Senator McPhedran: Thank you for this opportunity. Meegwetch.

Hon. Senators: Hear, hear!

The Hon. the Speaker: Honourable senators, when shall this bill be read the second time?

(On motion of Senator Gold, bill placed on the Orders of the Day for second reading two days hence.)

Senator Gold: — fall upon us as parliamentarians to assess the quality of the work that is done through all of the processes that I underlined.

I do want to also underline the fact that much of what is being reported in the media comes from anonymous, leaked sources which I regret seems to be a currency in this debate. We, as Canadians and as parliamentarians, should be careful to applaud and approve the leaking of classified information by those who take oaths to preserve it.

Senator Gold: Well, you have certainly included various measures in your question. The consultation is one of a suite of measures that I have already announced, and it’s the position of the government that this combination of measures is going to address the problem in the most appropriate way.

Senator Dalphond: I understand that the government is looking into this, but I would point out that the U.S. government banned this practice 17 years ago. In Canada, in the last five years, 14,500 horses have been shipped to Japan to become raw sushi for wealthy people. Don’t you think it’s time to put an end to this practice rather than finding humane ways to send them to slaughter in Japan?

Senator Dalphond: I understand that the government is looking into this, but I would point out that the U.S. government banned this practice 17 years ago. In Canada, in the last five years, 14,500 horses have been shipped to Japan to become raw sushi for wealthy people. Don’t you think it’s time to put an end to this practice rather than finding humane ways to send them to slaughter in Japan?

Senator Gold: Thank you for the question.

Jurisdictional limitations are indeed a factor here. That being said, I will look into this with the government to check on the progress or status of this report in relation to regular discussions between the Minister of Justice and his team, and his provincial and territorial counterparts.

[English]

Hon. René Cormier: Senator Gold, the Health Canada directive on sperm donors that disqualifies men from donating if they’ve had sexual relations with other men in the past three months is extremely troubling. Since we know that sperm donations are subject to rigorous testing before they can be used, this directive is discriminatory and perpetuates the stigma against men with HIV/AIDS. A lawsuit has been filed with the Ontario Superior Court of Justice in order to change this directive.

Senator Gold, why doesn’t Health Canada make its directive on blood donation more inclusive and non-discriminatory against gay and bisexual men, like Canadian Blood Services and Héma-Québec did recently?

Hon. Marc Gold (Government Representative in the Senate): Thank you, senator, for the question and for underlining the important work. I do not know for sure, and so I will have to make inquiries. I will report back as soon as I can.

Senator McPhedran: Thank you kindly.

[Translation]

Senator Gold: I will certainly add that to my question.

Senator McPhedran: In addition to that inquiry, Senator Gold, I wonder if you could add a more specific question, which is the extent to which the Government of Canada allows for non-disclosure agreements to be used against athletes where there are disputes and resolutions.

Senator McPhedran: In addition to that inquiry, Senator Gold, I wonder if you could add a more specific question, which is the extent to which the Government of Canada allows for non-disclosure agreements to be used against athletes where there are disputes and resolutions.

Hon. Marc Gold (Government Representative in the Senate) tabled the reply to Question No. 37, dated November 23, 2021, appearing on the Order Paper and Notice Paper in the name of the Honourable Senator Plett, regarding the Department of National Defence infrastructure.

Hon. Fabian Manning: Honourable senators, to say in most cases that you are pleased to speak on a piece of legislation — that’s usually how you start your comments, but, believe you me, I’m not necessarily pleased to be speaking on Bill C-39.

Hon. Fabian Manning: Honourable senators, to say in most cases that you are pleased to speak on a piece of legislation — that’s usually how you start your comments, but, believe you me, I’m not necessarily pleased to be speaking on Bill C-39.

While I have great respect for Senator Kutcher and, certainly, his opinion, I respectfully disagree with much of what he has said. When we started the debate on medical assistance in dying back in 2016, every weekend I travelled home to Newfoundland and Labrador and I went to see my dad who spent the last two years in bed before he passed away in May of that year. I struggled with MAID at that time for obvious reasons, and I still struggle with parts of it today.

What concerned me in 2016 still concerns me in 2023. One of those concerns was what we call the opening of the barn door. I don’t necessarily agree with what Senator Kutcher said in relation to some of the slippery slope concerns, but we could also lean in that direction.

