had the same right to assistance in dying. The progressive government did not appeal the case. It embraced the ruling and brought forth legislation to expand physician-assisted death to people who were not dying.
When that bill was before committee, the justice minister explained why physician-assisted suicide could not be expanded to include people whose sole condition was mental illness. The minister said there was no consensus. The bill then went to the Senate, where suddenly a secret consensus was discovered, unbeknownst to the medical community. The government flipped and flailed, and embraced this expansion to include mental illness.
The minister claimed the government would strike an expert panel to shape the necessary protocols to ensure that only the non-suicidal would be eligible for physician-assisted suicide. Last May, that expert panel returned with a protocol, albeit with two fewer members than when it started, after they resigned in protest. What did the expert panel have to say?
There is limited knowledge about the long-term prognosis for many conditions, and it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient.
The expert panel, handpicked by the Liberal government, said it was impossible to make accurate predictions about future prognosis. Despite that admission, the Liberals still went ahead with recommending a protocol for allowing physician-assisted suicide for people whose sole condition is mental illness. The government claims it is listening to the experts, yet two of the experts on the panel resigned. They were prevented from providing a dissenting report. They are not the only experts speaking out.
I would encourage all my colleagues to get their hands on the article in the Globe and Mail, published last November, entitled “Canada will allow assisted dying for mental illness starting in March. Has there been enough time to get it right?”, written by Erin Anderssen. The article introduces readers to Dr. Madeline Li, a psychiatrist at Princess Margaret Cancer Centre. Many of my colleagues here may remember Dr. Li from her appearance before the Special Joint Committee on Medical Assistance in Dying. While the article touches on a number of the regressive aspects of expanding assisted suicide, I feel this passage is particularly relevant to our conversation:
But among the many experts who have lined up to express their objections to the direction and pace of Canada’s euthanasia laws, Dr. Li’s deserves particular attention. She led the creation of MAID protocols at the University Health Network, a group of Toronto-area hospitals that together form the largest health research group in the country. At the national association for MAID providers, she is the scientific lead currently developing the government-funded assisted-dying curriculum for doctors. She has administered assisted deaths directly to patients, and provided oversight to hundreds of cases as the MAID program lead at the UHN.
All that experience, she said in an interview, has made her personally opposed to expanding MAID for patients without a foreseeable death, especially those with mental illness. The debate among doctors has become too ideological, she said, and the current system doesn’t have enough safeguards to prevent unconscious bias from factoring into decisions.
Can doctors—a mostly healthy, privileged group of people living in a society that routinely stigmatizes people with disabilities—objectively judge what makes life worth living? Dr. Li says she once watched a doctor use an actuarial chart to calculate that an older woman seeking MAID after a fall had, on average, three years left to live; he approved her for MAID, over the objections of three other physicians. “What if it had been six?” she asked. “How many years is enough?”
Dr. Li worries that since many psychiatrists won’t participate in MAID, there will be “an echo chamber of a few assessors who will all practice in the same way,” leaning hard toward patient autonomy. Already, she argues, MAID assessments are too often focused on whether a patient is eligible for an assisted death, rather than exploring why a patient wants to die in the first place.
The federal expert panel recommended that decisions should be made on a case-by-case basis, with the doctor and patient reaching a shared understanding. But while the law requires that patients must give “serious consideration” to clinically recommended treatments to relieve their suffering, they can refuse those treatments if they don’t deem them “acceptable.”
For instance, Dr. Li described the case of patient in his 30s, who asked for an assisted death, even though multiple doctors said his cancer was curable. Two assessors approved him for MAID. Faced with his adamant refusal to get treatment, and his progressing condition, Dr. Li said she helped him die “against her better judgment.” If MAID didn’t exist as an option, she believes he would have gotten treatment, and still be alive.
The government and its hand-picked experts assure us they can devise protocols rigorous enough to prevent vulnerable people from receiving assisted suicide. The expert panel says that despite it being impossible for doctors to predict a future prognosis of mental illness, Canadians should trust the opinion of doctors in making a determination of intolerable mental suffering, yet Dr. Li, against her better judgment, went ahead with assisting in the death of a man in his 30s who had a treatable cancer.
Unlike cancer, where we can have an objective test to determine a prognosis, we are supposed to just trust the opinion of doctors. Dr. Li was of the opinion the young man's death was not foreseeable. His condition was treatable, yet she assisted in his suicide. She is opposed to expanding this. How reluctant will physicians who support assisted suicide be when assessing people with mental illness?
