Hon. Paula Simons: Thank you, Your Honour.

On May 5, 2016, the Court of Appeal of Alberta brought down a landmark decision in the case of the Canada (Attorney General) v E.F.; the Honourable Mr. Justice Peter Costigan, the Honourable Madam Justice Marina Paperny and the Honourable Madam Justice Patricia Rowbotham — three of Alberta’s most respected jurists — delivered their judgment unanimously. They ruled that E.F., a 58-year-old Alberta woman, had the right to receive medical aid in dying, even though her illness was not terminal and the cause of her constant searing pain and near paralysis was psychogenic, the result of a psychiatric condition known as conversion disorder. E.F. was not suicidal. She was not delusional. The court held that she was competent to make her own medical decisions, and they allowed her to do so.

The decision came at an unusual moment in Canadian legal history — after the Supreme Court of Canada’s Carter decision and before the passage of Bill C-14, Canada’s first medical assistance in dying legislation. At that point, patients who wished to receive MAID had to petition the court for permission. E.F. had originally been granted the right to die in a decision from Madam Justice Monica Bast of the Alberta Court of Queen’s Bench, as it was then known. The judge held that even though the patient’s symptoms had a psychiatric genesis, she met the threshold established in the Supreme Court’s Carter decision. Justice Bast wrote:

The evidence . . . establishes that none of the multitude of traditional or non-traditional treatments, therapies, or trials that the applicant has undergone for over nine years since the onset of her medical condition has remedied the applicant’s medical condition or made it right. The evidence clearly establishes that the physical symptoms suffered by the applicant as a result of her medical condition deprive her of any quality of life. The fact that the applicant’s medical condition is diagnosed using the DSM-5 or the fact that it has a psychiatric component cannot be permitted to overshadow the real horrific physical symptoms that the applicant is most definitely experiencing on a continual and daily basis.

The Court of Appeal concurred with Justice Bast, but they went further. Let me quote now from that unanimous Alberta Court of Appeal decision:

The specific issue of whether those suffering from psychiatric conditions should be excluded from the declaration of invalidity was very much part of the debate and the record before the Supreme Court. For example, at paragraph 114, the court discussed Canada’s position regarding the risks associated with the legalization of physician assisted death in these terms:

Here, the Alberta court went on to quote the Supreme Court’s original Carter ruling, and I will do so as well:

In [Canada’s] view, there are many possible sources of error and many factors that can render a patient “decisionally vulnerable” and thereby give rise to the risk that persons without a rational and considered desire for death will in fact end up dead. It points to cognitive impairment, depression or other mental illness, coercion, undue influence, psychological or emotional manipulation, systemic prejudice (against the elderly or people with disabilities), and the possibility of ambivalence or misdiagnosis as factors that may escape detection or give rise to errors in capacity assessment. Essentially, Canada argues that, given the breadth of this list, there is no reliable way to identify those who are vulnerable and those who are not. As a result, it says, a blanket prohibition is necessary.

The evidence accepted by the trial judge does not support Canada’s argument. Based on the evidence regarding assessment processes in comparable end-of-life medical decision-making in Canada, the trial judge concluded that vulnerability can be assessed on an individual basis, using the procedures that physicians apply in their assessment of informed consent and decisional capacity in the context of medical decision-making more generally. . . .

The Alberta justices continued:

The court concluded, at paragraph 116, “. . . the individual assessment of vulnerability (whatever its source) is implicitly condoned for life and death decision making in Canada”, and accepted that “it is possible for physicians, with due care and attention to the seriousness of the decision involved, to adequately assess decisional capacity”.

The Government of Canada could have appealed the E.F. ruling to the Supreme Court. It did not, so E.F. was granted the release she had sought, and we were left with this somewhat unusual precedent. Some have argued that the E.F. case somehow doesn’t count because it was heard in that strange legal limbo time, after Carter and before Bill C-14, because it dealt with the issue of whether E.F. was entitled to MAID at that particular moment.

