“I disagree that people are not being pressured into medically assisted death. The current system is not working. Canadians are being pushed to end their lives without asking for it or consenting to it.”

“Madam Speaker, I humbly disagree. There are Canadians who have been suggested and coerced. I spoke of Miriam Lancaster, who went to the hospital with pain. It was suggested that she should have MAID. It happened that she had a fracture, and she ended up getting treatment and going home. The problem is that the current framework is not working. Canadians are still being coerced and pressured into ending their life without asking for it and, in some cases, without consent.”

“I do not want medically assisted dying expanded. The current safety rules are not working. In Ontario, one woman died this way without her consent. Different rules across provinces could let people shop around for doctors who say yes. My constituents have told me clearly that they do not want these rules expanded.”

“Madam Speaker, I will just say, to the first part of my colleague’s remarks, that the current framework is not working. I referred to the death of Brigitte Stegemann, here in Ontario, who did not want and did not consent to MAID. Her death is under investigation because the current framework’s safeguards are not working. If we add the mishmash of different provinces and territories, we then could end up with MAID tourism, where people are shopping around to get what they want if one doctor says no, that they do not think that the situation fits into that framework. This is a problem. I will say, regarding hearing from constituents, I have received many petitions, specifically on Bill C-218. Many of my constituents wanted to see that passed. I have received many letters and phone calls regarding the importance of this and not wanting to see MAID expanded at all in any area.”

“We all agree that people should not get medically assisted dying just for mental illness. Disability and mental health groups agree with that too. We should not combine that agreed rule with a plan to expand assisted dying, which needs much more study before our deadline.”

“Madam Speaker, why? This place has arrived at a consensus, albeit it took some time, on the first part of the bill. All the disabled groups, mental illness groups and everyone else recognized that the path the government was going down was the wrong one, in allowing mental illness to be the sole driver for MAID. Why combine it with an expansion process that needs far more study, irrespective of where one is on the spectrum? Why combine it, with the deadline that the House is facing? What is the logical path for combining those two issues?”

“The Liberals combined these issues just to divide us for political gain. Less than a month ago, they voted against another bill that could already be in committee. Any problems with that bill's wording could have been fixed there.”

“Madam Speaker, I believe it is just for political gain. I believe the Liberals wanted to wedge and thought they could wedge us on this. At the end of the day, less than a month ago, that party voted against Bill C-218. It could have already been in committee. I heard a Liberal member say they had an issue with some of the verbiage. That could have been amended in committee. This could have been moved along, and we—”

“I oppose this bill because it lets people ask for medically assisted death in advance. It allows someone to be killed based on a paper signed years earlier, without asking them or telling them what is about to happen. People should not be able to give someone else the power over their life and death before they even experience their illness.”

“Madam Speaker, I am opposed to this bill on the grounds of the advance directives proposal. There is nothing in the bill that would even require that a person who had previously, maybe years before, signed an advance directive be consulted or told what is about to happen to them. The bill would allow a person to be killed based on a piece of paper they signed perhaps years before, without informing them what is about to happen to them. It is obviously a bit of a stretch to say, in the name of autonomy, that somebody can delegate the power of life and death for them to someone else. It means that somebody else would make that decision for them, again, without asking them or without telling them, potentially, and would have to assess, external to them, what is or is not intolerable in the particular circumstances. The person signing the advance directive would do so before they even have the lived experience of that condition. If I get a diagnosis today and am asked to sign a document about something in the future that I have never experienced, I am obviously doing that in relative ignorance of that experience. Does the member share these concerns at all about how this would work in practice? Even if she likes the idea of advance directives in theory, what would it mean in practice when somebody else has the power of life and death over a patient on the basis of something they signed years before?”

“I want the member to define intolerable suffering. Under this bill, a doctor would have to decide if a patient is suffering intolerably, even when that patient can no longer communicate. Right now, there is no definition for those words.”

“Madam Speaker, I wonder if my Liberal colleague could provide us with a definition of intolerable suffering. A doctor would have to somehow decide that somebody has intolerable suffering. That person is not able to communicate with them, but they have made an advance request. As far as I understand, there is no definition at this time of the actual wording “intolerable suffering”.”

“The head of an assisted dying group said they want anyone who wants this service to have it. That statement does not mention illness or suffering at all. I want the member opposite to tell us if she agrees with that idea.”

“Madam Speaker, I did appreciate the opportunity to work with my colleague opposite on the special joint committee. She is very passionate about this issue. She actually has co-hosted an event with Dying With Dignity Canada. The CEO of Dying With Dignity said the following: “Dying With Dignity Canada envisions a world where everyone who wishes to consider a MAID death can do so.” There is no acknowledgement in that line of any medical condition or any suffering whatsoever. Does my colleague agree or disagree with that vision?”

