Medical Assistance in Dying Safeguards Act

Bill C-41, Medical Assistance in Dying Safeguards Act · Second reading · now at second reading in the House Where it stands

What Bill C-41 would do

The bill would permit doctors and nurse practitioners to provide medical assistance in dying to people who have lost the capacity to consent, if they made an advance request while still able to do so. To qualify, the person must have been diagnosed with a serious and incurable condition expected to cause that loss of capacity, and their province must have a system to store and track those requests. The bill would also permanently exclude people from receiving assisted dying solely on the basis of a mental illness.

Official text (opens in a new tab)

10 statements

Michael Cooper, St. Albert—Sturgeon River

Conservative
“We should not allow assisted dying for people with only a mental illness. Expert doctors agree we should not move forward with this. Moving ahead without their support would be reckless and dangerous for vulnerable people.”
Official Hansard

Mr. Speaker, on the question of mental illness and MAID, I sat on all of the special joint committees in this Parliament and in the last Parliament. In the last Parliament, 17 chairs of psychiatry wrote to the Minister of Justice calling on the minister to delay implementation of MAID where mental illness is the sole underlying condition. Today, if there is a consensus among experts, among psychiatrists, it is to not move ahead with this. On a question of life and death involving some of the most vulnerable persons in Canadian society, I would put it to the hon. member that moving ahead with this, lacking consensus among leading psychiatrists and other experts, would be reckless.

Luc Berthold, Mégantic—L'Érable—Lotbinière

Conservative
“It is very hard for people to get mental health care in Canada. People might give up on getting better because care is so hard to find. We may not be ready to allow medically assisted dying for mental illness until we fix our care system. I want to hear my colleague's thoughts on this.”
Official Hansard

Mr. Speaker, this debate is always very important, and both voters and members of the various parties always provide a lot of food for thought. We do not all share the same views on medical assistance in dying. One thing that I find very troubling when it comes to mental illness is the unfortunate shortage of mental health care services in Quebec and Canada. I will not get into my own experiences, but I have to say that it is extremely difficult to get access to specialists and treatment, and that can discourage people from seeking care that might actually help them. I think that perhaps we are not ready to allow access to MAID for reasons of mental illness because we have not put a system in place that gives people access to care if they need it. I would like to hear my colleague’s thoughts on that. That is a problem, and I think that we need to have answers in that regard before taking a position on this issue.

Luc Berthold, Mégantic—L'Érable—Lotbinière

Conservative
“Quebec already has rules for advance requests for medically assisted dying. I want to know if this federal bill matches Quebec's rules so we do not have to reopen the debate later.”
Official Hansard

Mr. Speaker, as I mentioned earlier, MAID is a sensitive issue that matters to people. There are a lot of different opinions on the subject. Quebec has already taken action with regard to advance requests. I wanted to know whether the federal government has made sure that Bill C-41 is consistent with Quebec’s legislation on advance requests, so that we do not have to reopen the debate after the bill is passed and so that we have some guidance in case amendments need to be made to the bill in committee. I would like to hear what my colleague has to say about that.

Luc Berthold, Mégantic—L'Érable—Lotbinière

Conservative
“Quebec already passed a law allowing people to ask for medically assisted dying in advance. Almost 3,000 people are waiting, but federal law still stops it. I want to know if the government made sure this bill works with Quebec's law, or if it plans to change the bill.”
Official Hansard

Mr. Speaker, I will ask the same question I asked my colleague earlier because it is very important. Quebec has already passed its own legislation on advance requests. There is apparently a backlog of nearly 3,000 advance requests in Quebec right now, but not one has been carried out because the Criminal Code still prohibits advance requests. Has the government ensured that Quebec’s existing law is consistent with Bill C-41, so that we do not have to debate this again at a later date, or does the government intend to introduce amendments to Bill C‑41 in committee instead?