However, Justices Costigan, Paperny and Rowbotham didn’t simply grant E.F.’s petition. They provided a close reading and sharp analysis of Carter, specifically as it related to MAID in cases of serious psychiatric disorders. In effect, they found that Carter established a constitutional right to medical aid in dying for psychiatric patients who faced unendurable and irremediable suffering, with their vulnerability and capacity to be assessed on a case-by-case basis.

Based in no small part on the legal logic of this very ruling, we, the Senate of Canada, determined in 2021 that Bill C-7 was unconstitutional because it contained a blanket denial of MAID to anyone whose sole underlying cause of unendurable medical suffering was deemed to be psychiatric.

Let me remind all of you who were in the Senate that day and all of you who have joined us since of how we voted: by a margin of 57 to 21, with 6 abstentions, to accept an amendment from Senator Kutcher to allow for people with serious, intractable and profoundly debilitating psychiatric disorders to receive MAID, with a sunset clause to allow governments and medical professionals to prepare. The Senate then voted to accept Bill C-7, as amended, by a margin of 66 to 19, with 3 abstentions, and the government itself accepted Senator Kutcher’s amendment.

Yet, here we sit today as many seem to wish to relitigate this whole debate, as though all our careful work in 2021 never happened and as though the E.F. decision itself never happened. How did we get back here, retreating and ceding hard-won ground in Canadians’ fight for personal liberty and bodily autonomy?

The government tells us that Canada is not ready for this exercise of constitutional equality. The truth is that it is our provincial and federal politicians who are not ready, because they are afraid that this decision will be controversial.

A three-year extension, one which kicks this issue down the road until after the next election? Let us be honest. If we wait three years, one of two things will happen. Either the Liberals will be re-elected, and then perhaps they’ll feel insulated enough to respect the courts and the Charter. Clearly, they won’t stand on principle now. Why bother if your opponents are going to weaponize your position to score political points? In the second scenario, the government will be defeated, and the Conservatives will make good on their public threat to defy the Constitution and the courts and deny MAID to those with irremediable and unbearable psychiatric or psychogenic illnesses.

This isn’t just about Canadian politics. The backlash goes far deeper than that. Over the last three years, North Americans have seen a broad legal and cultural assault on the very idea of bodily autonomy and on the rights of patients and doctors to make private and personal treatment decisions based on the best medical evidence.

In 2022, the Supreme Court of the United States upended the long-standing abortion rights and privacy protections of Roe v. Wade. Now, some states are taking harsh steps to limit the ability to end a pregnancy or even to receive life-saving care in a gynecological emergency. Women have been stripped of their fundamental rights to bodily autonomy while doctors have been robbed of the responsibility and the duty to do their jobs based on the best science. The best interest of the patient has been trumped by religious fundamentalism and straight-up misogyny, putting patients and physicians alike in danger of criminal prosecution.

Then there’s the war on trans youth and adults and on the doctors who treat them. It started in the United States; then it spread to Canada. This very month, in my home province of Alberta, doctors were told that they will have to make treatment decisions based not on the best medical interests of their patients but rather on a series of arbitrary rules and regulations created by the premier’s office. Young patients are being told that their bodies don’t belong to them or even to their parents, but rather to politicians and bureaucrats.

Because this culture war on trans kids and the physicians who treat them is seen as a popular vote winner, we are denying patients bodily autonomy and denying physicians their professional rights and responsibilities and putting them under threat of sanction.

It’s no accident that the very day Premier Smith announced a crackdown on doctors who treat young trans patients, a coordinated push poll began in Alberta aimed at limiting abortion access for teens in the province as well.

This new pushback against MAID is absolutely akin to the war on reproductive choice and the war on gender-affirming medical care.

We’re told not to worry, that this is just about a temporary delay in MAID for practical reasons. Don’t be fooled. If we pass Bill C-62 with a three-year extension, all hope for equal access to end-of-life medical care will evaporate. This will be a wedge, the thin edge of a wedge — a cue to start rolling back access to MAID for more and more people.

