44th Parl. 1st Sess.
February 15, 2023 02:00PM
Madam Speaker, it could get interesting with two members from western Canada debating in French in the House on the topic of mental health.
I think that program funding and increased government services are not the only things that matter when it comes to mental health. There is the role of the family and the community. It is about having a career, a profession and a reason to live. There is faith, which is very important for many people.
Of course, it would be good for the government to provide more services to people having mental health issues or difficulties and who are asking for help. The provinces are responsible for providing the services. I know that my province of Alberta is working hard to ensure that people have a choice and access to services, but more can be done in the communities to provide services in rural regions and big cities. That said, I want to reiterate the importance of family, friends, work and faith, all of which must also play a role.
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Madam Speaker, it is always a pleasure to rise on behalf of the people of Kamloops—Thompson—Cariboo.
Prior to asking my learned colleague a question, I want to reflect on the life of a constituent who passed away over the holiday break. That was Paul Da Silva. I am very sorry for his family's loss, and I wish his wife and children all the best in this difficult time. May eternal light shine upon him.
My question to my learned colleague is this. We just heard from the parliamentary secretary about an expert panel. Typically, in law, when we talk about expert panels, they generally come down to what the court says. In this case, I am not sure if my colleague is aware, but I would like him to comment on how no court, from what I can see, has unequivocally stated that there is a right to medical assistance in dying for people who are mentally ill. I would like his comment on that.
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Madam Speaker, the beginning of his comments sounded almost like an S. O. 31, and I encourage the member to try to catch the Speaker's eye the next time he rises.
He is absolutely right. From what I can tell, at no time in the decisions of Truchon or Carter, and I have read both, did the government say there was a right to die in Canada because of an underlying mental illness as the only condition.
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Madam Speaker, I want my constituents to know that I am staying in the riding to take care of my newborn, but I am happy to participate, in hybrid fashion, on their behalf on this very important subject.
Bill C-39, an act to amend the Criminal Code regarding medical assistance in dying, seeks to delay the expansion of medically assisted death to individuals whose sole condition is a mental illness. We are here today because of previous legislation in the last Parliament, Bill C-7, that responded to the Truchon decision and the justice minister's interpretation of it by removing critical safeguards to accessing MAID, particularly that death must be reasonably foreseeable. However, Bill C-7 contained an arbitrary deadline of March 17, 2023, to expand MAID to those whose sole condition is a mental illness, and now the government is seeking to delay that arbitrary deadline another year down the road.
As I do not want MAID to be offered to those who are solely suffering from a mental health issue, I will be supporting the bill, but I do so in the context of very big and life-altering concerns regarding the direction the Government of Canada has taken since the debate on MAID commenced in 2016.
The Conservatives believe that we should never give up on those experiencing mental illness and should always be focused on offering help and treatment rather than assisted death. The Conservatives will bring forward alternative proposals to support those with mental illness instead of the government's approach.
Going back to 2016, the preamble of Bill C-14 spoke about the vulnerability of persons. It states:
Whereas vulnerable persons must be protected from being induced, in moments of weakness, to end their lives
It also states:
Whereas suicide is a significant public health issue that can have lasting and harmful effects on individuals, families and communities
Man, have we seen a lot of change in the last seven years.
Conservative members at the time, despite these assurances in Bill C-14, observed that the approach of the government was going down a slippery slope. The member for Selkirk—Interlake—Eastman highlighted a concern that has sadly now become a reality in Canada. He stated, “many believe that the policy will be used prematurely to end the lives of those who have become a burden to their families, society, or the medical system.”
At the time, because of big public concerns, many Liberal members were careful when it came to speaking about expanding MAID in the future. The former justice minister, Jody Wilson-Raybould, said, “In terms of eligibility, the policy choice made by the government was to focus on persons who are in an advanced state of irreversible decline and whose natural deaths have become reasonably foreseeable.” The current member for Lac-Saint-Louis said, “Bill C-14 would not normalize medically assisted dying as perhaps has occurred in Belgium and the Netherlands, the two most often cited examples of the slippery slope.”