My concern back then was, and is today, that when we start this process, where do we draw the line? When does there come a time when we look and say that we need to put the brakes on? We had a parliamentary committee, and I congratulate them on their work, and I know everybody does this for the right reason when talking about extending MAID to children.

My concern is the snowball effect. We all know the story of the snowball at the top of the hill. We let it roll down. As it rolls down, it picks up speed and it gets larger and larger. By the time it reaches the bottom of the hill, in some cases, it is too large to handle. My concern also is the vulnerable people who are out there who are suffering from mental health illnesses. Certainly, I agree with Senator Kutcher in talking about more resources, such as finance resources and human resources. They are lacking right across this country, and they are lacking in my home province of Newfoundland and Labrador. We need to have more financial resources and human resources put in.

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It is the evolution of mental health illness over time. I look back at our parents’ generation, and they had no — or very little — understanding of mental health; I remember this while growing up as a young boy in my hometown of St. Bride’s. Now I know — I didn’t know then — that there were people in that community who were suffering — and still are — from mental health issues. But our comment was always “There’s something wrong with him, or something wrong with her.” It wasn’t mean-spirited in any way, shape or form. It was just the way it was. It was the lack of understanding, lack of education and lack of knowledge. Maybe, more importantly, it was the lack of having a conversation about it.

Today, most of us — and I do not pretend in any way, shape or form to have an understanding of mental health that Senator Kutcher may have in his profession — have a limited understanding of mental health issues. We all read, we all listen and we all have a great opportunity here in this chamber to hear others talk about it — to hear from people with a background in dealing with mental health. We can understand more, and educate ourselves more, so that we can pass that on to others. That is a privilege that we have here in this chamber that many across this country don’t have.

As I said, in today’s generation — because we’re talking about it more, and because it is not a taboo subject anymore — we are gaining a limited understanding of mental health issues. The present generation — our children — are developing a much better understanding. I truly believe that, and I truly hope that, because they are gaining a much better understanding, they will, in turn, have much better ways of dealing with mental health issues in the future.

Mental health is unpredictable. It is not like physical health when we have a broken leg or broken arm. There are very troubling diseases that people live with for their lifetime.

Respecting, and showing respect, love and understanding to people suffering with mental health is something that we all need to work toward.

The purpose of Bill C-39, as put forward by the government, is to extend it for another year. If I believed that we are extending it for another year to ascertain across the country if we are doing the right thing regarding mental health issues — or we are trying to figure out if we are doing the wrong thing in bringing this forward — I may find some way of being able to support it. But I truly believe, in my humble opinion, that the reason we have Bill C-39 is because there has been such a backlash across the country from people who are very concerned about where MAID is going, and very concerned about the snowball effect. I think that is why we are sitting here today dealing with a piece of legislation that is asking for another year.

The government is not asking for another year to determine the path they want to travel. They are asking for another year so they can, hopefully, bring the numbers up on the polling that’s been done in order to ensure their side of the story is being accepted.

Again, I have some great concerns with how that’s been done.

I’m not a medical doctor; I’m not a psychiatrist. I have not received training in health care; I have not received training in the legal side of things. I am just an individual who is aware of several people who are living with, and have lived with, for their lifetime, poor mental health issues — people, in my view, who require help and assistance from all levels of government and all levels of the health care profession. They don’t need help in dying.

I understand the sensitivity of this issue, and I respect everyone else’s opinion. Some people have different backgrounds than I have. Some people have different ways of dealing with things in how they accept — or don’t accept — mental health issues. I am not going to judge anybody else on their opinion of that.

I respectfully disagree with assisted dying, I respectfully disagree with the extension that we’re talking about here today and I respectfully disagree with extending assisted dying to children.

I think we should be talking about counselling, and bringing more counsellors in. I think we should be talking about therapy — extra therapy. I think we should be talking about ways to try to deal with this very serious issue that we face in this country today.

I am not going to belabour the point. I just wanted the opportunity today to say a few words in order to put my opinions on the record — for what they may be worth.

It’s very ironic because I was travelling to Newfoundland last week, and I stopped at a local business. I’m always looking for books — I love to read — especially books related to Newfoundland and Labrador in any way, shape or form — particularly, the history of the province and the people that made the place that I’m so proud to call home. I stopped into a store, and I picked up a book — and the book is called From The Shadows: Surviving the Depths of Mental Illness.