“This bill does not require that a person be told before their life is ended. Under an advance request, someone could be given life-ending medication without knowing it.”

“Madam Speaker, the member pointed out that this legislation says that if a person were to resist, then the act of ending their life should stop, but what she does not acknowledge and should, I think, is that the legislation would not require that the person be informed before their life is taken. Very likely what would happen, based on an advance directive, is that someone would have something put in them without—”

“I do not want this bill to pass. It lets people ask for medically assisted dying in advance, before they lose the ability to consent. The government is rushing this through without enough study. People can change their minds, and this could end someone's life against their wishes.”

“Madam Speaker, I will be splitting my time with the Leader of the Opposition. The Liberals have learned absolutely nothing over the past five years from their disastrous planned expansion of MAID for mental illness. They decided to move ahead with this planned expansion before studying the issue. They did so by accepting an eleventh-hour Senate amendment to Bill C-7, legislation that had nothing to do with MAID and mental illness, until of course they accepted the amendment. They then proceeded to shut down debate and ram through the bill without any meaningful debate, consultation or study, thus setting the train in motion for MAID for mental illness. Had they studied the issue first, rather than recklessly moving ahead with it, they would have heard what has been now made loud and clear by leading experts, including psychiatrists, namely that MAID for mental illness cannot be implemented appropriately and safely. The Liberals, because they did not do their homework, had to bring in two emergency bills to delay implementation. Here we are, five years and four bills later, and they have finally admitted they got it wrong all along and are now bringing forward legislation to put an indefinite pause on MAID for mental illness. At the same time, here we are again, with the Liberals’ recklessly seeking to ram through a new expansion of MAID, this time advance requests, by shoehorning advance requests into a bill to put an indefinite pause on MAID for mental illness, an expansion that will take place unless a bill is passed by March of next year. What the Liberals are doing is shutting down parliamentary debate and parliamentary scrutiny of the complex issue of advance requests. If there ever was an issue that deserves careful scrutiny, it is advance requests, because there are profound legal, ethical and practical issues at play, and there are significant risks. The most significant risk identified in its 2018 report by the expert panel the Council of Canadian Academies, which is appointed by the government, by the way, is that in the case of advance requests, MAID could be administered against a patient’s wishes. That is not an isolated or remote risk. It is a very real risk underscored by Health Canada’s data in its annual reports on MAID, which show that each year, anywhere between 10% and 20% of patients who withdraw their consent withdraw it immediately before the administration of MAID. The possibility that MAID could be administered against a patient’s request really gets to the heart of the central issue around advance requests, and that is the issue of consent. On the question of consent, the Supreme Court of Canada, in the Carter decision, said that in order to qualify for MAID, a patient must clearly consent. The court used those words multiple times in that decision, “clearly consents”, which arguably implies that such consent must be contemporaneous. Hence, advance requests raise serious legal questions about whether they fall outside the parameters for MAID set by the Supreme Court, and whether explicit contemporaneous consent is constitutionally required. Not only are there issues that are legal in nature, but there are also profound ethical concerns involving consent, because when consent is made in advance, it can never be fully informed consent. That is because it is made based upon future assumptions about one’s circumstances, capacities or preference, not upon one’s lived experience. There is abundant research into effective forecasting that demonstrates that when a person is diagnosed with an illness or a condition, they are often poor predictors of what the future will look like. As Dr. Romayne Gallagher, a clinical professor in palliative medicine, told the Special Joint Committee on MAID: ...medical and social science literature reminds us that people are poor at anticipating what life would be like with a life-changing illness or disability. People adapt to illness and disability and adjust their needs for a decent quality of life. Many medical conditions have long and unpredictable courses. If consent cannot be contemporaneous and therefore cannot be fully informed, it raises the question, can there be true consent? If there cannot be true patient consent, then how can we ethically proceed with an advance request regime? Now, proponents of advance requests often cite individual autonomy, but I would submit that individual autonomy in the context of advance requests is illusory. That is because advance requests necessarily result in not patient consent but third party consent, based upon observations that are often highly subjective in nature. After all, how does a MAID assessor confidently and accurately determine if a patient is suffering intolerably, which is a prerequisite for MAID to be administered, if the patient cannot communicate the degree to which they are suffering? That is what we invite with advance requests, namely, the administration of death based upon third party, often highly subjective observations of patients who cannot communicate and often have no ability to withdraw their consent. Then there are other issues that need to be considered, including legitimate concerns that advance requests will lead to abuse and coercion resulting in vulnerable persons having their lives ended. There are concerns from a human rights perspective that advance requests undermine human dignity and will lead to discrimination against persons with cognitive disabilities, that a message is being sent that their lives are not worth living and that they are lesser human beings, completely undermining a fundamental principle of human rights: the universal and equal value of all human beings. All of this underscores the need for careful study and meaningful consultation, none of which has happened, by the way. The Liberals have not done any meaningful consultation since the 2018 expert review, which recommended against moving ahead with advance requests, but instead the Liberals have learned nothing. Here we are again with the Liberals recklessly trying to ram through a complicated expansion of MAID. Canadians deserve better.”