As senators, it is part of our job to uphold Charter rights and to defend the Constitution. We are not elected; we are appointed. We are not beholden to election cycles and popular opinion. We have the freedom and the responsibility to take tough decisions. At this moment in our history, most of us — though not all — are non-partisan. We are not beholden to a leader or a party. We have been given the privilege to think for ourselves and to speak for ourselves in a way that few other politicians in Canadian history — or world history — have ever had.

It is also our job to exhibit responsible restraint, to show due deference to the elected other chamber. We do not overstep precisely because we are not accountable. We do not answer for our decisions at the ballot box. We can’t be self-indulgent and exploit our protected appointed status to be social revolutionaries. Instead, we are meant to be conservative — in the best sense of the word — to protect the fundamental foundations of our Constitution.

But here is the thing, my friends: We have shown a lot of restraint and deference. When Bill C-7 came to us in 2021 in its original, unconstitutional form, we could have defeated it. We did not. We were restrained. We debated it carefully and found a compromise, which was Senator Kutcher’s amendment. We could have passed that amendment without a sunset clause or asked for a shorter sunset clause, but we did not. We showed restraint and deference.

And when the government didn’t make that first deadline and brought us Bill C-39, we showed restraint again. We deferred to the will of the elected Parliament and granted their request for another extension.

When do we stand our ground and defend Bill C-7 as it was passed by the Senate and accepted by the other place? It is our job to defend the Charter and the rights of minorities, and what minority group could possibly be more marginalized than those with serious psychiatric illnesses who have been waiting for Bill C-7 to come into full effect for three years now? They have been waiting with restraint and patience for the right to have their competence and their legal capacity to make their own medical decisions respected.

Of course, some would, with the best of intentions, deny those very people their right to self-determination because they believe it is for their own good. We are told that it is because psychiatric patients are routinely discriminated against in this country that we must protect them from themselves and the consequences of their decisions.

It is true that we in this country have a profound crisis when it comes to a lack of mental health care. Many people with mental health problems, or more complex psychiatric conditions, live in conditions of poverty and isolation: some are unhoused; others are housed only precariously. There are all kinds of people who have already given up and either taken their own lives or begun killing themselves, slowly and inexorably, through substance abuse.

When opponents of MAID for mental illness paint a picture of a dystopian future in which hundreds of hopeless people, tired of poverty and discrimination, ask for MAID simply because their lives seem too hard and miserable, I’ll agree that isn’t so far‑fetched. But let’s please stop using our moral failure to address the socio-economic needs of those with addiction and mental illness as a way to slough off our legal duty to protect the Charter rights of those with extremely serious psychiatric illnesses who are being forced to suffer while we dither.

We can walk and chew gum at the same time. We can do two things at the same time: We can provide better health care and better social and economic supports to those who need them. We can treat those who can be treated and save them from despair and desperation. Simultaneously, we can protect the Charter rights and bodily autonomy of those seriously ill psychiatric patients who genuinely meet the strict criteria for medical assistance in dying.

Those two goals are not antithetical; they are, necessarily, complementary. If we fail in our duty here to respect the courts and the Constitution, then we force suffering patients to somehow find the wherewithal to go to court to fight for their rights — a process that could take years.

I want to quote the wise words of Senator Carignan from 2021, when he spoke in support of Senator Kutcher’s amendment.

The English translation is as follows:

. . . the provision in Bill C-7 discriminates against persons with mental disorders. Obviously, this will once again force the less fortunate and vulnerable to appeal to the courts to declare this bill unconstitutional. In fact, this bill will clearly be ruled unconstitutional based on Supreme Court case law.

We must avoid placing the burden of court challenges on the less fortunate. . . .

My friends, that was true three years ago, and it remains true today. I just hope we can remember why we amended Bill C-7 in the first place.

Thank you, hiy hiy.