I also believe in faith. There is a reason for everything — again, in my humble opinion.

From The Shadows is written by E. Pauline Spurrell who suffered mental illness issues all her life. She lives in the small community of Hillview in Newfoundland with her husband Don; they have for almost 40 years. They have one son, Andrew. It’s a compelling story — I will not get into all the details today — but for anyone who wants to become educated about the concerns of how people deal with mental health, or for anyone who wants to learn from someone who has lived it within very tragic circumstances, I suggest that you buy a copy of her book.

After a joyful early childhood, E. Pauline Spurrell suffered trauma that led to unhinged teenage years and a turbulent adult life. She was diagnosed — and misdiagnosed — with numerous mental illnesses. She endured a seemingly endless cycle of prescription treatment and failure until, one day, enough was enough. Following the years lost in the depths of despair, she fostered ideologies of self-discovery. Spurrell created tools to understand her disorders and the resulting impacts on her life. She reclaimed priority, found the inner child she had left behind and emerged from the shadows as a portrait puzzle of perfect imperfections.

I had the opportunity yesterday — after reading her book last week — to speak to Spurrell for about an hour on the phone in order to gain some insight. Again, I don’t have the background; I just have the privilege to be here in the Senate of Canada to participate in the debate on important legislation like the one we have before us. I spoke to Spurrell, and she is now living a full and happy life. She is still suffering from bouts of mental illness, mind you, but she found a way out. She was medicated to the hilt with medication that I wouldn’t even bother to try to pronounce here today.

She found a way out. There were times when she was in desperate situations; you can read about it in her book. The trauma is unbelievable. But she found a way out.

In reading the book, I found a reason not to be supportive of assisted dying for people who are suffering from mental health illness. I found a reason to stand here today and say a few words and to tell you the story of people like Pauline who found a different way, who found an avenue from a life of despair, a life of trauma, a life of tragedy. And she found a way to be able to live a full and happy life with her husband, Don, her son Andrew and her family and friends.

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These are not easy discussions, honourable senators. In all my time here, we have had many pieces of legislation dealing with financial issues, and from time to time we can agree and disagree on how we deal with the fiscal policies of this country.

We have, from time to time, dealt with legislation that is very personal and brings out different parts of us that we don’t even know we have, sometimes. This is one of those pieces of legislation.

I believe the snowball effect of medical assistance in dying is not going to stop with Bill C-39. I strongly believe that, for those who have the opportunity to spend more time here, we will be dealing with another part of that snowball in the not-too-distant future.

As I said, I’m no expert. I’m no expert on dealing with some of these serious issues, but I am a person who is living a life, and I respect the opportunity for others to live theirs.

Thank you.

Hon. Donald Neil Plett (Leader of the Opposition): Honourable senators, I rise today in a very unusual position. It is not every day that I find myself compelled to speak about ill-conceived and objectively shortsighted legislation while committing not to stand in the way of its passage. But in this case, the government has tied our hands, as the alternative to the passage of Bill C-39 is much more dire.

Hon. Donald Neil Plett (Leader of the Opposition): Honourable senators, I rise today in a very unusual position. It is not every day that I find myself compelled to speak about ill-conceived and objectively shortsighted legislation while committing not to stand in the way of its passage. But in this case, the government has tied our hands, as the alternative to the passage of Bill C-39 is much more dire.

As Senator Manning said in his eloquent, emotional speech, we disagree with each other, but I respect everyone’s opinions in this chamber even though they may be different than mine. I respect my colleague Senator Kutcher and his opinion, but I do want to make a few comments about what I find very troubling about his comments a few minutes ago.

Suicide is the act of intentionally causing one’s own death. We can call suicide by something else, but it is suicide. If somebody intentionally chooses to take his or her own life, even if they solicit the help of somebody, let’s at least call it what it is.

When the good senator says that somebody who is suicidal will not be given access to suicide — when we are, in fact, passing a bill that does exactly that — I find that mind-boggling because calling it MAID is still not taking away from the fact that one is intentionally causing one’s own death and, in this case, soliciting the help of someone.

