Discussion · Government Orders
Stéphane Lauzon Liberal
“I want the House to pass this bill and send it to committee. It lets people diagnosed with diseases like dementia ask for medically assisted dying in advance, before they lose the ability to consent. Most Canadians support this change. It gives people control over their end-of-life care while letting provinces set the rules for how it is safely handled.”
“Mr. Speaker, first and foremost, I would like to thank my colleague from La Prairie—Atateken for his excellent speech and his commitment to this issue. Since arriving here, he has immersed himself in the issue of medical assistance in dying. Today, we are seeing positive results. Parliament established the Canadian framework for medical assistance in dying in 2016. I was here at the time. Since then, Canadians have been engaged in an ongoing, compassionate dialogue on this issue. It is something I have discussed around the kitchen table with my family. Since 2016, it has been a topic that comes up regularly. While this issue can divide families around the dinner table, it can also divide members of this House. It is not an easy issue. Nevertheless, it is one that deserves serious consideration. I am proud to support my government’s approach. Today, I will focus primarily on how we can recognize and place appropriate limits on certain actions related to decisions about medical assistance in dying. I recall that we recognized at the time that there were some very complex issues that would need to be examined further. That is exactly what Parliament did. One of those sensitive issues was the possibility of allowing MAID based on an advance request. The court ruling has brought the issue of MAID before us once again. As my colleague made clear at the end of his last response, there is more work to be done. We can start drafting the legislation and refine it over time. There is no unanimous consensus on mental illness at the moment. It is important to note that advance requests for MAID are not currently permitted under the Criminal Code, because a person must be capable of providing consent immediately prior to the administration of MAID. Quebec has served as a model for us. Contrary to what the Bloc Québécois sometimes says, specifically that we are using this bill as a bulldozer, we are actually working together to move the bill forward. The Bloc Québécois should be proud to tell us that Quebec is a model. It is a model for us, a model for Canada, a model for drafting Canada’s medical assistance in dying legislation. We recognize that people with dementia can live for many years with this disease and that, depending on how the disease progresses, they can continue to enjoy a good quality of life and participate in meaningful activities. For some people, it is especially important to maintain their autonomy when it comes to decisions about their future health care. The decision is made now. When someone is diagnosed with Alzheimer’s or dementia, they are fully aware of the decisions they are making. Today, thanks to technology, the disease can be detected more quickly. Patients can find out what lies ahead. They can understand how their condition will deteriorate and how fast it will happen. People are thinking about the care they wish to receive at the end of their lives. Decisions about the future are made now. This may include the option to choose medical assistance in dying, even in circumstances where the person would have lost the capacity to consent by the time they become eligible to receive MAID. That is the major change introduced by the bill. I believe that Bill C-41 will allow people diagnosed with a condition that will result in a loss of capacity to submit an advance request for MAID. The eligibility criteria and safeguards must be established in the Criminal Code. This has to be clear at the national level. As my colleague so aptly put it, this is an incredibly important step to take before referring the bill to committee. A great deal will happen in committee. Thousands of witnesses have given evidence since 2016, when the entire legislative framework was overhauled, and now the committee will hear more. It is important to recognize that the provinces and territories are responsible for delivering health care services. The bill will also require provinces and territories that choose to allow advance requests to enact legislation setting out how this would work in practice. My colleague was clear on this point. In his response to the Bloc Québécois, he made it clear that governments will have to adapt to the bill. We are establishing a national framework. Nothing in this world is perfect, but this bill provides an excellent foundation for adapting MAID legislation across the provinces and territories. This approach reflects the division of responsibilities and respect for jurisdictional boundaries. Responsibility is shared across Canada. The federal government establishes the criminal law framework, while the provinces and territories are responsible for the delivery of health care. In the case of requests for MAID, the federal legal framework proposes to create eligibility criteria and safeguards that practitioners must adhere to. The provincial and territorial laws would specify how MAID based on an advance request could be safely administered, by establishing the terms governing how requests are stored and accessed by health