Finally, while Dr. Li feels the debate has become too ideological, Canadians following the debate in this House might be confused. We have seen social Conservatives, small “L” liberals and socialists all raising serious concerns. We all seem to have the same goal of the maximum amount of compassion and care, while protecting the vulnerable.
I imagine there are about three million Canadians who grow angry hearing the Minister of Justice centre this debate on balancing the protection of vulnerable Canadians while preserving individual autonomy. On this issue, the minister seems to be more concerned with the autonomy of individuals to make their own medical determinations, while less concerned with the impact on vulnerable people.
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Madam Speaker, virtually all medical health experts contend that mental illness is not irremediable. Why the delay for a year? What is going to change in this next year that should not be dealt with right now?
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Madam Speaker, the question is whether we can get it right in a year. I have to ask this back: Can we ever get something like this right? It is incalculable that we have come so far. We have not gone down a slippery slope; we have jumped off a ledge.
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Madam Speaker, we have seen how slippery this slope has become with what I would call a botched expansion of MAID by the Liberal government.
A few short years ago, MAID was seen as a procedure that would be used in exceptional circumstances and that would require very strict criteria to be placed around it. Now MAID is being administered under increasingly questionable and concerning circumstances. The criteria has become looser and is wildly subjective, and many of the safeguards that once existed seem to have evaporated.
The recent scandal at Veterans Affairs around medical assistance in dying has revealed how bad the Liberals rushed and mismanaged it, and, I would say, how careless the expansion of MAID has become. Since Canada's inception, our men and women in the Canadian Armed Forces have fought and sacrificed to defend freedoms here at home and all around the world. Whether that be on the ground, in the air or at sea, they have done so with valour and distinction. In doing so, many of them endure physical, psychological or other injuries during their service.
There is nothing that we as Canadians can do to fully repay them for what they have done for Canada, but at the very least, it is incumbent upon us to remember and honour their sacrifices and ensure that when they transition out of service, they are fully supported and cared for as veterans. Sadly, under the Liberal government, Veterans Affairs Canada has fallen into disrepair. I have heard from many veterans that Veterans Affairs Canada feels more like an insurance company focused on reducing its financial liability and placing an unfair onus on veterans to have to prove their disabilities or illnesses over and over again.
I can think of a lot of examples, but one of the worst examples I can think of is a veteran I met who is in a wheelchair. He is missing both of his legs from his time serving our country, and every single year, he has to prove to Veterans Affairs that he is still missing his legs. Can anyone imagine what it must feel like for that veteran to prove every single year to Veterans Affairs that he is still missing his legs and is required to have a wheelchair because he served this country? That should never be the case.
I can think of another veteran who has been fighting Veterans Affairs Canada for years to have a wheelchair lift installed in her home. She is in a wheelchair because of her service, and she simply wants a wheelchair lift installed in her home. She has faced repeated delays and denials, and she still does not have the wheelchair lift she needs in order to access her home. She is forced to crawl across her driveway and up and down her stairs because of that. Is that what a veteran deserves after a life of service?
When I thought about the context there, I was that much more alarmed and disturbed when Global News broke a story last summer about an anonymous veteran who had been pressured to consider medical assistance in dying by Veterans Affairs Canada. We learned that the veteran had gone to Veterans Affairs Canada seeking help and support for injuries that he sustained while he was serving in our armed forces.
Initially, he was experiencing positive improvements in his mental and physical health. To him and his family, that must have been very promising. Then he got a call from a Veterans Affairs service agent who suggested that he consider medical assistance in dying.
The service agent brought the suggestion up repeatedly, even after the veteran asked her to stop. The service agent further asserted that she had helped another veteran successfully access medical assistance in dying and that the veteran had gone through with the procedure and was now deceased. In describing how she helped this veteran access medical assistance in dying, she concluded that it was preferable to traditional forms of suicide, like, as she said, “blowing [your] brains out all over the wall or driving [your] car into something.”
After learning about those accusations, the Conservatives demanded that the Minister of Veterans Affairs and his officials come before the Standing Committee on Veterans Affairs and answer for those appalling accusations. The minister came to the committee about this disturbing incident and indicated that it was, in his claim, isolated to one employee and was not indicative of a pattern of behaviour or a systemic issue. In fact, between the minister and his officials, they described the incident as isolated six different times. However, later in that very same meeting, they admitted that there was a second case involving the same employee.
That did not quite seem right either, so we asked the minister and his officials to come back to the committee, and the very night before the minister came back to testify that second time, another anonymous veteran came forward. He told the Operation Tango Romeo Trauma Recovery podcast that he too had been offered medical assistance in dying by Veterans Affairs Canada and that he too had felt pressured. This employee told the veteran, in the veteran's recollection, that they could help end his suffering because they had helped someone else end their suffering.
