Hon. Renée Dupuis: Minister, welcome to the Senate. In your mandate letter of December 16, 2021, the Prime Minister asked you to do the following, among other things:

 . . . collaborate with Indigenous partners — by working together to close socio-economic gaps and improve access to high-quality services.

I would like to come back to the drinking water issue, because it seems to me that it falls under at least three of the sustainable development goals that Canada has committed to achieving by 2030, namely sustainable communities, the resolution of the difficulties accessing drinking water and the elimination of discrimination. Closing socio-economic gaps means more than just investing money. We must also examine how we close the gaps with services provided to citizens in general.

My question is about the 27 or 28 communities you mentioned, where 31drinking water advisories remain in effect. Are these 27 or 28 communities part of the First Nations that will be compensated according to the provisions of the settlement between the federal government and the First Nations that have filed class action suits?

[English]

Senator Plett: Thank you, Senator Dean.

It struck me as a bit odd that Bill S-241 basically turns over the accreditation standards of Canadian zoos to an American accreditation body known as the Association of Zoos & Aquariums, or AZA.

There is currently a bill, Senator Dean, before the U.S. House of Representatives called the SWIMS Act. This bill would prohibit the breeding and the importation and exportation of orcas, beluga whales, false killer whales and pilot whales for the purpose of public display in the U.S. This is very similar to rules which Canadian zoos and aquariums are already required to abide by. The U.S. is not, however.

The AZA, Senator Dean, is opposing this bill in the U.S.

Senator Dean, can you tell me why you would want to turn over the accreditation standards of Canadian zoos to an American accreditation body that does not even support the existing Canadian standards?

Hon. Lucie Moncion: Welcome, minister. My question relates to your role as the Minister responsible for the Federal Economic Development Agency for Northern Ontario. It is about the Ring of Fire.

Development of the Ring of Fire is subject to the environmental assessment process, regulatory processes and the Crown’s obligation to consult. The Government of Ontario needs the federal government’s support to ensure that the Ring of Fire’s full potential can be achieved and to advance regional, environmental and economic development, which is of national importance.

Could you explain what financial and other supports the federal government is offering for these different projects?

[English]

Hon. Donald Neil Plett (Leader of the Opposition): Minister, chiefs from four remote nations in northeastern Manitoba are calling for the federal and provincial governments to come together to build a local hospital. The Island Lake region chiefs have said their communities are in great need of proper infrastructure. These communities currently rely on nursing stations that can only provide limited treatments.

Chief Charles Knott said, “I think it’s time the government come visit our community to see firsthand what we go through every day.”

And Grand Chief Scott Harper said:

We have been negotiating with Canada for decades to fund our hospital and related facilities while our members keep dying from preventable deaths.

Minister, I know this is near and dear to your heart. You live close to these communities. The riding that you represent is not that far away. Have you visited these communities, minister? What are you doing to ensure that the people in these remote communities get the health care they deserve?

Senator Dean: I could simply say, Senator Plett — thank you very much for the question — that the AZA is considered to have higher standards than its Canadian counterpart. The proponents of the bill and those who support it were very much in favour of adopting the AZA standards. I have no idea why the AZA takes this position, if indeed they have so. I can’t help you on that.

On the question of why the AZA is mentioned in this bill, it offers the highest standards available, and that’s what the proponents were looking for.

Senator Plett: One final question, maybe more of a comment than question: You mentioned in your speech that I was travelling around to different zoos and aquariums, and I indeed have done that. I have been in Kelowna at the kangaroo zoo, the Calgary Zoo, the Assiniboine Park Zoo, Parc Safari, Granby, here at Parc Omega.

Every speaker in this chamber has the absolute right and, in fact, the duty to say the things that they believe, and so I’m not wanting to take anything away, but it seems there is always something being alluded to that somebody is maybe delaying this legislation. Do you not think that the proper way as well would be, though, Senator Dean, for both the critic and the sponsor to do what I have been doing and visit all of these zoos before we go to committee so that we have all the information that we can have before we go to committee? Because, indeed, I think over the years it has been shown here that I indeed support most of — if not all — legislation going to committee. I believe that is where this chamber does its best work, at committee.