I want to make it clear at the outset, for anyone listening, that allowing this bill to pass should not in any way be interpreted as an endorsement for the legalization of assisted suicide for mental illness. Quite the contrary. If this bill does not pass on March 17 — that’s next week, colleagues — Canadians suffering from mental illness as the sole underlying condition will be eligible to end their lives with the assistance of a medical professional.

While I believe that the Liberal government should be abandoning this dangerous expansion altogether, those of us who remain steadfast in our opposition will take advantage of this delay and continue to fight for the many vulnerable Canadians struggling with mental illness, trying to keep them alive.

Two years ago, at third reading of Bill C-7, an amendment was moved in this chamber to remove the exclusion of mental illness for eligibility, with a sunset clause of 18 months. The government, shockingly, accepted this amendment but proposed a new arbitrary expiry date of 24 months, therefore bringing us to March 17, 2023.

The government’s endorsement of this amendment came after Minister Lametti stated at our Legal and Constitutional Affairs Committee and at the House of Commons Justice Committee that there is no consensus in the mental health and psychiatric community that could justify moving forward with extending access to those suffering from mental illness at this time. He also correctly stated that it is not a requirement of the Supreme Court decision.

This third reading amendment was accepted without the opportunity for parliamentarians to vet the proposal with expert witnesses and, certainly, without any medical consensus.

Then, after the fact, the government struck up an expert panel not to determine whether implementing assisted suicide for mental illness could be done safely, but rather to establish recommendations on protocols.

As a former president of the Canadian Psychiatric Association, Dr. Sonu Gaind, stated when he testified at the joint parliamentary committee, this is “. . . not how science works.” He pointed out the following:

No drug company is told their sleeping pill will be approved in two years without evidence of effectiveness or safety while being asked to develop instructions in the meantime on how to use the pill. The sunset clause and the federal panel’s mandate are based on less evidence than is required for introducing any sleeping pill.

The sunset clause was sold as a way to allow time to develop standards and safeguards. But this notion has been discredited by many in the psychiatry community, as it ignores the only true safeguard we have in avoiding premature death: irremediability. The government had no interest in studying whether to implement this extremely controversial, life-and-death policy, only in developing a how-to guide.

Late last year, after a number of heartbreaking stories made headlines demonstrating the dangers of our newly expanded regime, the government announced they would be proposing some changes to the law in the new year.

Then, at the eleventh hour, weeks before the expiry of the sunset clause, the government tabled Bill C-39, which proposes a one-year delay.

I cannot help but wonder why, after admitting that a two-year delay was insufficient, they would take the risk of another arbitrary date in the hopes that evidence would suddenly present itself.

Why would advocates of assisted death for mental illness not just remove this expansion entirely and propose this policy later if and when there is evidence to justify doing so? How is the government so certain that there will be sudden clarity on this topic a year from now when the psychiatry community is not convinced we should be moving forward at all?

Colleagues, I will not rehash all of the arguments against assisted suicide for mental illness today, as I spoke at length to this issue in 2021 when the policy was first proposed. However, there is a great deal of new, notable testimony from the special joint parliamentary committee study which raised alarms. I would encourage all colleagues in this chamber to review the work of the committee and note the concerns raised by experts in the field.

For example, the committee heard expert testimony stating that vulnerable and marginalized Canadians are at greater risk of premature death; that psychiatric patients have indicated their intention to stop potentially effective treatments in anticipation of MAID; that sufficient data does not yet exist; and that it currently remains impossible to distinguish between suicidality and assisted suicide requests.

Today, however, I want to highlight the testimony that is fundamental to the discussion at this time, focusing on one key factor: Canada’s entire assisted dying regime, as stipulated by the Supreme Court of Canada, is founded upon the notion that only those suffering from conditions that are grievous and irremediable should be eligible.

Here is what we know from experts about irremediability of mental illness. The Centre for Addiction and Mental Health has concluded:

There is simply not enough evidence available in the mental health field at this time for clinicians to ascertain whether a particular individual has an irremediable mental illness.

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Dr. John Maher, a clinical psychiatrist and medical ethicist, told the joint parliamentary committee:

Psychiatrists don’t know and can’t know who will get better and live decades of good life. Brain diseases are not liver diseases. If guesswork is good enough for you, it is not good enough for psychiatrists who understand the science and respect our duty to abide by a professional standard of care. You have been systematically misled by discriminatory ideology over clinical reality. Passing a law telling psychiatrists to make impossible predictions doesn’t magically make it possible.