In the last Parliament, in his charter considerations on Bill C-7, which expanded MAID to include those without a reasonably foreseeable death, the current Minister of Justice cited inherent risks and complexity as a reason not to expand MAID to those with mental illness as a sole condition. However, the Minister of Justice, unfortunately, as we find today, is speaking on both sides of this issue very irresponsibly. On the one hand, he communicated in the Bill C-7 charter consideration that due to the complexity and inherent risks, we should not be expanding MAID to those with mental illness as a sole condition. On the other hand, in the same bill, he included a sunset clause to expand MAID to these Canadians and said that his hands were tied by a Quebec court decision. However, not only has the government refused to challenge it at the Supreme Court, but leading legal experts in our country have stated that his interpretation of the decision is flawed.
After telling Canadians time and again that the legalization of MAID would not lead to a slippery slope by allowing death on demand for any citizen whenever they may want it, the government seems set on expanding MAID to anyone.
I plead with the backbench members of the Liberal Party to stand up against the justice minister today. You have more influence than any Canadians right now to stop what he is trying to do.
Do not forget that in 2016, on Bill C-14, he voted against the—
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- Feb/15/23 7:16:28 p.m.
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We have a point of order from the parliamentary secretary to the government House leader.
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Madam Speaker, I can certainly appreciate the passion in the member's speech, but he did just start talking directly to Liberal members. He said, “You have...”, and I am certain he was not talking about you. Perhaps he would like to rephrase that.
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- Feb/15/23 7:16:49 p.m.
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I appreciate the hon. member noticing that.
Yes, the hon. member has to speak through the Chair. That is just a reminder.
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Through you, Madam Speaker, I implore the Liberal members of Parliament to stand up against their justice minister and the irresponsible decisions he is taking.
Across Canada every year we celebrate Bell Let's Talk. Mental health services have expanded in hospitals, schools and universities because there is an inherent belief by all Canadians that mental health challenges are things we can overcome. Every family in this country is impacted by mental health, and it pains me to see my country considering offering death to those suffering at their lowest points. We do not need to do this.
Again, through you, Madam Speaker, I implore Liberal members to challenge the justice minister on his overly broad interpretation of the Truchon decision, a ruling of the Quebec court, and to stop what he wants to do.
A recent article in The Globe and Mail talked about Donna Duncan, a 63-year-old woman from my community. Her daughter successfully delayed, through the court, her mother's access to MAID because her mother suffered from a mental illness. However, just hours after leaving the hospital, Donna received a medically assisted death without her daughters being informed, even though their mother already suffered from a mental health condition that was documented.
Both daughters, Alicia and Christie, testified at the medical assistance in dying committee and they made a number of recommendations.
The first, which seems so sensible, is “mandatory access to health care”.
The second is an increase in the required number of independent witnesses to be formally interviewed as part of the assessment, to at least three.
The third is “...a pre-death assessment review. Doctors should be required to submit all assessments to an independent review board prior to a patient's death.”
The fourth is “continuity of care. Multiple assessments should be completed by the same medical professional.”
The fifth is “mandatory wait periods”.
The sixth is “...mandatory release of records. Hospitals and health authorities should be required to release unredacted copies of their MAID assessment records to those who are entitled to them.”
I would be remiss if I did not mention the fact that, when Bill C-39 was tabled in Parliament, the Association of Chairs of Psychiatry in Canada called for this delay at the beginning of December. I will note as well that University of Toronto law professor Trudo Lemmens and numerous colleagues from across Canada challenged the Minister of Justice on his actions today.
Again, my plea today is to the Liberal caucus, through you, Madam Speaker, to challenge the decision of the justice minister, not to irresponsibly expand MAID in one year's time for those suffering from mental health. Canadians know that mental health can be overcome. Canadians know that this does not have to be the solution. Canadians know that they want to take care of people when they need to be taken care of.