care professionals. In addition, these laws would have to establish specific rules governing the submission, modification and possible withdrawal of advance requests by individuals who change their mind. That aspect has been made clear; it was mentioned by the minister in his opening speech. I think he placed a lot of emphasis on the fact that people have the right to reconsider at any time. This approach is rooted in years of parliamentary studies and public dialogue on this issue. We have been talking about MAID for several years now. In its 2023 report, the Special Joint Committee on Medical Assistance in Dying recommended that the Government of Canada amend the Criminal Code to allow for advance requests for MAID following a diagnosis of a serious and incurable medical condition leading to incapacity. Then came all the definitions, the testimony, the public consultations and the digital consultations. Thousands of consultations were held. From November 2024 to February 2025, the government launched a national conversation on advance requests, during which thousands of people from across the country made their voices heard through an online public survey, public opinion polls and virtual round table discussions. Nearly 46,000 Canadians completed the online survey, and 69% said they supported advance requests for people diagnosed with a serious and incurable condition resulting in a loss of decision-making capacity. More recent surveys show even greater support for advance requests. For example, a 2025 survey found that 84% of Canadians support the right of people in this situation to make an advance request. During the national conversation, participants pointed out the importance of being able to make decisions about their future health needs and maintaining control over their final moments. At the round tables, we heard testimony from people who had gone through such experiences and from family caregivers. They described the difficult choices that sometimes have to be made when a person might lose the ability to consent to MAID as their illness progresses. For those with conditions like dementia, this can create an impossible choice: receive MAID sooner than they would like, while they are still able to provide consent, or wait and risk losing that option. Although participants expressed strong support for advance requests in principle, they also emphasized the need to ensure that this is implemented safely. Health care professionals pointed out the challenges associated with assessing suffering when a person has lost their decision-making capacity. They also explained how difficult it is to determine eligibility for MAID when the conditions described in the advance request do not exactly match the person’s current situation. In closing, this is an extremely sensitive issue, and I am sure that the committee will do its job and come back to the House with a sound decision.”
Mr. Speaker, first and foremost, I would like to thank my colleague from La Prairie—Atateken for his excellent speech and his commitment to this issue. Since arriving here, he has immersed himself in the issue of medical assistance in dying. Today, we are seeing positive results. Parliament established the Canadian framework for medical assistance in dying in 2016. I was here at the time. Since then, Canadians have been engaged in an ongoing, compassionate dialogue on this issue. It is something I have discussed around the kitchen table with my family. Since 2016, it has been a topic that comes up regularly. While this issue can divide families around the dinner table, it can also divide members of this House. It is not an easy issue. Nevertheless, it is one that deserves serious consideration. I am proud to support my government’s approach. Today, I will focus primarily on how we can recognize and place appropriate limits on certain actions related to decisions about medical assistance in dying. I recall that we recognized at the time that there were some very complex issues that would need to be examined further. That is exactly what Parliament did. One of those sensitive issues was the possibility of allowing MAID based on an advance request. The court ruling has brought the issue of MAID before us once again. As my colleague made clear at the end of his last response, there is more work to be done. We can start drafting the legislation and refine it over time. There is no unanimous consensus on mental illness at the moment. It is important to note that advance requests for MAID are not currently permitted under the Criminal Code, because a person must be capable of providing consent immediately prior to the administration of MAID. Quebec has served as a model for us. Contrary to what the Bloc Québécois sometimes says, specifically that we are using this bill as a bulldozer, we are actually working together to move the bill forward. The Bloc Québécois should be proud to tell us that Quebec is a model. It is a model for us, a model for Canada, a model for drafting Canada’s medical assistance in dying legislation. We recognize that people with dementia can live for many years with this disease and that, depending on how the disease progresses, they can continue to enjoy a good quality of life and participate in meaningful activities. For some people, it is especially important to maintain their autonomy when it comes to decisions about their future health care. The decision