[Translation]

Some Hon. Senators: Hear, hear.

Hon. Julie Miville-Dechêne: Honourable senators, I rise in support of Bill C-62, which proposes a three-year extension to the temporary exclusion of medical assistance in dying eligibility for persons suffering solely from mental illness. In the interest of full disclosure, and specifically for the benefit of our recently arrived colleagues, I’d like to remind you that three years ago, I voted against the Senate amendment that extended MAID to psychiatric patients. At the time, there was no consensus among experts on this social issue, and that is still the case today.

Although defending minority rights is at the heart of our mandate, the Senate is not a court of law. While some may argue that denying access to MAID violates the constitutional rights of those with mental illness, this conclusion is far from clear. In its Charter statement, the Department of Justice spells out the competing rights and values at stake, including the autonomy of individuals versus the protection of vulnerable people from any incentive to end their lives. The Department of Justice adds:

 . . . feelings of hopelessness and the wish to die are common symptoms of some mental illnesses, which can make it difficult for even experienced practitioners to distinguish between a wish to die that is fully autonomous and well considered and one that is a symptom of a person’s illness.

After analyzing international science-based evidence for a year and a half, the Council of Canadian Academies’ expert panel found no evidence that the irremediability of mental illness could be predicted. Some mental disorders may even impair a person’s decision making and increase their risk of incapacity.

The fact that provincial governments aren’t ready is another compelling argument. We mustn’t forget that the provinces deliver medical care and have jurisdiction in this area. It would be a mistake to equate their serious concerns with an ideological objection to MAID in every case. Take Quebec, for example, a place I know better than others: It was a frontrunner in expanding medical assistance in dying and even holds the world record for this practice. Last year, MAID accounted for 5,200 or 6.8% of deaths in Quebec, a 42% increase in a single year. Of that number, a disturbing 16 cases failed to meet all the criteria specified in the act.

Last June, Quebec amended its Act Respecting End-of-Life Care to legalize advance requests related to cognitive illness leading to incapacity, but it excluded patients who exclusively suffer from a mental disorder. This decision was based on a report by Quebec’s end-of-life care commission, published in December 2021, which concluded, and I quote:

Medical aid in dying is care of last resort for persons whose illness cannot be cured and whose decline in capability is irreversible. Given the lack of consensus in the medical community on the incurability and irreversibility of mental disorders, a strong doubt remains as to whether medical aid in dying is appropriate care. In this context, the risk that this gesture be premature appears very real to us. We are faced here with the grim prospect of individuals obtaining medical aid in dying rather than appropriate medical follow-up that would favour a fully satisfying life.

I share those very same concerns. Some have argued the following — and I’m quoting the report of the Special Joint Committee on Medical Assistance in Dying:

 . . . there is no consensus on many existing medical practices, and that this is not generally considered a justification for prohibition.

I think that it’s inappropriate to equate MAID with a simple medical practice, as though this were about a hormone treatment or taking antibiotics. We have to have the honesty or lucidity to come to grips with this. This is about helping a person to die. It is irremediable.

Another sensitive aspect is the fact that, in the report of the Special Joint Committee on Medical Assistance in Dying, witnesses observed that the eligibility criteria for MAID didn’t require people with mental disorders to have exhausted all reasonable treatment options. Bill C-7 only required that the patient be informed of treatment options. In theory, this would mean that the patient could receive MAID even if he or she hasn’t had access to adequate care. This is particularly worrying in a country like ours, where the shortage of psychiatric care is an established fact.

In Belgium and the Netherlands, where psychiatric patients have access to MAID, more robust safeguards exist.

According to the submission of Professor Scott Kim from the University of Michigan, 1,150 applications for MAID were made in the Netherlands in 2022, which is quite a lot. However, only 5% to 10% were granted. Belgian and Dutch laws require doctors to agree with the fact that there are no options other than MAID in each case, so MAID really is a last resort. I’m aware that the right to refuse all treatment is well established in our country, and it is a paramount right, but it seems to me that the exercise of this right, combined with a life-ending medical intervention, is a sensitive issue that warrants further consideration.

