“Allowing people to request assisted dying in advance causes serious problems in real life. When people are scared by a new diagnosis, they might sign a paper out of fear of the worst-case scenario. Later, when they are actually sick, their feelings may change. But doctors and family members are left to guess whether that old paper still matches what the person wants.”

“Mr. Speaker, I think it is important for us to, as my colleague has, drill into the practical aspects of advance directives, not just the theoretical questions around it. Some people who think, in theory, that advance consent makes sense, I think would maybe be chastened by some of these practical realities. A person can get a diagnosis for something that is very frightening and also something that they have not yet experienced. They do not have any lived experience with having that illness, but they know it is coming or they know it is on the way. They are potentially presented with a worst-case scenario. There are many cases of this where people kind of catastrophize what has been presented to them in the process of encouraging them to sign something or accept facilitated death. Hypothetically, based not on someone’s lived experience but fear of the future, they sign a document and their real experience of living with that condition may be very different from that expectation. However, it is others in their life, like doctors or family members, who have to decide whether what a person signed a year ago fits with their present expressed experience. Do these practical realities not raise serious problems for the implementation of something like advance directives?”

“I oppose expanding assisted dying. The current rules do not protect people, and the United Nations has said these safeguards are not appropriate. We should not expand the system when the protections we have now already fail.”

“Mr. Speaker, there are a lot of concerns, as he accurately raised. We hear from the government terms like “safeguards” to give the impression that there are appropriate safeguards already in place in the euthanasia regime in this country. I would never cite the United Nations in almost any other circumstance but since we have a government that likes to appeal to international organizations like it, the United Nations has said these safeguards are not appropriate. Track 2 euthanasia is already wreaking havoc on people in very different circumstances than the government initially intended it to target. The safeguards do not work and believing that an expansion of euthanasia is going to be controlled by pre-existing failed safeguards makes absolutely no sense.”

“We should call this euthanasia, not MAID. The government uses that short name to make ending people's lives sound harmless, but it is not.”

“Mr. Speaker, I agree that using language is important, which is why I call it euthanasia. MAID is an acronym and a term made to sanitize something that is morally very consequential. I think it was used by the government to take something that is very disturbing to many Canadians and make it sound innocuous. It is not innocuous. It is euthanasia. It is about people’s lives being ended. This is serious. We do not need government acronyms in order to talk about this.”

“I oppose this bill. I agree that we must permanently ban assisted dying for people whose only condition is mental illness. People with depression need care and hope, not help dying. But the government is tying that ban to a new rule that lets people request assisted dying in advance. Assisted dying has already grown far too fast in Canada. The government is rushing this bill to avoid hard questions about letting people make requests in advance. We should vote on these two issues separately.”