“We need to be careful with assisted dying laws. The government should look at the risks, consult people, and put safeguards in place. Instead, the Liberals are trying to shut down debate and rush this through. Expanding assisted dying to mental illness is reckless, and we need to stop it.”

“Madam Speaker, on a question of life and death involving an advance request regime, we need to proceed with caution. If the last five years is an illustration of the need for caution and the need to consult, it is precisely that. Yes, public opinion is one thing, but we need to look at how the regime could be rolled out, the risks involved, whether it is appropriate and, if it is appropriate, what safeguards need to be put in place. Instead of doing that work, the Liberals are trying, yet again, to shut down debate and just ram it through under the deadline with respect to the expansion of MAID for mental illness, with the need to pass that bill to put an indefinite pause on that completely ill-advised and reckless planned expansion.”

“I oppose letting people ask for assisted death in advance. A person cannot agree or change their mind at the time it happens. This is a serious safety and ethical problem, not just a legal detail. The committee did not study this issue enough.”

“Madam Speaker, contemporaneous consent and issues around the ability to withdraw, or the inability to withdraw in the case of advance requests, which are fundamental to fully informed consent, are not legalistic issues. Yes, there is a legal element to it, but these are profound ethical questions around whether advance requests can be implemented safely. The member spoke of the Special Joint Committee on MAID. All I can say is that there was a very limited, cursory review of the issue of advance requests at that committee, which studied multiple issues.”

“Liberals used to support expanding medically assisted dying to people with mental illness, but they changed their minds once they saw the problems. Now the government is rushing through advance requests. I ask my colleague why we should accept this rushed timeline, when we will likely find out in a few years that the safeguards do not work.”

“Madam Speaker, I thank my colleague for his work on the Special Joint Committee on Medical Assistance in Dying. I note that several of the members of the Liberal government who have spoken in favour of stopping the expansion of MAID to people with mental illness were, a few years ago, speaking in favour of expanding MAID to mental illness. The difference of a couple of years was enough for people to realize that this expansion should not be allowed to proceed. In that context, I wonder if my colleague could offer his thoughts on why we should accept the government’s artificial timeline to ram through advance requests when it is more than likely that in a few years, we will reach the same conclusion that we are reaching now on mental health, which is that the safeguards are failing and that can never be adequately woven into our MAID system.”

“Advance requests for assisted dying should not be in this bill. The government did not study this issue or consult people for years. Now they are rushing it through before the March deadline without proper review.”

“Madam Speaker, I completely concur with the member for Elgin—St. Thomas—London South. There is absolutely no reason the provision for an advance request regime needs to be shoehorned into this bill. For years, the Liberals did nothing around advance directives. They did no studies, they had no consultation, and now, all of a sudden, they drop it into a bill in the face of a deadline to pass a bill by March. It is completely unacceptable, it is cynical, and it is really just an attempt to ram this through, just as they did with mental illness, without any of the scrutiny that comes with careful study and review.”

“I want the government to split this bill into two parts so we can vote on them separately. I agree with banning medically assisted dying for mental illness. But I do not want people to be able to ask for it years in advance, because their wishes might change.”