Michael Barrett, Leeds—Grenville—Thousand Islands—Rideau Lakes

Conservative
“I support this bill going to committee so we can add stronger rules. I am glad the bill stops people from getting medical assistance in dying only for mental illness. People with mental illness need care instead. We must also protect our veterans. Some veterans asking for help were offered assisted dying instead of medical treatment. We need strong oversight and legal penalties for any government worker who offers assisted dying to a veteran asking for care.”
Official Hansard

Mr. Speaker, I will be sharing my time this afternoon. Bill C-41 is a profound and deeply personal issue, I think, to everyone who will consider it, and everyone who has intervened on it today approaches it from different life experiences, different backgrounds and different beliefs. Today, I am approaching this from my perspective as a Roman Catholic. I am guided by my faith and my belief in the inherent dignity and value of human life from conception to natural death. The dignity that every person has is not diminished by suffering or by illness. Their dignity is not diminished by disability or by their dependence on others. It is through that understanding of dignity that I approach this, and my concern for the compassion and care of others. I recognize that the serious suffering, which is probably unimaginable to any of us, that leads some people to consider MAID is at the heart of why this issue was ever brought to the attention of legislators. Those who support MAID may do so out of compassion and respect for the individual autonomy of those who are suffering. Certainly, suffering is not something we should seek, celebrate or ignore. I think we have a responsibility to relieve suffering where we can, but suffering, again, does not diminish the dignity of a person who is experiencing it, and it does not make their life any less valuable. In this legislation, the provision of MAID for mental illness as the sole underlying medical condition has been excluded. With the difficulty in determining the irremediability of a psychological condition, that is a positive change. I am certainly supportive of that exclusion being included in this legislation. We need to make sure that there is access to treatment for people who are suffering with mental illness. We also need to make sure they have timely access to treatment. In recent years, we have heard about veterans who have approached Veterans Affairs Canada for care in response to injuries and illnesses related to their service to Canada. It is so difficult to imagine that the testimony concerning this that Canadians heard at the Standing Committee on Veterans Affairs described things that could have happened here. Veterans, in multiple cases, who were seeking that care were offered MAID instead of receiving treatment, a benefit they are entitled to by virtue of their service to Canada, which they offered with unlimited liability. That is a specific phrase, the “unlimited liability” that our veterans serve our country with. It means they can be put in harm’s way, leading to their death, in service to Canada. When they leave the service, what is our liability to them? Certainly, we owe them the care for conditions arising from their service. Has Canada done a great job in taking care of our veterans? No, it has not. Is that problem unique to any period of time? No, it is not, but it is incumbent on us now to do better, to get it right and to take care of our veterans, who served us with unlimited liability. The testimony we heard at committee was, of course, that some of these veterans were offered MAID, not care, but death. That is hard to imagine. We will hear in some of the speeches from some of my colleagues that there are not sufficient safeguards for Canadians, for people who are suffering, for people who are considering their condition in the future and considering an advance directive. There are not sufficient safeguards. What I want to raise for the government’s and the minister’s consideration is what protections there are for veterans approaching the government for care for those service-related injuries and illnesses. They should never be encouraged to end their lives. There is, I think, a departmental directive that veterans affairs employees are supposed to no longer offer medical assistance in dying to our veterans. I think that for an issue as grave as this, the opportunity that is afforded to us in crafting the legislation, because we have to get it right, is to make sure there is independent and sufficient oversight but also legal protections, which would bring legal consequences for anyone who was to offer MAID to a veteran seeking care for an illness or injury arising from their service. That is not the role of Veterans Affairs Canada. This is not an easy conversation for any of us to have. I think we all know someone who has spent their final days, weeks, months or, in some cases, years not just in a diminished capacity but suffering. It is a hard conversation to have. It is one that we are having, and I appreciate the need to be respectful of one another in engaging in this, because we are all coming at it from different perspectives. In finding the balance, should this law come to pass, to make sure there are sufficient safeguards for everyone, I have highlighted, in particular, some of the safeguards that could be considered for veterans. I encourage the promotion of the dignity of all people. I think something we can agree on, in a conversation where there will be disagreement, is that we need to look out for each other, especially the most vulnerable among us. It is with that view that I have offered this intervention, and I will take questions on that. Hopefully, we can get this right if and when it moves to committee.

Michael Barrett, Leeds—Grenville—Thousand Islands—Rideau Lakes

Conservative
“Hospice and palliative care workers do vital, caring work. We need more resources to give people good and dignified care, especially in hospices and palliative care.”
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Official Hansard

Mr. Speaker, we have among us in our hospices and among those who provide palliative care some of the most compassionate and most important people. I aspire to have the strength to care for people when they are at their worst in the way that these people do. We need to do more to make sure that we have the resources to provide dignified and sufficient care for people, and I think hospice and palliative care are two places to do that.