is made now. When someone is diagnosed with Alzheimer’s or dementia, they are fully aware of the decisions they are making. Today, thanks to technology, the disease can be detected more quickly. Patients can find out what lies ahead. They can understand how their condition will deteriorate and how fast it will happen. People are thinking about the care they wish to receive at the end of their lives. Decisions about the future are made now. This may include the option to choose medical assistance in dying, even in circumstances where the person would have lost the capacity to consent by the time they become eligible to receive MAID. That is the major change introduced by the bill. I believe that Bill C-41 will allow people diagnosed with a condition that will result in a loss of capacity to submit an advance request for MAID. The eligibility criteria and safeguards must be established in the Criminal Code. This has to be clear at the national level. As my colleague so aptly put it, this is an incredibly important step to take before referring the bill to committee. A great deal will happen in committee. Thousands of witnesses have given evidence since 2016, when the entire legislative framework was overhauled, and now the committee will hear more. It is important to recognize that the provinces and territories are responsible for delivering health care services. The bill will also require provinces and territories that choose to allow advance requests to enact legislation setting out how this would work in practice. My colleague was clear on this point. In his response to the Bloc Québécois, he made it clear that governments will have to adapt to the bill. We are establishing a national framework. Nothing in this world is perfect, but this bill provides an excellent foundation for adapting MAID legislation across the provinces and territories. This approach reflects the division of responsibilities and respect for jurisdictional boundaries. Responsibility is shared across Canada. The federal government establishes the criminal law framework, while the provinces and territories are responsible for the delivery of health care. In the case of requests for MAID, the federal legal framework proposes to create eligibility criteria and safeguards that practitioners must adhere to. The provincial and territorial laws would specify how MAID based on an advance request could be safely administered, by establishing the terms governing how requests are stored and accessed by health care professionals. In addition, these laws would have to establish specific rules governing the submission, modification and possible withdrawal of advance requests by individuals who change their mind. That aspect has been made clear; it was mentioned by the minister in his opening speech. I think he placed a lot of emphasis on the fact that people have the right to reconsider at any time. This approach is rooted in years of parliamentary studies and public dialogue on this issue. We have been talking about MAID for several years now. In its 2023 report, the Special Joint Committee on Medical Assistance in Dying recommended that the Government of Canada amend the Criminal Code to allow for advance requests for MAID following a diagnosis of a serious and incurable medical condition leading to incapacity. Then came all the definitions, the testimony, the public consultations and the digital consultations. Thousands of consultations were held. From November 2024 to February 2025, the government launched a national conversation on advance requests, during which thousands of people from across the country made their voices heard through an online public survey, public opinion polls and virtual round table discussions. Nearly 46,000 Canadians completed the online survey, and 69% said they supported advance requests for people diagnosed with a serious and incurable condition resulting in a loss of decision-making capacity. More recent surveys show even greater support for advance requests. For example, a 2025 survey found that 84% of Canadians support the right of people in this situation to make an advance request. During the national conversation, participants pointed out the importance of being able to make decisions about their future health needs and maintaining control over their final moments. At the round tables, we heard testimony from people who had gone through such experiences and from family caregivers. They described the difficult choices that sometimes have to be made when a person might lose the ability to consent to MAID as their illness progresses. For those with conditions like dementia, this can create an impossible choice: receive MAID sooner than they would like, while they are still able to provide consent, or wait and risk losing that option. Although participants expressed strong support for advance requests in principle, they also emphasized the need to ensure that this is implemented safely. Health care professionals pointed out the challenges associated with assessing suffering when a person has lost their decision-making capacity. They also explained how difficult it is to determine eligibility for MAID when the conditions described in the advance request do not exactly match the person’s current situation. In closing, this is an extremely sensitive issue, and I am sure that the committee will do its job and come back to the House with a sound decision.