Bill C-62 will do just that. It will allow time for such careful consideration of the state of our knowledge and the scientific and ethical grey areas.

Obviously, I’m aware that there is intolerable mental suffering that is as great if not greater than the suffering associated with physical illnesses, but we can’t expand access to MAID any further until we’re able to confidently assess the applicant’s incurability, the irremediability of their condition, their capacity and their suicidal tendencies.

The severe shortage of psychiatric care and services must be at the heart of this reflection on the health care systems’ state of readiness, or at least that’s what I think. We can’t focus solely on the fact that there are protocols for administering MAID. That is not enough.

Finally, the precautionary principle applies when lives are at stake. Thank you.

[English]

Hon. Patrick Brazeau: Honourable senators, I rise today on the topic of Bill C-62, to make a few brief points and to add another dimension to the debate.

As we know, the government proposes a three-year pause on MAID for those with mental illness. Passions run high on this issue from every angle. It is possible — not only that, it is actually the case — that compassionate, thoughtful and loving people will study the same facts and come to opposite conclusions on this legislation.

As noted in the final report of the expert panel on MAID and mental illness, comprehensive and meaningful engagement with Indigenous people has yet to occur. The expert panel says that compared to the non-Indigenous Canadian population, a disproportionate number of Indigenous people live in poverty, have inadequate housing, a lack of clean drinking water and have limited access to education and health care. Let’s add all the mental illnesses that were created because of residential schools over generations, even to this day.

Most alarmingly, as we consider Bill C-62, the report notes that Indigenous leaders have said that in their communities, it is easier to access a way to die than to access the resources they need to live well. As this chamber knows, I have personally spoken on the issue of suicide prevention quite often, but before I go on, I am fully aware that when I mention suicide prevention efforts, some will object that MAID and suicide are different things. Others will feel that there is no ultimate or meaningful difference between the two. I will briefly share my own personal view on the distinction, although I hope that even if you disagree, you will appreciate my perspective.

Quite bluntly, suicide is death caused by injuring oneself with the intent to die. MAID is a procedure in which a patient is given medications to intentionally and safely end their life. The result of both those actions could be the same thing: death. I think this is what causes people to have such strong emotions on the subject matter.

The major and most notable difference between both actions is that people contemplating receiving MAID will likely get the time to think deeply about it — we hope so — and discuss it with family members and other loved ones. It would also include having numerous amounts of discussions with health experts to come to a determination to receive MAID. Unfortunately, oftentimes this is not the case with suicide.

I’m not here to try to convince you of my position on this matter. We do not need to agree on whether the distinction is meaningful or not for the purposes of today’s debate.

[Translation]

If we can provide the help that is so desperately needed, the demand for MAID for people with mental illness will go down. We may never be able to stop it completely, but shouldn’t we do our due diligence to help those who are in crisis?

When I talk about due diligence, I have a simple question: Have we done enough for the men and women suffering from mental illness? What community supports are in place to help people with serious mental illness?

When we closed asylums and opted for community outpatient care instead, did we fund these alternative measures properly? Or did we instead turn a blind eye as the patients from the psychiatric hospitals ended up in the street and in prison?

Desperate families are calling on the governments for help for their loved ones, Your Honour. I have witnessed this several times within my immediate and extended family. For example, my youngest son’s grandmother has had Alzheimer’s for about 15 years. It is really not a good quality of life. That being said, Ms. Violette is turning 100 next week.

When a loved one goes off their meds and poses a danger to themselves or others, family members are often left to face obstacles alone.

Medical assistance in dying exists now.

We’re being asked to wait three years to ensure that the provinces and territories have time to prepare. As the Minister of Health told us directly, “They are not ready.”

I think we need to ask ourselves whether the provinces and territories are ready to care for patients suffering from mental illness today, right now, before we talk about medical assistance in dying.