The Hon. the Speaker: Honourable senators, we welcome today the Honourable Patty Hajdu, P.C., M.P., Minister of Indigenous Services and Minister responsible for the Federal Economic Development Agency for Northern Ontario, to ask questions relating to her ministerial responsibilities.

Pursuant to the order adopted by the Senate on December 7, 2021, senators do not need to stand. Questions are limited to one minute and responses to one-and-a-half minutes. The reading clerk will stand 10 seconds before the expiry of these times. Question Period will last one hour.

Hon. Amina Gerba: Honourable senators, every year on November 19, we celebrate Women’s Entrepreneurship Day, which is intended to give women the means to actively participate in our country’s economic life.

I rise today to pay tribute to Vickie Joseph, a female entrepreneur and diversity success story. Vickie is a graduate of Montreal’s International Academy of Design, a serial entrepreneur and a philanthropist. She worked for many businesses before she created Nu.I by Vickie in 2006, a fashion company known for its original creations designed for women who want clothing that is both elegant and comfortable.

Vickie is also the co-founder and president of V Kosmetik International, which specializes in the manufacturing and distribution of beauty products. Her makeup line, V Kosmetik, has 50 shades for darker skin tones and is available in Canada and around the world, including the United States, Morocco, Senegal, Tunisia, Benin, Saudi Arabia and South Africa.

Vickie believes that with success comes a responsibility to help others. For that reason, she co-founded, with her husband, Frantz Saintellemy, Groupe 3737, an important entrepreneurial incubator that promotes newly emerging businesses.

She also co-founded FemPreneurs to help women develop their businesses with special programs for women of diversity.

Recipients of several awards, Vickie and I are members of the first cohort of Excellence Québec, which I invite you to learn about online.

Colleagues, as I have often said, the prosperity of diversity contributes to the prosperity of our country. We must do everything we can to support female entrepreneurs, and Black ones at that. As a Black female entrepreneur myself, I know the systemic barriers Vickie had to overcome to get to where she is today. She deserves our recognition.

Please join me in honouring an inspiring female entrepreneur and diversity success story, my friend and sister, Vickie Joseph.

Thank you.

Hon. Senators: Hear, hear!

Hon. Dennis Glen Patterson: Honourable senators, today I have the honour of paying tribute to James Eetoolook, a giant among Inuit leaders. James was a pioneer and leader in the long struggle for the creation of Nunavut.

James began his long career as a leader working as a clerk for the Hudson’s Bay in what was then Spence Bay in the Northwest Territories, or the N.W.T. He became the co-op manager and then settlement secretary of the settlement of Spence Bay, now Taloyoak, in 1975. He then became senior administrative officer when the community became one of the first hamlets in the N.W.T. in 1976. He was elected president of the Kitikmeot Inuit Association in 1989 and president of Tunngavik Federation of Nunavut, the predecessor to Nunavut Tunngavik Inc., or NTI, in 1992.

That was the time we had to settle a dispute with the Dene over the western boundary of Nunavut. I worked with James and other Inuit leaders as we recommended mediation that led to the so‑called Parker Line. We then had to work to secure, for the second time, majority support in the N.W.T. for the boundary for our new territory. This was the second plebiscite in which Inuit leaders put everything on the line to democratically pursue our dream of Nunavut — the first being in 1982 when we managed, by high turnouts in what is now Nunavut, to secure 56.4% support for division of the Northwest Territories.

James has been a rock-solid leader of Inuit for all those years. Since that time, and as elected vice-president of NTI for 29 years, he has worked tirelessly, advocating for and supporting the rights of Inuit as a land claim negotiator. His signature is on the Nunavut Agreement of 1993, he was president of the Kitikmeot Inuit Association and Tunngavik Federation of Nunavut and, for the last 29 continuous years, the vice-president of NTI. He was the driving force of Inuit-led DEW Line and environmental cleanups all across Inuit Nunangat and fought for Inuit subsistence hunting rights against animal rights groups at Convention on International Trade in Endangered Species of Wild Fauna and Flora, or CITES, meetings, travelling all over the world from his isolated and remote home in Taloyoak on the Central Arctic Coast. He also led successful negotiations with Canada on parks, heritage rivers and protected areas.

