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House Hansard - 283

44th Parl. 1st Sess.
February 15, 2024 10:00AM
Context: House Hansard - 283 - Feb/15/24
Ms. Lisa Hepfner (Parliamentary Secretary to the Minister for Women and Gender Equality and Youth, Lib.)
Mr. Speaker, I will be sharing my time today with the member for Lac-Saint-Louis. I am very pleased to have the opportunity to speak in this House today in support of Bill C-62, particularly after listening to some of the debate this morning and hearing some of the language used in this House today. For example, the member for Abbotsford, throughout his speech today continually used the words “the mentally disorded” I believe in reference to people who are suffering from mental illness. A little later in the day, we then heard from the member for Leeds—Grenville—Thousand Islands and Rideau Lakes, who continually referred to people as “addicts” throughout his speech. In this House, we are leaders. Our words are important and we should not be furthering the stigmatization of people who suffer mental illness. I would caution my colleagues across the way to be careful in their language and to please not further marginalize people who are already suffering. I will turn back to Bill C-62. As the Minister of Health and the Minister of Justice have emphasized, the government believes an extension of three years is necessary to provide individual clinicians as well as provinces and territories the time they need to prepare for this change. I also believe a three-year extension of the period of ineligibility to receive MAID on the basis of a mental illness alone is necessary. Although significant progress has been made, more time is needed to ensure the safe assessment and provision of MAID in these circumstances. I have heard from psychiatrists in my riding of Hamilton Mountain who have said these very things. They need more time to get the system ready. My remarks today will focus on the progress that has been made in preparing the health care system, and also what more needs to be done. In 2021, as required by former Bill C-7, an expert panel examined the issue of permitting MAID where the sole underlying condition is a mental illness. It concluded that the existing legal framework of eligibility criteria and safeguards is sufficient, providing that MAID assessors apply the existing framework appropriately with guidance, through the development of MAID practice standards and specialized training. Our government understood the importance of the panel's findings. To that end, we have been working in collaboration with the provinces and territories and other health care partners to implement consistent standards across the country and support a highly trained workforce to undertake these complex assessments. For example, we supported the development of a model practice standard for MAID by individuals with clinical, regulatory and legal expertise. A model practice standard for MAID was released in March 2023 and has been adopted, or is in the process of being adopted, by most regulators across the country as a basis for assessment for clinical decision-making. The standard also provides guidance for MAID clinicians as they navigate more complex MAID requests. We also supported the development of the first national, fully accredited bilingual MAID curriculum, which was launched in August 2023. The curriculum consists of seven training modules addressing various topics related to the assessment and provision of MAID, including how to do a MAID assessment, how to assess capacity and vulnerability, how to manage complex chronic situations and how to assess requests involving a mental illness. Over 1,100 clinicians have registered for the curriculum since August of last year. This progress is the result of leadership and collaboration among health system partners, including federal, provincial and territorial governments, health professional organizations, regulatory bodies, clinicians and organizations like the Canadian Association of MAID Assessors and Providers. This collaboration and progress will continue to make improvements in approaches to safety and quality in assessments and provisions of MAID. In terms of the future, I want to briefly speak to the Regulations for the Monitoring of Medical Assistance in Dying, which outline the reporting requirements relating to MAID requests. These regulations came into force in November 2018, but were recently revised to facilitate enhanced data collection and reporting on MAID activity. Most notably, the regulations now allow for the collection of data based on race, indigenous identity and the self-reported presence of a disability, where a person consents to provide this information. The revised regulations came into force on January 1, 2023, and information on MAID activity in 2023 will be released in Health Canada’s annual MAID report this year, in 2024. This information will provide valuable insight into who is requesting and receiving MAID, including those under track 2, whose natural death is not reasonably foreseeable. Despite all this work, we have heard that the provinces and territories are at various stages of readiness for the lifting of the exclusion of eligibility and that they need more time to prepare their health care systems. I know that the suffering caused by a mental illness can be just as severe as that caused by a physical illness, but I strongly believe that this extension is necessary to ensure that MAID can be safely assessed and provided on the basis of a mental illness alone. This extension does not question the capacity of people with mental illness to make health care decisions. It is about giving the health care system more time to adopt or implement some of these key resources to ensure that MAID practitioners are properly equipped to assess these complex requests, and that the provinces and territories have the necessary mechanisms in place to support them. For example, both the expert panel that I referred to earlier and the special joint committee on MAID have emphasized the importance of case review and oversight of MAID, both to educate practitioners and to support accountability and public trust in the law. While the majority of cases of MAID, 90%, take place in provinces with formal oversight processes, other provinces do not have formal MAID case review and oversight processes in place beyond those already undertaken by professional regulatory bodies. Work is being planned to explore best practices through a federal-provincial-territorial working group, with a view to encouraging more consistent and robust mechanisms across the country. The expert panel and the special joint committee also identified engagement with indigenous partners as a priority. The Government of Canada has launched a two-year engagement process on MAID to hear the perspectives of first nations, Inuit and Métis, including urban indigenous people, indigenous people living off-reserve with or without status, indigenous people living with disabilities, and two-spirit, LGBTQQIA+ and gender-diverse indigenous people. The proposed extension under Bill C-62 would provide the necessary time to have these discussions with indigenous partners. It is an essential process to appropriately inform implementation as well as guidance and training material for clinicians to support enhanced integration of cultural safety in MAID practices. Health Canada will provide its first official update to Parliament on this work in March 2024, just next month. In conclusion, the Government of Canada remains committed to ensuring that laws reflect the needs of people in Canada, protect those who may be vulnerable, and support autonomy and freedom of choice. While we have made significant progress in the study of MAID and mental illness, and in the development and dissemination of key resources, we are not yet ready. We need to act prudently and not rush this change without the necessary resources in place. This decision is not an easy one, but I want to assure the House that we will continue to work collaboratively with our partners to improve the mental health of Canadians. I thank all members for the opportunity to speak today as we debate this important bill.
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