[English]

I suffer from mental illness. I know what it is to feel alone, broken and hopeless. I know what it is to suffer inside. Physical pain is physical pain. Mental health pain goes to the very core of one’s existence. We all know somebody who suffers from mental illness, but if you’ve never experienced mental health pain, how can you know what pain they are in or what they are suffering? However, I’m not asking you to understand people’s pain. I’m asking you, from this day forward, to be aware of it and — most of all — to be compassionate, non-judgmental and understanding of those suffering from mental illness. They have enough to deal with, and here we are collectively trying to make the best decision for all those people concerned.

I think the best way to deal with this issue is to put our minds, knowledge and expertise — and, most of all, our care and compassion — into focusing on effective ways and new solutions for those suffering from mental illness. Are we really providing a shortcut for people to end their lives because we are not collectively doing what is necessary to help those who are suffering? When will mental health be treated equally to physical health in Canada? We have international days, national days, municipal days and regional days of mental health awareness, but people suffering from mental health live with this every single day of the year.

Regardless of our personal views, MAID exists, and, in 2027, it will be available for those having a mental illness as their sole condition. My hope is that the committee will focus on three areas. These are mostly provincial jurisdictions, but here is where the Senate could be a leader in focusing on better mental health care for Canadians.

First, we need to provide more mental health resources. People who need help need places to go.

Second, we need to investigate the reopening of mental health institutions or mental health centres. I don’t know about you, colleagues, but when I look at the news and see homeless people flooding our streets, well, I’m not an expert, but a whole lot of those people should be in mental health institutions receiving the proper help and care they deserve. Unfortunately, they end up abusing other substances and becoming homeless, and here we are trying to politicize the very problems that are going on in their lives.

Third, I’ll talk about a procedure in Quebec that is called Law P-38. It would put more power into the hands of family members so they could intervene when a loved one has prescribed medication, but decides to stop that medication one day. I know many families like this — one is a distant family where it’s a constant revolving door. A person has been diagnosed with a mental illness and has medication to take. This person takes their medication, but along the way, during the year, decides to stop it. What happens? Well, the family cannot intervene whatsoever because the danger has to be clear, imminent and immediate. Therefore, families are helpless and hopeless. What do you do if somebody who needs to take their medication to, at least, function doesn’t take it? Sometimes they become menaces to society.

Like I said, these are all issues of provincial jurisdiction, and we are talking about MAID. We are talking about Bill C-62, but we have to continue the discussion on providing proper mental health resources to people who need them.

In closing, what protections do we owe those struggling with their mental health? What assistance can we give to desperate family members who feel abandoned by medical authorities as they seek help for their loved one? I’m asking that this chamber consider not putting the cart before the horse. Let’s accept the Minister of Health’s word that more time is needed before extending MAID, but insist that those three years are dedicated to providing mental health care to all who need it.

I thank you for your time.

Hon. Yonah Martin (Deputy Leader of the Opposition): Honourable senators, thank you to all honourable colleagues who have intervened this evening on this very important issue and debate.

I rise today to speak to Bill C-62, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2, as the opposition critic in the Senate. Bill C-62 extends the exclusion of eligibility for receiving medical assistance in dying in circumstances where the sole underlying medical condition identified in support of the request for MAID is a mental illness until March 17, 2027.

Former Bill C-7 expanded the eligibility for MAID to persons whose natural death is not reasonably foreseeable. Originally, the bill excluded eligibility to receive MAID in circumstances in which mental illness was the sole underlying medical condition. However, as others have noted, Senator Kutcher’s amendment was adopted at third reading to allow MAID for mental illness, with a sunset clause. I did not personally support that amendment, but the government accepted this amendment, and the law that was ultimately passed included a sunset clause date of March 17, 2023.

Parliamentarians heard from constituents and media who spoke and reported on the concerns and dangers MAID for mental illness was creating in Canada, specifically with the looming coming into force of the sunset clause on March 17, 2023.