“Mr. Speaker, there are few debates in Parliament that are more consequential and more deeply impactful than when we are called to debate life-and-death legislation. Issues of this importance require us to look beyond being partisan, and this is not the first time the chamber has had to grapple with such profound moral weight. We just have to look at our history. I am thinking of capital punishment. A private member’s bill was introduced to abolish it in 1914. For decades, in the 1950s, 1960s, 1970s, 1980s and 1990s, parliamentarians in this chamber grappled with that issue. They debated whether deterrence prevented murders, the morality of a state taking a human life, whether life imprisonment was a sufficient punishment and the irreversible possibility of making a mistake. We fast-forward to today. Medical assistance in dying is, without question, one of the most consequential public policy decisions this Parliament has ever made. It is a matter of life and death, literally, and that is precisely why we cannot afford to get this wrong. When Canada first introduced medical assistance in dying in 2016, Canadians were assured by the government that it would be a carefully controlled, exceptional measure built on very clear limitations and uncompromising safeguards. We were told it was strictly an end-of-life compassionate option for those facing a reasonably foreseeable natural death. That is what we were told, but look at where we are today. The data tells us a staggering story. In 2024 alone, 16,499 Canadians received MAID. Since its introduction, more than 76,000 Canadians have died through this program. It is approaching 100,000 now, in 2026. In 2024, MAID accounted for approximately 5.1% of all deaths across Canada. This is an extraordinary number. To put this in perspective, let us look across the border at California. It is a jurisdiction with about the same population size as Canada. Medical assistance in dying was legalized in both Canada and California at exactly the same time, yet we can look at the comparison of numbers: in Canada, 76,475 deaths, versus just 5,423 in California. In 2024, as I mentioned, there were 16,499 in this country versus 1,032 in California. I think about how dramatically our legislation has evolved. In 2021, through Bill C-7, the government expanded eligibility far beyond those whose natural deaths were reasonably foreseeable. We created two distinct tracks, including a track for individuals who are not approaching the end of life. In so doing, Canada became one of the most permissive jurisdictions in the entire world when it came to assisted dying. By removing the requirement of natural death to be reasonably foreseeable, the government extended MAID to people with disabilities and chronic illnesses who were not otherwise dying. This approach is far outside the traditional, globally recognized end-of-life care model. Mental illness was initially excluded from this expansion, but only temporarily. Ever since, Parliament has repeatedly had to step in to extend that exclusion as a matter of crisis management. Bill C-39 kicked the deadline down the road. Bill C-62 extended it again, to March 17, 2027, a date that we are now quickly approaching. We must ask ourselves why MAID for mental illness was delayed in the first place. It was delayed because committees heard testimony after testimony from the front lines stating that this was an incredibly dangerous direction to go in. There was substantial, overwhelming agreement among mental health advocates, disability advocates, psychiatric professionals and academic experts. The special joint committee’s recommendation was clear, to permanently exclude mental illness as a sole underlying condition for MAID, and Conservatives agree entirely with this. We believe that someone suffering from depression, PTSD or another severe mental illness should be met with access to treatment, support and hope, not a path to assisted death. Mental illness can be utterly devastating. It distorts how a person sees themselves, how they view their current circumstances and how they perceive the future. However, we know that circumstances can change. Treatment can work. People can recover. People who once saw absolutely no hope can go on to live incredibly meaningful, beautiful lives. I have shared this before, but it bears repeating. In my early twenties, I went through a clinical depression. It was a very dark period of time in my life. I had suicidal thoughts. Thankfully, I never made any attempts, but in that darkness I received vital support from health care professionals and those closest to me. I came out of it. Today, that dark period is a very distant memory. I feel no pain from it, but at the time I felt utterly incapacitated. With time and support, I recovered. I went on to go to university, become a teacher, an MLA in British Columbia, a member of Parliament, a father and a grandfather. I have lived a full and rich life and I am thankful. If MAID for mental illness had been legal and readily marketed for people like me at that time, how many would have gone that route? The government itself has recognized these serious concerns, which is why it repeatedly extended the exclusion. However, with the current exclusion set to expire on March 17, 2027, there is an urgent need to act, and Conservatives have acted. The member for Cloverdale—Langley City introduced a private member’s bill, Bill C-218, which would have permanently and cleanly excluded mental illness as a sole underlying condition for MAID. What happened? The Liberals voted against it. On October 7, this House had a clear opportunity to advance that protective legislation and the government voted it down. Now, just weeks later, the government has introduced its own legislation, Bill C-41, which we are debating right now as we approach midnight. What has it done? It has taken the exact permanent exclusion for mental illness and attached it to a completely separate, massive and entirely undebated element, the advance request for MAID. Let us call it what it is. The Liberals do not want to subject their new expansion of MAID to the raw public scrutiny that the mental illness expansion faced. The more the expert witnesses, physicians, psychiatrists and professional organizations spoke out about mental illness, the more the general public became concerned. They do not want to go in that direction. By chaining these two issues together in Bill C-41, it is trying to sneak a massive new policy under the radar. I say, shame. The political dynamic in this House has shifted. Following the by-elections and floor crossings earlier this year, the Liberal government now holds a majority. It no longer needs collaboration with the opposition. It no longer needs to seek multipartisan consensus on matters of life and death. Because of this, it has the raw numbers to pass legislation independently, and it is using that power to ram this through. It is rushing this bill through the House, cutting off the thorough, isolated scrutiny that each one of these profound issues desperately deserves. Conservatives are deeply concerned with the safeguards in this bill, particularly with the sudden expansion to advance directives. The cold, hard fact is that there is already widespread abuse and inappropriate promotion with our current MAID regime. Time and again, I talk with residents in my community who tell me horror stories about family members having MAID actively promoted and suggested to their loved ones. One of my own staff members was offered MAID three separate times because of the migraines he suffered from a fall a decade ago. Another man told me how his father was offered MAID because of a hip injury. The son had to step in and tell providers that his father needed exercises and stretching, not MAID. He helped his father get the proper rehabilitation and guess what. He is out of the hospital. He is not dead.”

• 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 am against this bill. People are already being pushed toward medically assisted dying. There are too many problems we still need to talk about before adding more to the system.”