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Madam Speaker, first, I sincerely appreciate the incredible passion the member has demonstrated in his speech. I congratulate him for relaying that in such a passionate manner to the House. Second, I certainly take great opportunity to reflect on this legislation and the issue before us, so I do not want the member to think there are not members of the Liberal bench who are always highly concerned over the manner in which this medical procedure would be used.
Finally, I am unsure exactly what the member is asking when he makes a plea to Liberal backbenchers, in his terms. The whole point of this extension is to make sure that everything that would be put in place would be done in a responsible and appropriate manner.
By the member's own admission, he is voting in favour of this extension. Therefore, what is it, exactly, that the member is asking? Is he asking for something that is supposed to happen a year from now?
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Madam Speaker, I thank the member for the opportunity to clarify a key point, which is that I do not believe that mental health sickness should be a reason for someone to receive MAID in Canada. The legislation before us today would delay the ability of medical professionals to offer MAID on the basis of mental health sicknesses. I do not want to see my country ever reach that point. Therefore, in the year ahead, I implore the Liberal members of Parliament to challenge their justice minister, because I know, and they know, that the large majority of Canadians are against this.
In fact, I did a survey in my community. While my community was equally divided on MAID in general, there was unanimity among all of my constituents that, at a minimum, proper medical supports and mental health supports should be offered to all people irrespective of their medical conditions, and especially for those considering the use of MAID.
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Madam Speaker, it is always a pleasure to rise on behalf of the people of Kamloops—Thompson—Cariboo. I will admit that my hon. colleague kind of stole my thunder, because I was going to ask a bit about what his constituents were saying.
However, I am wondering if there were any responses that particularly stood out. As I understood his last comment, he said that it was about fifty-fifty on the issue of medical assistance in dying, generally. However, it sounds like there was near unanimity from his constituents, and obviously on a moral issue he has to bear that in mind. I wonder if the member wants to take 30 to 45 seconds of this important time in the House on this very important topic to elaborate on that.
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Madam Speaker, my colleague is from Canada's number two riding, after my riding of Mission—Matsqui—Fraser Canyon. I will note that, under the proposed redistribution boundaries, he is going to take part of Canada's number one riding, which I am very sad to see.
However, to the member's point, my constituents believe that we, as a country as rich and prosperous as Canada is, should be offering the medical treatment to allow people to make informed decisions about their lives, especially when they are most vulnerable. Right now, we are not there. I could [Technical difficulty—Editor] for example in my community, that a woman decided to receive MAID because she felt she was a burden on society, in Abbotsford, and did not have access to adequate housing. Where are we as a country and a society when we are permitting the death of an—
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- Feb/15/23 7:25:19 p.m.
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I apologize to the hon. member, but his sound is very unstable. I think we are having issues with interpretation. We are running out of time also, but the last bit was a bit unstable. It was very difficult to understand all the sentences, and we are out of time.
Resuming debate, the hon. member for Kamloops—Thompson—Cariboo.
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Madam Speaker, it is always a pleasure to rise on behalf of the people for Kamloops—Thompson—Cariboo, especially when we are talking about something that is really quite critical and that is quite important to a number of people in the House.
This is an issue that really tugs at the heartstrings of a number of Canadians. My hope, and what I have seen so far, is that we can have a rational debate on this issue. What we are debating in this bill is the one-year postponement, putting it in my words, of the provision of medical assistance in dying to people who are suffering solely from mental illness. It is also intertwined with the greater question of what we, as Canadians, should be doing. If there is no other place that we should be debating this, it is right here.
I want to reflect a little bit on how we got here and also where I anticipated we might go, based both on what materials have been provided to the Minister of Justice and what the government has put out through its charter statement.
It was not that long ago that I was in high school. Maybe it was a while back, 1993, if I recall.
Mr. Mark Gerretsen: I thank the hon. member for being honest.
Mr. Frank Caputo: Madam Speaker, the member for Kingston and the Islands commended me for my honesty. I appreciate that. I like to think I am always honest in this place.
