Rosemarie Falk

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Madam Speaker, when considering legislation, we have a responsibility as parliamentarians to think carefully about the decisions we make in this place and the real-life impacts they have on Canadians. That responsibility is even greater when we are dealing with matters of life and death. Medical assistance in dying is not an ordinary policy issue. The decisions made under this legislation have final and irreversible consequences. There is no opportunity to change course or undo what has been done. I approach this legislation with a deep respect for the inherent value of human life and with the conviction that our laws must offer protection to those who are most vulnerable. That responsibility is particularly important when we consider the changes to Canada’s MAID framework before us today. One area where these concerns have been particularly evident is the question of MAID for individuals whose sole underlying medical condition is mental illness. Previous Liberal legislation amended the Criminal Code to include a two-year prohibition on the availability of MAID for mental illness. The legislation included a sunset clause that would allow the exclusion to expire, opening the door to this expansion of MAID eligibility. Including a sunset clause on such a significant change was reckless. Mental health experts and advocates have continuously raised serious concerns about expanding MAID eligibility to include mental illness, and a mental illness should not be treated as irremediable. Recovery is possible even for those experiencing severe and prolonged suffering. A person’s circumstances and response to treatment can change over time. Someone experiencing severe suffering today may find relief through treatment and support tomorrow. The most important message we can send to those struggling with their mental health is that there is always hope for recovery. Offering someone MAID when they are experiencing hopelessness risks taking away the opportunity for that recovery. That is why the Special Joint Committee on MAID recommended making the exclusion for mental illness permanent in the Criminal Code. This recommendation followed testimony from medical experts, researchers, advocates and Canadians with lived experience. The chief medical officer at the Centre for Addiction and Mental Health told the committee that there is currently no established criteria or consensus among psychiatrists about whether or when a mental illness should be considered irremediable. He also pointed to the difficulty of distinguishing a request for MAID from a suicidal intent, explaining that researchers found no reliable way to make that distinction. Professor Brian Mishara, an expert in suicide prevention, also spoke to the uncertainty of predicting whether someone will recover. His testimony reinforced the importance of recognizing that even when someone is experiencing severe and prolonged suffering, their circumstances and outlook can change. We cannot lose sight of that possibility when considering legislation with such irreversible consequences. Another important concern raised before the committee was the lack of access to mental health treatment and support. The chief medical officer also acknowledged there may be individuals who have not had the opportunity to access treatments that could help them. There is something deeply troubling about offering someone an irreversible end to their life when they may not have had a real opportunity to access the treatment and care they need. We cannot say someone has truly exhausted all their options when all options have not been made available to them. For someone struggling with mental illness, access to treatment should not be out of reach. They deserve the opportunity to receive care, explore treatment options and find a path forward. We cannot allow gaps in our health care system to become a reason why somebody is offered MAID. A system that offers MAID without ensuring access to appropriate care is failing the very Canadians it should be protecting. Permanently excluding MAID for people whose sole underlying condition is a mental illness is the right decision. This is a recognition of the serious concerns Conservatives have been raising all along. Expanding MAID to include mental illness would undoubtedly lead to the death of someone who still has a chance to recover. With the right treatment, care and support, their future would be very different. We should never rob someone of the opportunity to get better, or, in fact, rob their families and friends of the opportunity to see them recover. This makes the Liberal government’s handling of MAID all the more troubling. The government had an opportunity to take a clear and direct step to protect Canadians with mental illness. If the Liberals were serious about protecting those affected, they would have supported Bill C-218. That Conservative private member’s bill would have addressed the issue directly and provided an opportunity to work together on a measure that has broader support. Instead, the Liberals voted down Bill C-218 and then brought forward their own legislation. Bill C-41 would go beyond permanently excluding MAID for mental illness. It would also include further expansion to Canada’s MAID regime. These are separate issues. Each deserves its own debate and careful consideration. The recent committee study focused on MAID for mental illness. It did not examine these further expansions to the regime. This is why these issues should not have been combined in one bill. The recent committee study focused on MAID for mental illness. It did not focus on or scrutinize further expansions of the regime, but the committee did hear testimony from witnesses who raised serious concerns about vulnerabilities within the existing MAID framework. Those included gaps in access to care, social and economic pressures and questions about whether the current safeguards are working as intended. Beyond these broader concerns, there have also been several public accounts of Canadians being offered MAID when they had not asked for it. Miriam Lancaster, an 83-year-old woman in British Columbia, has spoken about being offered MAID when she went to the hospital with severe pain. She had not yet even been diagnosed. Ultimately, doctors later found a fracture and she went on to recover. The death of Brigitte Stegemann, an 83-year-old grandmother who died by MAID in July, is now under investigation. Her family says she had made it clear that she did not want MAID and that she did not give final consent before the procedure. These are just a few recent cases that have received media attention, and they raise serious concerns about consent, pressure and the protection of vulnerable people. These cases have occurred under the current MAID framework. These concerns become even more serious when we consider the Liberal government’s proposal to expand MAID. If we are still struggling to ensure consent and to protect vulnerable people under the current framework, there are serious questions about whether the proposed safeguards will be enough. This is particularly concerning when someone can no longer speak for themselves. Bill C-41 raises serious questions about the direction of Canada’s MAID framework and the protections in place for vulnerable Canadians. The exclusion for MAID where mental illness is the sole underlying condition must be made permanent. Expanding eligibility to those with mental illness should never have been a consideration to begin with. The Liberals had an opportunity to work with Conservatives on targeted legislation to permanently address this issue. Instead, they put forward this bill that combines this important measure with further expansions to the MAID framework. These are separate issues, and they should have been dealt with separately. It is reckless to further expand MAID when serious issues remain around consent, pressure and coercion under the current system. We have a responsibility to ensure that the law protects those who are most vulnerable. When it comes to the decision about someone’s life, getting it wrong even once is one time too many.