“Mr. Speaker, I am opposed to the abuse we are currently seeing in the system, with people being encouraged to pursue medical assistance in dying. Now there is an effort to introduce yet another element. There are a great many concerns that still need to be discussed.”

“The member is talking about the law we already have. This debate is about whether people should be allowed to get medical assistance in dying only because of a mental illness. Most of this House agrees they should not. The debate is really about end-of-life choices for people with diseases like Alzheimer's.”

“Mr. Speaker, the member is talking about what is already the law. What we are discussing now is whether MAID should be available to people whose sole underlying condition is a mental illness, and there is broad agreement in this House that it should not be. However, the debate primarily focuses on end-of-life decisions for persons with Alzheimer’s disease, for example, or other similar health problems.”

“We need more debate on this bill about medically assisted dying. This is about life and death, and we should not rush it. The Liberals made mistakes and delayed this before, and they will get it wrong again if we rush.”

“Mr. Speaker, what we are saying is that there needs to be a debate about this. This is not something we should be rushing through. We are talking about life and death. The Liberals made a lot of mistakes. As a matter of fact, that is the reason they delayed it once, twice and I believe three times. Now they realize that they got it wrong. They got it wrong before, and they are going to get it wrong again. This is serious. It is very complex. There are a lot of different pieces that we need to look at, not have rushed debates in the middle of the night that have to be done by a certain period. This is not good for Canada. No matter what the member may think, we need to make sure it works.”

“We should not vote on this bill yet. Medical professionals who give these medications have concerns about it. We need to study this bill more and listen to these doctors and nurses first.”

“Mr. Speaker, I have listened to this debate at length. I think my hon. colleague knows that my record stands in the House as one fighting against suicide. As I said in my speech and my comments, we are seeing a number of concerns already with the legislation as it stands. The medical community, those who have to deliver those lethal doses, those end-of-life medications, have concerns. We are asking on this side if, perhaps, this should be studied a little bit more, if we should hear from those professionals, because none of us in the House are doing that. There is nothing to prepare any of us to be able to vote on this. I do not think there has been enough study of this bill. I think it is out of compassion that we are pushing back and fighting for those who are perhaps considering this.”

“I do not want this bill to pass as it is. We should split it into two parts so we can study mental illness and advance requests separately. People with mental illness need care and hope to live, not help dying. We need stronger rules to protect vulnerable people.”