On February 2, 2023, the government tabled Bill C-39, which extended the deadline for one year, and reconstituted the Special Joint Committee on Medical Assistance in Dying to review the readiness for MAID with the sole underlying condition being mental illness. The reconstituted committee was tasked with studying the degree of preparedness attained for safe and adequate application of medical assistance in dying where mental disorder is the sole underlying medical condition.

I had previously served as co-chair of the Special Joint Committee on Medical Assistance in Dying with former MP Marc Garneau in the spring of 2023, and once again when the committee was reconstituted in the fall of 2023 along with co‑chair of the House, Member of Parliament René Arseneault. Our colleagues Senator Dalphond, Senator Kutcher, Senator Mégie and Senator Wallin also served on the committee along with members of Parliament representing all parties.

The most recent Special Joint Committee on Medical Assistance in Dying heard from 21 witnesses, which included legal and medical experts, practitioners, representatives of professional associations, mental health organizations and regulators as well as representatives of Health Canada and the Department of Justice.

The committee heard from several witnesses to the effect that it is difficult if not impossible to accurately predict the long-term prognosis of a person with a mental disorder. But we also heard that, in practice, a person would need to have a long, documented history of failed treatment attempts in order to be found eligible for medical assistance in dying where a mental disorder is the sole underlying medical condition, or MAID MD-SUMC.

The committee also heard that many psychiatrists do not support the practice of MAID MD-SUMC. Some witnesses expressed concerns regarding the potential impacts of MAID MD-SUMC on vulnerable groups, women, Indigenous people, people with disabilities and people living in poverty. The committee also heard differing views as to whether there is an adequate number of trained practitioners — psychiatrists in particular — to safely and adequately provide MAID MD‑SUMC.

On January 29, the final report was tabled in the House of Commons and backdoor tabled in the Senate. The report concluded that the medical system in Canada is not yet prepared for medical assistance in dying where mental disorder is the sole underlying medical condition.

The committee recommended:

That MAID MD-SUMC should not be made available in Canada until the Minister of Health and the Minister of Justice are satisfied, based on recommendations from their respective departments and in consultation with their provincial and territorial counterparts and with Indigenous Peoples, that it can be safely and adequately provided; and

That one year prior to the date on which it is anticipated that the law will permit MAID MD-SUMC, pursuant to subparagraph (a), the House of Commons and the Senate re‑establish the Special Joint Committee on Medical Assistance In Dying in order to verify the degree of preparedness attained for a safe and adequate application of MAID MD‑SUMC.

We all know that on February 1 Minister Mark Holland tabled Bill C-62, which gives a three-year extension for mental illness as a sole underlying condition for MAID, and here we are today debating this very bill at second reading.

During my technical briefing with the officials, I asked about the importance of the letter which was reported on January 30 of this year that the health and mental health ministers from all three territories — along with quite a few of the provinces, and those that were ready, still signed on to the letter — which asked for a delay because they were not ready. I asked the officials what the importance of that letter was and why it would have weighed into the decision for the minister to table Bill C-62.

I was told that Health Canada has a federal-provincial-territorial administrative committee on MAID specifically to work with the provincial and territorial counterparts to get a handle on the state of readiness, that they meet quite frequently and, therefore, because the provinces and territories are responsible for the readiness — undertaking training — that their state of readiness as stated in the letter was very important to the minister in his decision to table Bill C-62.

Other important considerations that have led us to where we are today go back to 2022 when the Association of Chairs of Psychiatry in Canada called for delaying the MAID expansion, citing a lack of public education on suicide prevention as well as an agreed-upon definition of irremediability.

In February of 2023, 30 legal experts co-signed a letter addressed to Prime Minister Trudeau and his cabinet that called for the government to order a suspension and review — not just a delay — of further expansion of MAID. In June of 2023, Quebec amended an assisted dying law, the Act Respecting End-of-Life Care, to prohibit requests for MAID based on a mental disorder other than a neurocognitive disorder.