James Eetoolook, thank you so much for all you have done for the territory, Nunavummiut and Canada.

I am thankful for this opportunity to share with you, my dear Senate colleagues, just some of his many achievements.

Qujannamiik, James. Taima.

Hon. Donna Dasko: Honourable senators, the Ukrainian Holodomor is recognized on the fourth Saturday of November each year, and I rise today to remember the millions of victims of this genocidal famine that was perpetrated against the Ukrainian people in the 1930s. Under dictator Joseph Stalin, the Soviet government launched a policy of collectivization that involved the brutal confiscation of grain and all foodstuffs from the Ukrainian rural population. Villages were blockaded, and during the worst year — 1932 to 1933 — thousands died every day. Many millions of Ukrainians died of enforced starvation during the Holodomor.

In a tragic example of how history can repeat itself, today we are witnessing nothing less than another genocide perpetrated on the Ukrainian people by another tyrant. The crimes committed by the Russian army, commanded by Russian President Vladimir Putin since the illegal invasion of Ukraine began on February 24, include mass atrocities in the invaded territories: the systematic, willful killing of Ukrainian civilians; the desecration of corpses; identifying and killing local leaders and widespread instances of physical and mental harm and rape. Young children are kidnapped, forcibly removed from their families and stripped of their language and culture. Some are inducted into modern slavery.

These examples of genocide have been independently verified by the New Lines Institute, the Raoul Wallenberg Centre and others. Indeed, Putin has framed this as a genocidal war right from the beginning. Like his predecessor Joseph Stalin, Putin despises an independent Ukraine. His goal is to destroy this democratic and peaceful nation and return it to the dark days of authoritarian rule.

In the 1930s, the Soviets were especially successful at denying their crimes against humanity. Although a few brave journalists — including the trailblazing Canadian Rhea Clyman — were eyewitnesses to those events, and although many survivors shared their accounts, the story of the Holodomor remained covered up for over five decades.

Today, however, there is no hiding. The whole world knows about the illegal invasion of Ukraine and the crimes perpetrated there by Russian forces. I am proud that our government, Canadians across this country and democracies around the world are standing strongly and steadfastly with Ukraine in the face of this new genocide. Brave Ukrainians are fighting for their lives and for their country, but they are fighting for our freedoms too.

Thank you.

Hon. Donald Neil Plett (Leader of the Opposition): Let me add my welcome as well, minister.

Minister, part of your mandate as Minister of Indigenous Services is to:

Eliminate all remaining long-term drinking water advisories on reserve and make sure that long-term investments and resources are in place to prevent future ones . . . .

Back in 2015, the Prime Minister promised to put an end to these advisories by March of 2021. Yet Canada still has 34 long‑term drinking water advisories in 29 communities across the country.

Minister, why has your government failed to follow through on its promises to Indigenous peoples to end these advisories?

Hon. Senators: Hear, hear.

Hon. Michèle Audette: Good afternoon, honourable senators.

[Editor’s Note: Senator Audette spoke in Innu.]

Colleagues, I rise today to introduce you to my young guest. When I first met him, I thought he was 18, but no, he’s just 16 years old.

I met him on July 15, 2022, at a gathering about online safety held in Quebec City. It was such a pleasure to hear him speak, and I was especially honoured to meet him.

Jayden Paquet-Noiseux attended the meeting as a spokesperson for Children First Canada. I heard what he had to say and I admired his leadership. His contribution to the meeting was lauded not only by me, but also by other adults, other moms and other kokum. I knew right away that this young man would go far in life.

I was so impressed that I invited him, as I invite others every time I visit a primary or secondary school, or a university or college, to come and meet us in the Senate of Canada, since this chamber also belongs to them.

It finally happened on September 8, 2022. Jayden emailed me to ask if he could do a placement with me, which, of course, I accepted.

I was happy to know that, at 16 — he is in grade 11 — he is already very involved indeed. He is involved in his community. He is involved as a member of Children First Canada, known in French as Les enfants d’abord Canada, and he was also a member of the Young Canadians’ Parliament and the National Youth Advisory Panel.