“Mr. Speaker, it has been said before, and I said it in the original debate in 2016, that nothing in our lifetime prepares a member of Parliament to vote on such a consequential piece of legislation. There really is not. It truly is life or death. This legislation, as it stands today, raises serious questions about how Canada approaches medical assistance in dying, how we protect vulnerable people and what responsibilities the government has to Canadians who are suffering. From the moment I landed as a member of Parliament, I have fought every day for those who serve our country and our community and for those who are struggling and suffering silently. For over 1,000 days, I pushed the previous government to launch a national suicide hotline, 988. I believe life is so precious that we should be doing everything to fight for every breath we have in us. Since 2016, when I really struggled with that vote, I have contacted my pastor a number of times. It went against everything in my faith, in my fibre, everything that I had fought for in the 30 years leading up to my being elected as a member of Parliament. How could I vote with that? Since 2016, I have spoken with probably hundreds if not thousands of Canadians who had loved ones who suffered from cancer or ALS and chose MAID. In December 2023, my mother, from whom I was estranged, was diagnosed with acute leukemia. It was going to attack her brain. It was a painful disease. She chose MAID, and she set a death date. Whatever background we had, I put it aside and sat by her bedside for probably about four months as we marched toward that death date. I was tasked with making her a mixtape, as a matter of fact, to play on that day. Imagine my surprise and my brother’s surprise, as we had mentally prepared for that day, regardless of what our background was with our mother, when we arrived to be told by the doctors that when they were preparing her, she said no. We were frustrated because we knew what was lying ahead for my mom, but that was her choice. We met with the doctors, the medical team, the MAID team, and they said they could not in good conscience administer the final dose of the medication to end her life. That is my story, so I understand where families are. I am troubled by the number of Canadians, such as veterans, who are being offered MAID because they are struggling with PTSD or a mental illness. One in 10 Canadians knows someone who has been offered MAID. Approximately 13 Canadians die by suicide every day. Approximately 100,000 Canadians attempt suicide every year. That is 250 per day. About 20,0000 Canadians are hospitalized every year for self-harm. The MAID numbers are staggering. We are approaching 100,000 Canadians who have chosen to die by MAID. We are seeing commercials for end of life on TV and on social media. I sat with a veteran who was offered MAID. He phoned Veterans Affairs and was offered MAID. Not once, not twice, but three times he was asked if he had considered MAID. I have sat with people who have gone to their doctor for injuries that were causing them unbelievable pain. Our concern is with advance directives, and experts in the medical community have these same concerns. We are asking to split the bill to deal with mental illness and the advance directive separately to give us time to get this as close to right as possible, to put those further safeguards in place. I come at this with the purest of intentions. There was a time when I was consumed with death. It was for about five years. My best friend had died by suicide, and I did not see a way forward. My childhood had been filled with dysfunction and abuse. I was struggling, and I attempted suicide numerous times. I have thought about this, and if MAID had been available at that time, I would have taken it. Then I think about all the things I would have missed. Here I am so many years later, 38 years later, and I love life. I am so thankful I am here. I think of watching my four beautiful children grow up to be amazing adults; of my grandchildren, Ren and Meyer; and of finding the love of my life just at the end of that period of darkness. As Conservatives, we believe that we have to do everything in our power to offer opportunities for getting better, getting the supports people need. We believe in hope. We are in a mental health crisis and an addiction crisis in this country, yet time and again we hear empty promises from the other side. Tomorrow is budget day, and I hope there will be supports in place for mental health. We now spend more money in servicing our debt than we do in health care transfers. The health care transfers that go to our provinces for mental health are pennies on the dollar. We do not view mental health in parity with physical health. If we did that, as a country, we would be healthier and happier, and we would see the numbers go further down. This debate requires Parliament to think carefully about what kind of country we want to be. We must approach suffering people with compassion, respect and dignity, but compassion cannot simply mean offering another option at the end of someone’s suffering. It must mean doing everything we reasonably can to help that person live, to provide treatment, to offer support and to ensure that they are not left alone. On the question of MAID for mental illness, we are clear that we do not support it. I do not support it. We do not believe it should ever be permitted where mental illness is the sole underlying medical condition. Mental illness should be met with treatment, care and hope. Canadians deserve a health care system that gives them a genuine opportunity to recover and a government that works to make care accessible. I truly understand that there are Canadians who are suffering with unbelievable illnesses for whom MAID is perhaps the right choice for them, but as parliamentarians, we must do everything in our power to make sure those safeguards are in place as we move this legislation forward.”

“The member said I dumbed down this debate. That statement was stupid, and I will not answer it.”

“Mr. Speaker, I am not going to really dignify that with an answer. The member essentially said I have dumbed down this debate. I am going to keep my words parliamentary and not dignify that stupid statement with an answer. An hon. member: Oh, oh!”

“If medically assisted dying is made available to people with mental illness, we must make sure all safeguards are in place. In the past, I likely would have done whatever I could to access it.”

“Mr. Speaker, I appreciate our hon. colleague. I have a great deal of respect for our colleague all the way down at the far end there. My comment is only that if this was available to those who are struggling with mental illness, again, we would have to make sure that all those safeguards were in place. I would have likely done whatever I could to access this at that time.”

“People often change their minds about medically assisted dying. In one year, 692 Canadians asked for it and then changed their minds. Advance requests are wrong because they allow doctors to end a person's life without checking if they still want it.”

“Mr. Speaker, I want to really thank my colleague for a profound and thoughtful speech, for sharing the story about his mother as an example of somebody who changed their mind, who thought they would want one thing and then, in a moment, wanted something else. I suspect that the love and care that the member and others in his family showed may have influenced her decision to change direction at that point. That story relates to a broader statistic. In the latest reports, 692 Canadians in one year made a request for MAID and then changed their minds. Where does that leave us with advance directives when a person signs a document that allows something to happen to them without them being asked at some future point when their circumstances have changed? Maybe they have adapted, maybe there are new aspects to their life, things they did not think they could deal with that they are dealing with, and they are happy in the midst of them. What should we say to those 692 Canadians in one year who made the choice, like his mother did, to change their minds?”

“We must not rush this bill. We need to take our time to protect vulnerable people, put safe rules in place, and answer questions from medical experts.”