“Madam Speaker, imagine someone’s phone rings and the voice on the other end of the line, a stranger, gives them the surprise request that they need to pick up their 26-year-old son at the morgue because of medical assistance in dying. He had no life-threatening illness. He had type 1 diabetes and some vision problems, but other than that, it was just depression. He had been denied medical assistance in dying because he was not eligible. That was the story recounted to me by Margaret Marsilla, who came to visit me in this building. Kiano was only 26 years old, and although he struggled with diabetes and depression, he was not facing any end-of-life medical emergency. In fact, in Ontario, medical professionals had said he was not eligible. He shopped around for a different opinion and got one from a British Columbia doctor. I met his heartbroken mother in March, and her story is all too common. In the last few years, we have seen the predictable consequences of a medical assistance in dying regime that fails to protect the vulnerable and even preys on them. Canada has become famous around the world as a cautionary tale for abuses in a system that too often sees death not as a last resort for patients suffering but as a first option for an overburdened health care system. The statistics are stark. More than one in 20 Canadian deaths are by MAID. If we dig in, the numbers get even worse. One in 10 Canadians knows somebody who was offered medical assistance in dying even though they had no life-threatening condition and all of their conditions were treatable. Almost half of those who died by MAID in 2024 had reported feeling like a burden on family, friends and caregivers, raising the risk of induced death by guilt. Then there are individual horror stories, such as the Canadian Armed Forces veteran who contacted veterans affairs agents asking for government support for his ailments and was instantly offered MAID, or Father Larry Holland, a Catholic priest who went into the hospital for a fractured hip and was offered MAID not once but twice. These are not isolated cases. Even the BC Civil Liberties Association, which was one of the interveners that sued the government to legalize euthanasia in the first place, now believes the procedure has gone too far. Last year, it was “aware of ‘concerning reports’ of people being offered MAID in circumstances that may not legally qualify” as well as people accessing MAID as a result of intolerable social conditions, not medical conditions but people living in misery, poverty or loneliness and being told that the best option for them is to die. The organization called for safeguards to protect the more vulnerable patients so that they do not feel pressured to end their lives. Under these circumstances, the government had no choice but to pause its planned expansion of MAID for mental illness. I am pleased that the Liberals have once again reversed themselves on yet another radical experiment they had planned to impose on the Canadian people. Just as with net zero, mass immigration, catch-and-release criminal justice, legalized drugs and the carbon tax, they have been forced to reverse themselves yet again. The committee that studied the question heard from doctors who were worried about allowing patients to make a decision in a moment of personal crisis and despair that can and often does get reversed later on. The close link between mental illness and suicide also raises a practical problem. One psychiatrist actually testified that there is a problem, an incoherence, in that “Psychiatry claims it can both prevent suicide in one patient and help finalize suicide in another with [both of them having] the same suffering.” While I am glad the Liberals reversed themselves on one bad idea, I am disgusted that they have gone forward in the very same bill with another bad idea. In the same bill we are debating, which bans MAID for mental illness, the government would also legalize it for advance directives. These would allow persons to request MAID, at a time when they would not be eligible for it, for a future moment when they become eligible. Doctors have sounded the alarm at the impossible situation in which this may put them and the family members of the suffering person. Imagine the case of a patient suffering with dementia. They have signed an advance directive, but now they are smiling. They are happy. They enjoy sitting outside with the sun shining on their face. Their grandkids are sitting on their lap, enjoying an ice cream after dinner. However, they have signed an advance directive. Everyone knows that this person, though they have lost their faculties, is happy going on living. What does a doctor do at that point? Do they administer MAID to a patient who looks happy and who everyone knows wants to live on, or do they refuse the directive the government says they have to follow and consider the family? Most members would be aware of the story of Lisa Raitt, a former member of the House. She recently wrote online about her husband, who has been suffering with dementia for the last 11 years: “If Bruce had signed an advanced directive, would I have been left to make the decision on when to apply MAiD? “Even after 11 years, yesterday I saw him smile, laugh, interact and enjoy his meals while being non-mobile, incontinent and non verbal. “I can promise you, I would ignore any advanced directive. Yes, he is a different man with a different life now but subjectively and objectively he is comfortable and content. I would not believe this Bruce would want to stop living. “In this case, would the ‘state’ step in to provide MAiD over my objections and experience? We are rushing to a set of really complex entanglements. So much room for harm.” Instead of looking for more ways to end life, we should be looking for ways to allow people to live the fullest life, with better care, more support, pain treatment, love and compassion. We also know there is the fundamental problem that advance directives may not be accurate measures of what a patient would actually want in future circumstances. We have all said to ourselves that if such and such were to happen, we would want X or Y. Then when that eventuality comes about, we change our mind because the experience was different than what we thought. The attitude of a young person to death, for example, may be very different from an older person’s and may be different from that of the person they become. It would be easy to say that someone would not want to live that or live under those circumstances, but when they find themselves in those conditions, it can turn out to be that life is better than they thought and they no longer desire death. Many Canadians who are suffering serious health conditions can tell us from personal experience that there is hope they find and comfort they reach in the loved ones who surround them. Assuming that the conditions they live with would be reasons for someone else not to live ignores the experience and risks here, devaluing the lives of people in those circumstances. I am not prepared to take away from doctors or from family members like Lisa Raitt the ability to act for their loved ones when no one else really knows what the loved one wants and no one else has a greater interest in the well-being of that loved one. These are painful decisions for doctors and families at the best of times. We should not make harder by rushing through dangerous legislation. Unfortunately, the government has forced me and many others in this room into an impossible dilemma, those of us who want to ban MAID for mental illness and give people hope that they can have a brighter future and can come out of the bottom of the valley and get back to the mountain top. We want to vote to save their lives, but we do not want to vote to introduce new dangers that could end other lives that people would believe are worth living. That is why we are calling for the government to split this bill. There is no reason to rely on the arbitrary deadline that is necessary to repeal MAID for a mental illness in order to avoid it coming into effect in March, to also then apply it to the swift passage of an extremely complex and highly dangerous new practice that is done almost nowhere in the world and that is fraught with serious risks. This is literally a matter of life and death. I ask the government to split this bill to allow Canadians and their parliamentarians to express their conscience by voting on each section separately so that we can stand in this place and offer hope, compassion and love to the people who need it most.”