In 1993, if memory serves, we had the Rodriguez case. I am probably simplifying this, but that was a question on the right to die. It was a five-four split, but the Supreme Court of Canada said that there was no charter basis for that decision. It has been a while since I reviewed that in depth, but that is my recollection.
We fast-forward 22 years to the Carter decision in 2015, which came to the opposite conclusion. That case, I believe, was a per curiam decision for the court, which means that all nine justices found that the prohibition did offend the charter. The question that often comes to the House after that occurs is how Parliament should respond. I was not here then. I got here in 2021. Being here has been 18 of the best months of my life.
I can say that, from 2015 to 2023, we have seen a dramatic shift in what seemed to be envisioned both in the legal community and in the Canadian community at large, that change from medical assistance in dying for people who had irremediability, a terminal condition or a condition that was not going to get better, with death being foreseeable. My understanding when I was growing up, and it was an issue when I was in high school and university, was that this was really at the crux of the issue. Should somebody who is terminally ill have a right to euthanasia? That is how we framed it.
I am going to go to the minister's charter statement, dated October 21, 2020. I am going to note that I am not sure whether or not a charter statement has been provided for Bill C-39. I was with the minister at committee yesterday and no charter statement had been provided, so here we are debating a bill on a very serious issue, and we do not have a charter statement.
I am looking at everybody on the government benches. There are a couple of people here on the opposition benches as well. I hope we can all agree that not having a charter statement, which is supposed to accompany legislation like this, is a problem. What is adding to that problem is that, when the minister was asked about that by one of my colleagues yesterday, there was no definitive answer. He was asked where the charter statement is and when it is coming.
We are being asked to decide on this issue inside of what I would call a legal vacuum, where we do not even know what department officials think about this proposed legislation. I would hope, and I would think, that all of my colleagues believe that to be a problem.
The charter statement on Bill C-7 was tabled on October 21, 2020. This was before the legislation was amended by the Senate. On page 7 of 18, the charter statement says, “While expanding eligibility for MAID to include people whose natural death is not reasonably foreseeable, the Bill would exclude individuals whose sole medical condition is a mental illness.” On the next page it continues, “In particular, the exclusion would apply only to mental illness”.
Further on, it says:
The exclusion is not based on the assumption that individuals who suffer from mental illness lack decision-making capacity and would not disqualify such individuals from eligibility...if they otherwise meet the requirements, for example, if they have another medical condition that is considered to be a serious and incurable illness, disease or disability. Nor is the exclusion based on a failure to appreciate the severity of the suffering that mental illness can produce.
This is the key part:
Rather, it is based on the inherent risks and complexity that the availability of MAID would present for individuals who suffer solely from mental illness. First, evidence suggests that screening for decision-making capacity is particularly difficult, and subject to a high degree of error.... Second, mental illness is generally less predictable than physical illness in terms of the course the illness will take over time.
These are static points, and by that I mean these things will not change with time. It is not like in 2020 there were inherent risks and complexity of judging MAID for people who suffer from mental illness, but now it has changed. We asked the minister about this, as I recall, yesterday. In any event, the minister has not articulated, and the government has not articulated, what changed. Either the charter statement was wrong, or something changed.
Neither has been put forward before the House. How is that possible? Was the charter statement wrong, or have the inherent risks and complexity changed? Has the predictability of mental illness over the course of time changed, or was the charter statement wrong? These are questions that, in my view, the minister has to answer.
One of the more difficult things we discussed yesterday at committee with the minister happened when one of my hon. colleagues asked him about a letter that was written by 32 academics. These are not insignificant people. I know some of these 32 law professors. The minister was asked flat out by the member for Fundy Royal if the professors were right, or if the minister was right. The minister said he was right.