“Mr. Speaker, I want to thank my hon. colleague for the kind comments. Our leader brought up our former colleague Lisa Raitt and her husband, who is living with dementia. She wonders what would have happened if he had made that advance directive early on. She knows full well that he is fully content. He would not have wanted to go forward with it. All we are asking is to make sure that we, as parliamentarians, do our job and make sure we are looking after the most vulnerable of Canadians, putting those safeguards in place, answering and addressing the questions that the medical community and the experts have. That is our job, not rushing something through in the 11th hour.”

“I do not want this bill to pass. It lets people agree to assisted dying in advance, instead of right before it happens. Canada already has far too many assisted deaths compared to other places. The government is being cynical by putting advance requests into the same bill that stops assisted dying for mental illness.”

“Mr. Speaker, it is an honour to rise to speak to the issue of medical assistance in dying, or as we call it more often in this country, government-assisted dying. Canada is a pariah on the international stage when it comes to the way we have implemented this. Here is an interesting story. California and Canada legalized assisted dying, or assisted suicide in the case of California, in the same year at about the exact same time. California has about the same population as Canada. California has a very similar political outlook on the world as Canada. The difference in the application of MAID is profound, just in the raw numbers of it. In Canada, we have over 15,000 people a year ending their lives through MAID. It sounds like it is going to be more this year. In California, there are about 300 people per year. That is a huge difference, and there are lots of reasons for that. We can speculate about all of those reasons, but I just wanted to put that out there. We are a distinct outlier in the world, in Canada, in terms of the MAID regime. I would point out that both Great Britain and Slovenia have looked at Canada, have had referendums on this issue and, because of the situation in Canada, have rejected the MAID regime entirely. They said they would not poison people to death and would demand that their health care systems promote the health care of their people, not the death of their people. I remember back in 2016-17 when the first MAID bill came in. I remember saying that it was a radical bill and that this was going to be a slippery slope. I was wrong about that. It has been a cliff, not a slippery slope. We are now on our sixth piece of legislation expanding MAID. We thought Justin Trudeau was a radical prime minister on this file. I remember being quite skeptical of Jody Wilson-Raybould and Jane Philpott. They kind of led the charge when it came to the Liberals bringing in the bill in the first place. I remember calling them radical and thinking they were radical. It turns out now that they were the voices of restraint when it came to this. I remember there were Liberals at the time who voted against the bill because they did not feel it went far enough. Here we are, once again, with an expansion of MAID in this country. There seems to be no concern or upper limit to the Liberals’ desire for Canadians to have the right to end their lives. Now, I would say that in Canada, the deaths of despair, whether they be drug overdose or whatever they are, continue to increase. We hear constantly, story after story, from family members of somebody who was offered MAID when they did not want it or took MAID when their family was unaware that they were even ill, and there is no recourse. There is no ability for the family to question what went on. They have no ability to get any information about it because the patient is dead, the patient is gone, and there was a discussion between the doctor and the patient. Now the government wants to expand MAID once again, with advance directives. I would point out that advance directives have been a part of the discussion all the way through, and since 2015-16, they have been rejected all the way through. They have not been studied in depth the same way that MAID for mental illness has, and I would suggest that Canadians have firmly rejected MAID for mental illness. The government has been supremely cynical by doing the thing that Canadians wanted it to do, by repealing MAID for mental illness, but putting advance directives for MAID in the same bill, pairing one off against the other. That is supremely cynical on behalf of the government. The Liberals had their opportunity to vote for Bill C-218, and they rejected it. I thought they just wanted to take credit for it, and they can take credit for it now that they are bringing the bill forward. The piece around advance directives is about contemporaneous consent. I remember moving motions and amendments to the original bill, trying to emphasize contemporaneous consent. The California model requires that in the moment that MAID is being administered, a nod must be given or the patient must press the button, essentially. Back in 2017, I felt the original MAID bill, I think it was Bill C-14 at the time, did not do enough to ensure contemporaneous consent, and here we are with advance directives being so far away from contemporaneous consent, because an advance directive could be signed decades before the situation ever arises. Maybe nobody has had a conversation for years about what advance directives even mean, but suddenly a number of different motivations have come into play. Suddenly, a bunch of people who are not the individual would be making a decision about whether this person should be euthanized or not, with no contemporaneous consent. We have examples from around the world, such as from the Netherlands, where this kind of thing happens. There is a particularly horrific story about a Dutch lady who had dementia. She was physically very healthy. She was not in pain in any way whatsoever. She was happy and she ate well. She was living in an extended care facility, and her advance directive said that when she could no longer recognize her children, she would like MAID. That was what her advance directive said. She still had her faculties and could still participate in conversation. She knew what was happening day by day, but she did not recognize her children most of the time. That is 100% the truth. On the day that she was going to be euthanized, she knew she was going to be euthanized, and she pleaded with everybody she came into contact with that day, telling them that she did not want to die. However, because there was an advance directive, her coffee was drugged and she was compelled. The horrific part about it and why it ended up being in the news is that her family had come and gathered around her, and they had to restrain her because the drugs from her coffee wore off. They had to restrain her while they euthanized her. That was a horrific experience for all involved, but it was what the advance directive said. Despite the fact that she repeatedly said to multiple people that day that she did not want to die, she was euthanized. She was euthanized because her advance directive said that when she could no longer recognize her children, she did not want to live anymore. She was perfectly healthy. There was nothing physically wrong with her. She was eating well and she had joy in her life, but she could not recognize her children any longer. That is not the case for every dementia patient. Some dementia patients live with a lot of angst, and we need to work to minimize the effects of dementia. Dementia is a horrific disease that I know about. I have experience with family members who had it, and it is a horrific disease. It is tragic to watch a loved one decline in that respect, but offering them MAID or having to compel somebody else to murder them is no solution to the problem.”