He has already had the opportunity to introduce and debate bills, which is something I have not yet done. Bravo! He debated a bill on mental health and had media appearances on CBC Kids News, Radio-Canada and elsewhere. He was also the bilingual services coordinator for Children First Canada.

I would like to thank our colleague, Senator Moodie, for organizing a round table recently that Jayden participated in.

Guess what? Jayden is going to come study at the University of Ottawa. Jayden, I hope we will have the privilege of seeing you again, and I wish you all the best in your political science and communications studies.

When I was young, I dreamed of becoming a senator, and I hope to see you here one day. Tshinashkumitnau.

Hon. Chantal Petitclerc: Honourable senators, in just 100 days, 3,300 young athletes competing in 20 different sports will meet for a celebration of amateur sport, the 56th Quebec Games.

The event will take place in Rivière-du-Loup, in the senatorial division of Grandville, which I have the privilege of representing. Young people representing 19 regions of Quebec will experience nine days of achievement, sports performances, perseverance and camaraderie.

Since 2016, Rivière-du-Loup has been preparing to host this celebratory event in the heart of winter. The Quebec Games have been part of our provincial athletes’ careers for over 50 years and are a unique opportunity to promote healthy lifestyles and sports.

I’m going to bet that on March 3, when the athletes make their entrance during the opening ceremonies, emotions will be running higher than usual. The Lower St. Lawrence has been waiting for these games for a long time. Our young people are emerging from a time in their lives that has not been easy. This will be the moment to recognize their incredible resilience.

The 100-day countdown to the games is a crucial, intense period that generates a lot of emotions, and it is a magical time. It comes with the realization that all the work done over the years will finally bear fruit, and the athletes will have the chance to give it their all, to challenge themselves to do even better.

I leave you, senators, with the words of Isabelle Charest, an Olympian and Quebec’s Minister responsible for Sports, Recreation and the Outdoors. She said the following and I quote:

I absolutely adored participating in the Quebec Games, where I made important contacts that influenced my career. I am convinced that the spirit of friendship that I felt so strongly there is still alive and well today, and that is partly thanks to you, dear organizers, volunteers and stakeholders in the sports community. We have been through some challenging times over the past few years, but you kept the flame alive.

Dear athletes, volunteers and organizers, I stand firmly behind you and wish you all the best as the 100 day countdown begins.

Thank you. Meegwetch.

Hon. Patty Hajdu, P.C., M.P., Minister of Indigenous Services and Minister responsible for the Federal Economic Development Agency for Northern Ontario: Thank you very much, Your Honour, and thank you very much for welcoming me into this very honourable place.

On the issue of water, let me first start that by saying that the commitment remains to work with First Nations communities and partners to lift all boil water drinking advisories. In fact, since 2015, we have lifted 136 long-term advisories and, importantly, prevented 231 short-term advisories from becoming long-term advisories. I expect that the majority of the remainder — 31 is the actual number remaining — will be lifted within the next 12 months.

Having said that, I will also tell you — and it’s something I have learned in my journey — that it isn’t the federal government that has the final say on whether a long-term drinking water advisory is lifted. That remains in the control and decision‑making power of the chief and council. We do a lot of work with communities that have new plants and a water system that is delivering water but which are not ready yet to lift that water advisory. We have programs to help community residents, who have been subjected to boil water advisories sometimes for the entirety of their lives, to trust the water that’s coming out of the taps.

This was something that, immediately upon hearing it, I recognized how it could be true, but hadn’t thought through prior to this position. We continue to work with those remaining 28 communities and the 31 advisories, and I know that our government will not rest until we are able to make that work.

Hon. Marc Gold (Government Representative in the Senate): Honourable senators, I have the honour to table, in both official languages, a Charter Statement prepared by the Minister of Justice in relation to Bill C-32, An Act to implement certain provisions of the fall economic statement tabled in Parliament on November 3, 2022 and certain provisions of the budget tabled in Parliament on April 7, 2022, pursuant to the Department of Justice Act, R.S.C. 1985, c. J-2, sbs. 4.2(1).