The next day at the veterans affairs committee, the minister confirmed that he was now aware of four cases involving one employee, but those did not include the allegations that were made the evening before on the Operation Tango Romeo podcast. Now we are talking about a situation where, after being told it was an isolated incident, we are aware of five different instances of this happening with two different Veterans Affairs employees at minimum. When we called on the Minister of Veterans Affairs to fire the employee who was involved in this, he refused to answer the questions, only saying instead that this employee was no longer in direct contact with veterans.
However, it got worse from there. Another veteran, Christine Gauthier, came to testify before the veterans affairs committee on something completely unrelated, but she revealed that she too had been offered medical assistance in dying. She was simply trying to get some help for her home to have a lift installed. Then, unprompted, a suggestion was made by another Veterans Affairs employee that if her pain was so unbearable, MAID was something she could consider as an option. In private conversations since then, I have learned of at least a couple of other veterans who have been offered MAID, so that makes about eight veterans and about four different employees, at minimum, whom we are aware of.
This whole thing has gone down a very bizarre trail, and we get repeated denials. The minister came out at one point and said, after he had admitted there were four cases, that Veterans Affairs has never offered this. Then, the very next day, he told us they fired the employee who was involved in the four cases. It is a story that no one on that side of the House can seem to get straight, and it is really concerning. Those are the kinds of inconsistencies that we are seeing.
When veterans go to Veterans Affairs Canada looking for help, support and assistance, whether with physical injuries or mental injuries, they should feel comfortable and safe when they are dealing with Veterans Affairs. There should be a level of trust there. However, instead of being offered help with things they need to help them live their lives, they are being told that maybe it would be better if they just went off and died. That is a pretty sad situation. Veterans are being betrayed by the very people and institutions they are supposed to be able to trust, and that creates further damage. That creates what is called sanctuary trauma, and that can further isolate veterans and further prevent them from wanting to get the help they need.
I hope a long, hard look at this is taken in the next year. If the Liberal government cannot even stop its own employees from pushing MAID on veterans, how can it assure Canadians that the necessary safeguards can be put in place to protect vulnerable people from being pressured into accessing medical assistance in dying?
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Madam Speaker, perhaps my intervention will be more of a comment than a question, but I am happy to hear the member's thoughts on it.
Let us be absolutely clear on what happened with this one particular individual. There was a case worker in Veterans Affairs who should never have been giving any kind of advice regarding MAID. They were certainly not qualified to do that, and that individual no longer works for Veterans Affairs. That is the reality of the situation. Pertaining to medical advice, that should only ever come from an individual's physician and the medical experts who are qualified to do that.
Let us be clear that this was an isolated incident. The individual no longer works for Veterans Affairs. It is very clear what has happened with this individual and the fact is that they are no longer employed by Veterans Affairs.
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Madam Speaker, I am glad the member raised this because it is really important to understand we are talking about this kind of slippery slope we are leading down when we talk about expanding this into mental health.
I mean, there are many veterans in this country who struggle because of the service they have given this country. They struggle with psychological injuries, mental injuries, and PTSD. They may feel that, if they go to Veterans Affairs, which is where they need to go to get the help they need, there is a chance that, instead, they might be counselled on how they could end their life.
This has happened. We know of at least six cases where it has happened, and who knows how many others there might be. However, if a veteran has to feel that way about going to Veterans Affairs, might that mean they will not get the help they need? We should never be in a situation where a veteran feels they cannot get the help they need from the government.
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Madam Speaker, I invite my colleague to read the expert report, which clearly states that, when treatment exists, people are not automatically eligible for medical assistance in dying just because the treatment is hard to get.
That is the shortcut the Conservatives have been taking since the start of this debate. Just because a person with depression asks for MAID does not necessarily mean they will get it. Just because someone somewhere is considering MAID because they are depressed does not mean they will have access to it. That is what they do not understand. There are assessors, providers, professionals whose job is to provide care for people whose condition is reversible. Is anyone here going to suggest that depression is irreversible?
Our colleagues talked about the experiences of people who attempted suicide. In every case, the condition was reversible. In fact, some Conservative members even talked about their own experience. They are here to tell the tale. We have to see things clearly. There are 16 key recommendations that are worth reading. I invite them to read the report.
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- Feb/15/23 6:09:00 p.m.
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We have to move on to Private Members' Business.
The hon. member for Banff—Airdrie will have about two minutes after Private Members' Business to continue with questions and comments.
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