Psychiatrist Dr. Sonu Gaind told the committee:

Those who advocate expanding access to MAID propose mitigating this reality with “safeguards.” This ignores the fact that irremediability is itself the primary safeguard built into the MAID framework, and bypassing it renders all other supposed “safeguards” meaningless.

Dr. Brian Mishara, a clinical psychiatrist and professor at the Université du Québec à Montréal, said in his testimony:

I’m a scientist. The latest Cochrane Review of research on the ability to find some indicator of the future course of a mental illness, either treated or untreated, concluded that we have no specific scientific ways of doing this.

Dr. Mark Sinyor, a psychiatrist and suicide prevention expert, stated:

In short, we are essentially missing all of the necessary scientific evidence to evaluate the safety of physician-assisted death for mental illness. If I had more time, I could list many examples, but let me focus on the fact that there is absolutely no research on the reliability of physician predictions of the irremediability of illness or suffering in psychiatric conditions. To my knowledge, there is not a single study.

Even the Expert Panel on MAID and Mental Illness stated directly in their report:

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.

This is the government’s own expert panel, colleagues, and they have stated outright that it is difficult, if not impossible, to predict irremediability.

While over 85% of Ontario psychiatrists who responded in a recent survey supported assisted suicide in general, less than 30% agree with expanding the law to sole mental illness.

The special commission on MAID established by the Quebec National Assembly, after several months of study, has now recommended not expanding access to assisted dying for people whose only medical issue is a mental disorder.

In October 2020, the Canadian Psychiatric Association surveyed its members, and less than half supported assisted suicide for mental illness.

Where is the general scientific consensus we have been told about?

Colleagues, we do not need to be scientists or psychiatrists to understand the gravity of this policy. As has been alluded to, a recent Angus Reid poll — which studied the attitudes of Canadians when it comes to assisted suicide — found that while Canadians are “generally supportive” of MAID overall, only 3 in 10, or 31%, say they support the concept of assisted suicide for irremediable mental illness.

Each of us knows someone who is afflicted with mental health issues. Most of us are keenly aware of the abysmal state of mental health care in our country. The idea that we would be moving toward a policy that offers them death before they have had an opportunity for acceptable treatment is heartbreaking. It’s a terrible indication of where we are as a society and the value we place on life.

Dr. Mark Sinyor told the joint committee:

. . . if this goes forward, MAID assessors will have no idea how often they are wrong when they make a determination of eligibility in the context of physician-assisted death for sole mental illness. They could be making an error 2% of the time or 95% of the time. That information should be at the forefront of this discussion, yet it is absent altogether.

How many errors are too many, colleagues?

Minister Lametti stated yesterday that if there is any question as to the irremediability of the mental illness, then that person will not receive MAID, full stop.

Senator Kutcher alluded to that in his speech.

Yet, more than half of the psychiatry community maintains it is never possible to ascertain irremediability with mental illness. This is not nearly as cut and dried as the minister is implying, and he knows it.

Senator Kutcher has publicly stated that psychiatrists who object to assisted suicide for mental illness are being paternalistic. At least one of the witnesses at committee found this comment jarring and insulting. Colleagues, imagine telling psychiatrists and other clinicians who have not exhausted all treatment options — who have seen improvements over the long term, and who remain hopeful for their patients — that they are being paternalistic for not wanting to throw in the towel.

Psychiatrist Dr. John Maher objected to this notion, stating at the joint committee:

You said that all psychiatrists in Canada who object to MAID for mental illness are selfish and paternalistic. I’m not sure what purpose that comment served, but I defy literally any psychiatrist to say that this particular patient has an irremediable illness, because you can’t. I have patients who get better after five years, after 10 years and after 15 years. You cannot do it. It’s guesswork. If you’re okay with guesswork, if you’re okay with playing the odds, or if your position is let’s respect autonomy at all costs — if someone wants to die, they can die — call it what it is. It’s facilitated suicide.