Michael Barrett, Leeds—Grenville—Thousand Islands—Rideau Lakes

Conservative
“I support this bill because it adds safeguards to medically assisted dying. People have the legal right to make this choice, but we must protect vulnerable people. We need rules to make sure no one is pressured, that they fully understand their choice, and that they are of sound mind when making it.”
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Official Hansard

Mr. Speaker, I appreciate what I infer from the hon. member’s comments to be his respect and advocacy for the individual autonomy of every person. While I arrive at this debate informed by my beliefs, I would offer in reply that the opportunity we have with this bill is to provide safeguards for individuals who exercise that choice, which is legal in this country. We must make sure that there is no coercion, that it is always informed, that there is proper oversight, that when someone has made that choice, they have done so freely without interference and were of sound mind and judgment at the time, and that there are always safeguards in place to protect vulnerable people when they are in their most vulnerable moments.

Ziad Aboultaif, Edmonton Manning

Conservative
“Current laws fail to protect veterans and people with mental illness. The government needs to listen and protect these vulnerable people.”
Official Hansard

Mr. Speaker, the current legislation has failed to protect Canadians with mental health and some veterans. Why does the government need to listen this time and make sure that protection is there for vulnerable Canadians?

Michael Barrett, Leeds—Grenville—Thousand Islands—Rideau Lakes

Conservative
“Our laws fail to protect vulnerable people from assisted dying. Some veterans with PTSD who ask the government for help are offered assisted death instead. We need stronger legal protections and independent reviews.”
Official Hansard

Mr. Speaker, I will go back to the example I offered about veterans. We have seen demonstrated the failure of existing legislation to safeguard against abuses. I cannot think of anyone who is more vulnerable than someone living with an operational stress injury like PTSD after serving our country. They seek help, have the courage to call for help from the government they served, and then they are offered MAID. We need to make sure there are legal protections and independent review. This is just one of many examples of where we need to make sure there are sufficient guardrails. This is truly too important for us not to get right.

Philip Lawrence, Northumberland—Clarke

Conservative
“Canada now has one of the highest rates of medically assisted dying in the world. We need to talk about this. I do not want people to qualify for medically assisted death only because of a mental illness. Mental health can improve, and we should help people get better instead of ending their lives.”
Official Hansard

Mr. Speaker, I want to start my speech by congratulating all members of the House for the debate so far. I have been here observing it. I thought the member for Winnipeg North had an excellent question about hospice. The Bloc Québécois members talked about a very difficult subject in a sensitive manner. I am not sure if Canadians are always proud of us in the House, but I definitely think they could be this afternoon and morning with this important debate. This debate is quite frankly overdue and necessary. Like I said, I commend members in the House again for the compassionate way in which we have been able to have a dialogue, with many members I am sure having many different opinions. In addition to Bill C-41 and the content in it, a general discussion about MAID is important, regardless of where, I might add, someone is on the issue and whether they are an advocate or believe there should be additional safeguards. Canada is about to hit the highest rate of medically assisted dying in the developed world. In 2024, we were number two in the world, next to the Netherlands. We were at about 5.1% of total deaths. I do not believe we have a national number yet for 2025, and if someone wants to interject, I am happy to take it, but for Ontario in 2025, the rate was 7.3%. We are creeping up to about 10% of total deaths being done by medical assistance in dying. I do not believe this was a number that was projected or that we thought would occur at the time that the legislation was initially passed. Numbers do not always tell the whole story. In fact, they rarely do, but data points can point us in the right direction. Regardless of where someone is on the issue, I think we need to have a discussion, especially as MAID creeps up closer and closer to 10% of total deaths in Canada. On to the substance of the legislation, one of the more troubling elements that has occurred since 2019, when I was first elected, is the potential inclusion of mental illness as the sole reason for accessing medical assistance in dying. This is challenging not because mental illness is not as real as a physical illness. It very much is. In fact, I would say 100% is. The challenge is that with some mental illnesses, it is very difficult, according to the experts and the practitioners, to fully understand the impacts of certain mental illnesses. What we would never, ever want to see is that there was a permanent solution to a temporary problem. I think most people in here, regardless of the suffering if in fact it was for a finite amount of time, would want to be there in supporting people to get through to the other side of that. If it is possible to get to a point where someone can once again enjoy living and the suffering is no longer overwhelming, I am sure the vast majority of Canadians would want to see the community and health practitioners helping a person get through it. Once again, I would like to commend the House on a thoughtful dialogue. I thank the House for allowing me to contribute to it.

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