There is quite a history of concern that has been expressed by the experts, and at committee we also heard differing opinions, which made us pause about the state of readiness.

Once again, we find ourselves in a position where the government must correct their fervour to implement their expansionist agenda for MAID. Bill C-62 is an attempt to fix the problems they created with their rushed approach to Canada’s MAID regime, but this is merely a short-term solution. I believe that as quite a few of the provinces and territories have requested, an indefinite pause on this critical expansion is what is needed. A three-year pause is merely a short-term solution.

As I stated in my second reading speech for Bill C-39, medical assistance in dying has been and remains one of the most complex and deeply personal issues for individuals and families across our country. There is a wide range of opinions in this chamber on what the appropriate parameters and safeguards should be as we continue to grapple with these questions in the development of our MAID regime.

I voted for the first Bill C-14 to enact a MAID regime because I thought that we needed a regime, but it was in Bill C-7 when there was an expansion to include offering MAID to those suffering from a mental disorder as a sole underlying condition that I voted against the bill.

I believe we have gone too far with the proposed expansion to include those with mental illness as a sole underlying condition. The lives of Canadians battling mental illness are not disposable. I think the introduction of Bill C-39 and now Bill C-62, which extends the exclusion of eligibility for receiving medical assistance in dying to circumstances where the sole underlying medical condition identified in support of the request for MAID is mental illness until March 17, 2027, is evidence that we have moved too far, too quickly, and it is an attempt to put a pause on a policy we should be repealing altogether.

However, colleagues, though this bill is only enacting a three‑year pause, I will reluctantly support Bill C-62 because, without it, MAID for those with a mental illness as a sole underlying condition will become law on March 17 of this year, and we know we will need more time. Thank you.

The Hon. the Speaker: Is it your pleasure, honourable senators, to adopt the motion?

Hon. Ratna Omidvar: Will Senator Martin take a brief question?

This question is appropriate for you especially because you were a co-chair of the MAID committee. This bill proposes that within two years after Royal Assent, a joint committee of Parliament will be struck to undertake a review relating to the eligibility and readiness. So, it is possible that this committee will be called into life after as late as two years, giving the committee just one year.

Here we are on February 26, and we are pressed for time to approve the bill by this Thursday; otherwise, the law will kick in. Do you believe that is enough time for your committee to study, once again in 2027, the questions of eligibility and readiness, when this time you didn’t — at least it doesn’t appear to me that you did — have sufficient time?

Hon. Marc Gold (Government Representative in the Senate), pursuant to notice of February 15, 2024, moved:

That the Standing Senate Committee on National Finance be authorized to examine and report upon the expenditures set out in the Supplementary Estimates (C) for the fiscal year ending March 31, 2024, with the exception of Library of Parliament Vote 1c;

That, for the purpose of this study, the Standing Senate Committee on National Finance have the power to meet, even though the Senate may then be sitting or adjourned, with rules 12-18(1) and 12-18(2) being suspended in relation thereto;

That the Standing Joint Committee on the Library of Parliament be authorized to examine and report upon the expenditures set out in Library of Parliament Vote 1c of the Supplementary Estimates (C) for the fiscal year ending March 31, 2024; and

That, in relation to the expenditures set out in Library of Parliament Vote 1c, a message be sent to the House of Commons to acquaint that house accordingly.

Hon. Patti LaBoucane-Benson (Legislative Deputy to the Government Representative in the Senate): Honourable senators, with leave of the Senate and notwithstanding rule 5-13(2), I move:

That the Senate do now adjourn.

Hon. Rosemary Moodie: There is a phrase you used that I don’t understand. What is “the right time”? Can you define that for me? What do you think is the right time?

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

(On motion of Senator Gold, bill placed on the Orders of the Day for third reading at the next sitting of the Senate.)

Hon. Senators: Agreed.

(At 9:07 p.m., the Senate was continued until tomorrow at 2 p.m.)