Honourable senators, this expansion bypasses the primary safeguards we have against premature death. Yet, somehow, we are supposed to find comfort in a one-year delay. Facilitating the death of mentally ill patients will be as dangerous in 2024 as it would have been next week. There is nothing magic about the date of March 17, 2024, just as there was no significance to the original date. However, allowing Bill C-39 to pass is effectively a vote against the immediate legalization of assisted suicide for mental disorders. We will be taking this opportunity to get it right.

My colleague in the House of Commons the Honourable Ed Fast, Member of Parliament for Abbotsford, has already tabled Bill C-314 which will make clear in the Criminal Code that a mental disorder is not a grievous and irremediable medical condition for which a person could receive medical assistance in dying.

In presenting this bill, the honourable member said that the government is more concerned with “suicide assistance than suicide prevention” and that the priority should be given to providing the social and mental health supports that vulnerable Canadians need.

I want to commend my colleague for his swift and thoughtful action.

Colleagues, we will have an opportunity to get this right when that bill comes before us, as I am hopeful that it will. I personally look forward to supporting that bill every step of the way, and I hope you will join us.

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I have always said that when it comes to assisted dying, it is a very personal, emotional issue on which reasonable people can disagree.

I do want to take a moment, however, to reflect on the debates we had when assisted dying was first legalized with Bill C-14 and, subsequently, when it was expanded through Bill C-7. Those of us who pointed to other jurisdictions and raised the slippery slope argument were told our concerns were unfounded. We heard it again this afternoon in this chamber. We heard these were logical fallacies and that Canada was taking a careful, cautious approach. We were assured that assisted suicide would be offered in the narrowest and most grievous of circumstances.

Colleagues, look where we are today. While I did believe we were on a dangerous trajectory, I could have never imagined that in just a few short years we would be offering assisted suicide to those living with a disability before we have made even marginal improvements in their quality of living. I could have never imagined that we would be offering assisted suicide to veterans, to those suffering from potentially treatable illnesses.

And now, colleagues, we are seriously talking about offering assisted suicide to children — just a few years after our slippery slope concerns were dismissed. Let us be cognizant of the speed at which we have moved the next time these issues are raised. Let us strongly consider heeding the warnings of international experts who have seen this play out in their jurisdictions.

Every policy decision we make is important, but in this case, the risk we are taking in getting it wrong has tragic life-and-death consequences.

To those listening who are struggling with mental illness or who love someone with mental illness and to those who treat and support them, please know this fight is not over. The work has only begun.

As I said, Bill C-314 has been tabled and will put an end to this reckless expansion. I look forward to continuing the fight in this chamber and I would encourage my colleagues to give the bill due consideration when it comes our way. Thank you.

The Hon. the Speaker pro tempore: Are senators ready for the question?

Hon. Yonah Martin (Deputy Leader of the Opposition): Honourable senators, I rise once again to speak to Bill C-39, an act to amend the Criminal Code (medical assistance in dying), as the official critic of the opposition.

Hon. Yonah Martin (Deputy Leader of the Opposition): Honourable senators, I rise once again to speak to Bill C-39, an act to amend the Criminal Code (medical assistance in dying), as the official critic of the opposition.

As I stated in my second reading speech, medical assistance in dying has been and remains one of the most complex and deeply personal issues for individuals and families across the country. There is a wide range of valid opinions in this chamber on what the appropriate parameters and safeguards should be as we continue to grapple with these questions in further development of our MAID regime.

However, colleagues, I believe we have gone too far with the proposed expansion to include those with mental illness as a sole underlying medical condition. I think the introduction of Bill C-39 is evidence that we have moved too far, too quickly, and is an attempt to put a pause on a policy that we should be repealing altogether.

This is an emotional topic for so many of us, yet the facts and expert evidence need to remain paramount to this discussion. The stakes are too high.

While little has changed since I last spoke on Tuesday, I do want to touch on some of the exchanges that took place during Committee of the Whole yesterday.

Senator Batters, a tireless advocate for mental health, asked the ministers about their 2021 election platform’s promise to establish and fund the Canada mental health transfer — a commitment of $4.5 billion over five years. According to their own platform cost breakdown, as Senator Batters noted, they should have already invested $1.5 billion in mental health care. Yet, they have not invested a single dollar to date. The state of mental health care in Canada is tragic, particularly given what is proposed in this expansion.