• Echo ×5

  A repeated line

  “This is a matter of life and death.”

  Said 5 times by 4 members since November 4.

  Every time it was said →

“I do not support letting people ask in advance to be helped to die later. People cannot agree ahead of time to their own future death. Setting up rules for that is dangerous and needs much more study than we can do before Christmas. We should split this bill so we can ban assisted dying for mental illness now without rushing into these risky new rules.”

“Madam Speaker, no I do not, because I do not believe that someone can grant pre-emptive consent for a subsequent death. There is a very serious risk no matter what we do. Let us assume that I had answered the question with “yes”. That framework would take time. Serious and deadly risks would come with creating a system of rules for people to grant permission to die much later on once their ability to consent is gone, and that would require immense study and surgical precision, which cannot be done with a bill that would be rammed through before Christmas. This bill needs to be split so that we can ban MAID for mental illness and give hope to these people, but at the same time not make the deadly mistake of expanding into the unknown without doing our research.”

“A person's life still has value when they get sick. Someone who can no longer speak might still want to live. I do not want them to lose their life. We should give them care, support, and love instead.”

“Madam Speaker, first of all, just because a person has finished one phase of their life and is beginning another does not mean that their life is over. A person may get sick, but their life still has value. Perhaps they want to continue living, but they are unable to communicate their will to live. I would not want such a person to lose their life. I think that, in situations like this, we need to provide the best care, the best support and the most love for that person, whether they are a former politician or anyone else.”

“Conservatives were right to warn against medically assisted dying for mental illness. Now the Liberals have changed their minds and agree with us. We should not rush into allowing advance requests either.”

“Madam Speaker, I thank the Leader of the Opposition for his tremendous intervention and for his leadership on this. He alluded in his speech to a very important point, which is that Conservatives won the argument on stopping MAID for mental illness. Everything that my colleagues who were in the previous Parliaments warned against has happened. I note that on the Liberal side, just eight members supported a bill from our former colleague Ed Fast to stop the mental health expansion, and now they are putting it in government legislation. Does the Leader of the Opposition agree that this is exactly why none of this, certainly not advance requests, should be rushed into on an artificial timeline? Even the Liberal government’s own record acknowledges that the Liberals’ minds were changed on this.”

“The Liberals were the ones who first made medically assisted dying legal for mental illness. Now they have changed their minds, which shows people change their minds.”

“Madam Speaker, let us remember that it was the Liberal government that first legalized MAID for mental illness, which was set to come into effect in March of next year. The Liberals have all changed their minds, apparently, which proves that people change their minds.”

“We should not just look at polls on deep, ethical issues like this. We need to debate advance requests for medically assisted dying thoroughly, just like we did with mental illness.”

“Madam Speaker, my colleague from Winnipeg North is suggesting that Conservatives should look at polls more, and I am suggesting that we should be debating these very deep, ethical, complex issues a whole lot more. Would he agree that we cannot just escape our duty as parliamentarians by looking at the polls, but that we need to do a deep dive and study this, like we did with MAID for mental illness? I would remind the member that, after six years, all the people on that side of the House changed their mind on that issue because of the deep debate that we had on that. Would my colleague agree with me that we need to have a similar debate on this very complex issue of advance medical directives?”

“The member for Winnipeg North now says he wants to stop expanding medically assisted dying to people with mental illness. But he has voted three times to allow it. Why did he change his mind?”

“Madam Speaker, I am glad to see my colleague from Winnipeg North supporting, in principle, anyway, a halt to the forthcoming expansion of MAID for people with mental illness. However, the member has voted three times against stopping that expansion. He voted for adding mental illness to the MAID regime in Bill C-7. He voted against Bill C-314 in the previous Parliament, and a couple of weeks ago, he voted against Bill C-218. To what do we attribute the change of heart?”