Hon. Ratna Omidvar, Chair of the Standing Senate Committee on Social Affairs, Science and Technology, presented the following report:

Thursday, November 24, 2022

The Standing Senate Committee on Social Affairs, Science and Technology has the honour to present its

TENTH REPORT

Your committee, to which was referred Bill S-246, An Act respecting Lebanese Heritage Month, has, in obedience to the order of reference of November 3, 2022, examined the said bill and now reports the same without amendment.

Respectfully submitted,

RATNA OMIDVAR

Chair

Hon. Stan Kutcher: Honourable senators, I rise today to speak in support of Bill S-248, introduced by Senator Wallin in this chamber, a bill that would allow for the provision of advance requests for medical assistance in dying, or MAID, for competent persons who wish to avail themselves of this method of asserting their end-of-life choice.

I will not repeat the well-researched and clearly presented information provided by Senator Wallin on what we know about Canadians’ opinions regarding advance requests or her discussion about Audrey’s Amendment and the details of this bill. I will focus my remarks on a number of key items that I hope will be considered at the committee that studies this important legislation. Before I do that, I want to echo two key points that Senator Wallin addressed in her speech.

First, it is clear that this bill amends the Criminal Code to allow for advance requests. It is permissive, not prescriptive. There is nothing in this bill that compels or directs any person to seek MAID using an advance request.

Second, this bill does not promote MAID as an alternative to palliative care or a remedy for access to needed services and supports. As Senator Wallin put it, “MAID is not an alternative to poverty or treatment or support or family.” I agree with both of these considerations.

That said, let me begin my contribution to this debate by considering what an advance request for MAID is and, equally important, what an advance request for MAID is not.

We can think of an advance request for MAID as a request made by a competent person, for MAID, in advance of a loss of decision-making capacity, to be acted upon under the circumstances outlined in the request after the requester’s loss of decision-making capacity, following the requirements set out in federal legislation.

This consideration has a number of key components that can assist us in thinking critically and compassionately about advance requests for MAID. It can help identify areas that need careful attention as safeguards and standards are constructed to help manage the application of advance requests.

I will focus on four areas:

First, an advance request is not a directive. MAID providers are not obliged to provide MAID simply in response to a request. They must still follow their professional guidelines, best judgment and all legal stipulations in responding to an advance request. Thus, the request itself must be clear, specific and stipulate the conditions under which it is to be considered by the MAID provider.

Second, the request must be made by a competent person, and as such, a clinically and legally defensible determination of competence should accompany an advance request.

Third, the advance request must be made voluntarily and be well considered. That means that the request cannot be the result of undue influence or coercion and that the person making the advance request has demonstrated that they have considered relevant information prior to them making the request.

Fourth, the request has been made in due consideration of the impact of the passage of time. It should be regularly updated so that the MAID provider has reasonable comfort that the request is current.

Before going into these four areas in more detail, I will address what an advance request is not and consider what some kinds of conditions are that we may expect that advanced requests would be made for.

An advance request is different than an advance directive. Advance directives already exist, are well established and are common in many different aspects of medical care. Senator Mégie raised this important issue in a question to Senator Wallin.

While an advance request for the federal regime for MAID would be governed by the Criminal Code, advance directives are governed by provincial/territorial regimes for other types of health care. Most frequently, they are given in the context of a choice or refusal of treatment.

For a personal example, when my elderly mother began to experience numerous and compounding health challenges, my brothers and I had many very emotionally problematic conversations with her about what kinds of treatments she would accept and what kinds of treatments she would not accept. These were difficult.

We wrote down her decisions and we all signed off on them. We made sure that we provided evidence of her cognitive capacity at the time of our discussions. We also all came to an agreement on substitute decision making. When the time came — and it did — we provided her medical team with her directives. They followed them.

I am certain that for many in this chamber, this is a situation not unknown to you. It can be very uncomfortable because it deals with the reality of the upcoming death of a loved one. But it is supposed to be uncomfortable because if it were not so, we would not be loving and caring people.

The same discomfort should and does arise in all of our discussions about MAID. Discomfort is a necessary part of this journey.

Advance directives can include preferences for treatment and stipulations for refusal of treatment. As such, they are logical extensions of the doctrine of informed consent for treatment and refusal of treatment.