Minister Duclos retorted with, “. . . not only are we not breaking that promise, but we are enhancing it.” I think we need to be wary of funding promises announced as achievements — enhanced as they might be — when struggling, vulnerable Canadians are still waiting for improved access to treatment.

A common theme in these debates, both in this chamber and in the special joint committee, is that it remains impossible to predict irremediability with any certainty. Yet, the ministers dismissed these concerns by stating that if there is any question as to the irremediability of the particular illness, then that individual will not get MAID. In practice, we cannot be certain that this is what will happen. Expanding MAID for mental illness still poses risks that people are receiving assisted suicide prematurely or wrongfully.

When Minister Lametti was asked about the profound lack of consensus and discomfort among psychiatric experts in Canada, he pointed to the expert panel assembled by his government — which, of course, was not appointed to study the merits of the expansion but to provide a road map. What we know with certainty is that psychiatrists do not agree that one can ever predict irremediability of a mental illness. There is no consensus on this matter.

Minister Lametti also attempted to discredit the statistics resulting from the surveys conducted by the Canadian Psychiatric Association and the Ontario Medical Association by stating that the questions were based on disinformation. Those surveys are publicly available, and the questions are clear and straightforward.

For example, the statistic that was referenced from the Canadian Psychiatric Association was the result of this question: Should persons whose sole underlying medical condition is a mental disorder be considered for eligibility for MAID? I do not believe this could be reasonably interpreted as disinformation.

Honourable senators, I asked the ministers about how they will address jurisdictional concerns. The National Assembly of Quebec, after wide consultation, tabled Bill 11 and ultimately decided not to allow MAID for mental illness. Minister Lametti acknowledged the lack of professional consensus in this area when asked about this decision. Unfortunately, he was not able to provide a clear answer on how they plan to handle this, how they can prevent cross-jurisdictional doctor shopping or which sets of guidelines Quebec clinicians will be expected to follow. Before we proceed with this expansion, it is imperative that our own Attorney General is clear on the jurisdictional considerations.

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Also, since I spoke on Tuesday, Senator Gold distributed the Gender-based Analysis Plus, or GBA Plus, which indicates what impact, if any, this legislation will have on women and other vulnerable groups. Senator Jaffer asked a question related to this to the ministers as well.

While this concern was raised by several witnesses at the special joint committee, I was shocked by the findings in this particular report, considering the fact that the analysis is provided by a government department. The GBA Plus states:

In the Benelux countries, where eligibility for MAID is not limited to those suffering physically, there have been controversial MAID deaths that have occurred, and it can be expected that similar cases would emerge in Canada under this option. For example, in the Netherlands, MAID was provided to a patient in her twenties who had been sexually abused as a child because of the emotional suffering she endured following the trauma. There have also been cases of transgender individuals and people who identify as gay obtaining MAID due to the suffering associated with those aspects of their conditions.

The government’s own department is suggesting we should see an uptick in these types of cases.

The analysis also states:

It can be expected that should MAID be made available in Canada for individuals whose sole underlying condition is mental illness, we would see an increase in women seeking MAID for psychiatric suffering, and at younger ages.

This is extremely troubling. As Senator Batters said when she raised this with the ministers yesterday, on International Women’s Day, “That’s hardly the kind of gender parity that we want.”

Honourable senators, how can the government ensure that a year from now we will have the necessary data, resources and safeguards in place to protect vulnerable Canadians struggling with mental illnesses from premature death? There is no evidence to indicate that the difficulties around such important issues as predicting irremediability and the inherent risk to vulnerable persons will be resolved in a year.

Colleagues, the idea of a mental health patient receiving MAID when the irremediability of their illness is subjective and open to interpretation troubles me greatly. We are debating the circumstances in which vulnerable Canadians live and die. The experts remain divided, yet this government is moving forward with an ideological decision that will undoubtedly put vulnerable lives at risk, and this is before a single dollar has been invested in their promised mental health plan.

The lives of Canadians battling mental illness are not disposable.

In spite of all these concerns, I will reluctantly be voting for Bill C-39. A delay of one year is clearly better than the alternative: a dangerous MAID expansion to happen next week. Thank you.

Some Hon. Senators: Agreed.

Some Hon. Senators: Question.

Hon. Marc Gold (Government Representative in the Senate): Honourable senators, I have the honour to table, in both official languages, the Departmental Plans for 2023-24.

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