I am going to list a few of these 32 professors, because the hon. minister has said that they are wrong. There is Archibald Kaiser, professor of law in the department of psychiatry at Dalhousie; Tess Sheldon, from the faculty of law at the University of Windsor; Elizabeth Sheehy; Brandon Trask; Brian Bird, a friend of mine who clerked at the Supreme Court of Canada and did his thesis on conscience rights for a Ph.D. in law; Janine Benedet, who I have heard speak to issues that relate to sexual assault; and one of my very good friends, Dr. Ruby Dhand. I am going to give her a few props here. She had five degrees by her 34th birthday. Professor Dhand is one of the smartest and most brilliant people I know.
The minister told us yesterday that he is right and these people are wrong. They wrote a letter saying that what the government is saying is the case with MAID, that it is rooted in Canadian law, is just simply not accurate. That is what they said. Who is wrong: them or him?
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Madam Speaker, I am quite concerned about the way my colleague has framed this issue. The issue of MAID for mental health as the sole underlying condition was resolved two years ago. An expert panel reported in the middle of last year with some recommendations. There has also been extensive work by the Special Joint Committee on Medical Assistance in Dying, which that was tabled today, and I think all of the evidence suggests that we are ready to move forward on MAID for mental health as the sole underlying condition, however there is a need to ensure that additional safeguards are in place.
I am wondering if my friend could comment on the role of the expert panel and its recommendations in this regard.
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Madam Speaker, I will address the member saying that this was resolved two years ago. Two years ago would have made it February 15, the day after Valentine's Day, 2021. This charter statement was tabled in the House October 21, 2020. Was this issue resolved mere months after this charter statement? I get it. Reasonable people can disagree sometimes, and we talk about expert panels.
I will say this much. This letter to the minister, led by Trudo Lemmens, was tabled February 2, 2023. These are serious concerns. When there are serious concerns about an issue this significant, we should not be saying we are pressing on in one year. We should be giving this more thought.
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Madam Speaker, I want to thank my hon. colleague, who often speaks in this place about the need for justice and the need to ensure that those who are left behind actually get support.
I often find myself thinking about solutions. New Democrats have tabled solutions to fix one of the core drivers of the mental health crisis in Canada, which is poverty. Poverty is one of the greatest contributors to the mental health crisis in this country. We have tabled solutions, and I understand the Conservatives may disagree with some of those solutions. One of them is the guaranteed livable basic income.
Could the member, given the kind of description of the problems of poverty and the effects it has on mental health, offer at least one solution so those who are struggling to pay their rent and struggling to pay for their groceries can ensure that they get that kind of support? Could the member elaborate on that?
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Mr. Speaker, I appreciate my colleague's intervention. I have been here 18 months, and it has been a pleasure to get to know him over that time.
My hon. colleague may not know this, but my wife, as a clinical lawyer, helps the most down-and-out people. She is somebody I consider an expert in this field, helping out people and giving them legal advice for the greatest issues. They are often the most poor, and one of the things she relates to me is that one of the contributors is actually trauma. That is one of the greatest issues when it comes to mental health as well. It is trauma.
I am not going to discount poverty. We, as Conservatives, talk about poverty every day in this place when we talk about the impact of inflation on poverty. If we really want to talk about this, we should talk about the government not legislating mandatory minimums for sexual offences. That is where trauma comes from. I hope, when we do speak about these things, that my colleague joins me. I look forward to chatting more about extinguishing poverty with him.
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Madam Speaker, the member spoke about the charter and how every single piece of legislation is supposed to be complying with it. He mentioned that, at the justice committee, they did not have information about whether this particular piece of legislation was charter compliant. I want to give him the extra time to go over the matter just so the House can be well briefed on the current situation with Bill C-39.
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Madam Speaker, we do not have a charter statement and we should. It is my understanding that, even when a bill is revised, there should be a charter statement. With Bill C-7, we had an initial charter statement. It came back from the Senate, and there is no new charter statement. The charter statement we are left with is pre-amendment. That is a problem, and if we couple that with the lack of a charter statement in the House, we are left with a huge problem.
In my view, the law is to be followed and there should be a charter statement. We should be following that. I wish we had it. We should have it.
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