They can range widely, from accepting palliative sedation while concurrently not accepting antibiotic treatment for a potentially life-ending infection to directing a “do not resuscitate” order, to refusing all foods and fluids administered via a feeding tube or by mouth, known as voluntarily stopping eating and drinking, or VSED, which usually — and we’ve lived through this — results in death in 7 to 10 days.

Thus, while an advance request for MAID is not the same thing as an advance directive, these different concepts share the acceptance of personal autonomy as it pertains to advance decision making, and we are underpinned by the doctrine of informed consent and the right to choose and refuse treatment, even if that choice results in or hastens death.

While it is anticipated that most advance requests will be made in the context of neurodegenerative diseases such as Alzheimer’s disease, other kinds of illnesses may also trigger an advance request. For example, a primary brain tumour, such as glioblastoma multiforme. GBM, as it is known in the medical community, is the most invasive type of brain tumour and is not curable.

People diagnosed with GBM typically live 10 to 22 months from the time of diagnosis. While most people are cognitively intact when diagnosed, decision-making capacity can decline very rapidly. End-stage GBM can include severe headaches, inability to swallow, delirium, hallucinations, delusions, loss of control over bodily functions, seizures and loss of consciousness. Knowing this reality, an individual may consider making an advance request for MAID at the time of diagnosis.

The challenge that this condition illustrates is that it is not possible to predict with any degree of certainty how long a period of decision-making competency will be in place before the changes — which can occur rapidly — happen, leading to an inability to consent to MAID even if that is the person’s end‑of‑life choice.

Incidentally, this uncertainty can lead to a person deciding to access MAID before they want to, a situation that is horribly unsatisfactory, to say the least.

Let us now return to the four points that I made arising from the definition of an advance request.

First, the issue of clarity, so that everyone, including the MAID provider, is certain about what the wishes of the competent person making the request are. It’s the wishes of the competent person.

Here, in my opinion, it is necessary to ensure that the request is made in written form and is specific to what the individual making the request considers to be their threshold that will trigger a MAID request. The request should provide as much information as possible for others to be able to clearly understand the conditions under which MAID can be administered.

Statements such as “when I am no longer able to enjoy life” or “when I am not able to make my own decisions” or “when I can no longer recognize my family” should not be put forward as situations for MAID consideration. Specificity is needed. For example:

I would like to receive MAID under the following conditions, even if I am not in pain and regardless of what others think about how my life is going: if I can no longer recognize any member of my family at any time of their visits for a period of two months; OR if I can no longer toilet myself for a period of one month; OR if I do not know where I am, what day it is and what month of the year it is, daily, for a period of one month.

What is important to stress here is that these conditions are specific and are what the individual considers to be intolerable to them. They will vary from person to person and are not conditions that a third party decides.

Furthermore, if the individual is willing, family members and others can participate in the discussions as to what conditions the individual considers to be the threshold for MAID when the advance request is being developed. With such specificity, fulfilling the advance request for MAID becomes clearer for the patient, clinician and family members alike.

My second consideration was that the request be made by a competent person, and, as such, a clinically and legally defensible determination of competence should accompany an advanced request. This means that the advanced request for MAID should include an assessment of competency provided by a qualified clinician, and a note describing the assessment and its results should be signed, dated and affixed to the written advance request. For example, a clinical interview plus a mini-mental state examination could be considered to fulfill this condition.

That safeguard is useful to avoid later questions as to whether the person making the advanced request was or was not competent to do so at the time the advanced request was made.

Third, the advance request must be made voluntarily and be well considered. That means the request cannot be the result of coercion, and the person making the advance request has demonstrated they have considered relevant information prior to making their request. This issue may be addressed in the legislation or it may be addressed in clinical guidelines that need to be developed to assist patients, their families, clinicians and MAID assessors.

In my own professional experience in conducting numerous patient decision-making assessments, the issue of clarifying that there is no undue coercion is always part of how such assessments are done. If the clinician is not certain about coercion, the usual practice is to seek a second opinion from a colleague. If there continues to be uncertainty, further investigation may be required to clarify the situation.

Perhaps this is the issue that Senator Batters was trying to address with her questions to Senator Wallin about two independent witnesses whose purpose was to confirm that the advanced request was made voluntarily.