“Canada's system is government-assisted dying because someone else performs the procedure. The United Nations says our system is flawed and harms people with disabilities. The member should read that report.”

“Mr. Speaker, the reality is that, with the Canadian system, it is a choice to some degree, but somebody else is administering it. This is government-assisted. That is the reality of the system. Whether the member wants to acknowledge that or not does not change that reality. The world is watching. The United Nations has issued a directive to Canada saying that our MAID regime is not working appropriately and is a detriment to those living with disabilities. The member should read the report from the UN.”

“I do not oppose advance requests in general. Usually, they let a person refuse treatment. This bill is different because it forces doctors to kill someone instead of just refusing care.”

“Mr. Speaker, to the point on advance directives, I am not opposed to advance directives. I would just point out to the member that, in most cases, an advance directive is a refusal of treatment or not compelling somebody to treat a person. This is a completely new world of compelling a doctor to murder someone. That is what an advance directive is. When a given set of circumstances exists, laid out in an advance directive, we are compelling the health care system, a doctor or a health care practitioner, to kill a person. That is what this advance directive is. It is not a refusal of care.”

“Our laws only let people make advance requests to refuse medical care, not to demand someone end their life. We do not allow people to give advance consent for other major actions. A person must agree at the time it happens.”

“Mr. Speaker, just to pick up on that, I think that is a very important point about the way advance directives operate now and the proposal for an advance directive for MAID. Advance directives now are essentially negative, saying “Do not do this to me”, or “Do not intervene under certain circumstances”. It is necessary that such a framework exists for indicating non-intervention in certain cases. That is very different from a person saying, “In a certain set of hypothetical circumstances, I want this thing done to me.” There is no other instance in which we create an advance directive for a positive action against a person, nor would we allow advance consent in other such cases. We can think of many cases of lesser gravity than ending a life where we simply do not allow advance consent. We require contemporaneous consent as a necessary condition of autonomy. This is a radical departure from that in what consent means.”

“I agree with what was just said. Letting someone ask for assisted dying in advance is very serious. A person cannot come back from it, and someone else will make the final choice to end their life.”

“Mr. Speaker, I am not sure if there was a question. I think it was more of a statement. I agree wholeheartedly with that sentiment. That is the fundamental issue with this. This is an advance directive on MAID. Someone does not come back from that. It is the end of their life, and that decision will be made by somebody other than them.”

“I oppose this bill. It lets doctors end a person's life based on a paper signed years earlier, without asking the person for consent at the time. Other people should not get to decide if someone dies based on an old document. We should vote against this bill and pass its rules about mental health separately.”

“Mr. Speaker, tonight, I am addressing the House on Bill C-41, the latest attempt to further expand the cases in which a doctor or nurse practitioner is legally permitted to end the life of their patient, a practice which is generally, if euphemistically, called MAID in Canada. The bill proposes to allow the use of so-called advance directives for MAID. Bill C-41 would allow a patient to sign an advance directive permitting a doctor or nurse practitioner to kill them under certain future circumstances, perhaps years or decades in the future. Necessarily, other people would have to assess and determine whether the conditions in the signed document had been met. The patient would have delegated the power over life and death for themselves to another person. Bill C-41 would eliminate the legal requirement that a person consent to their death when they are dying. It would replace the requirement for contemporaneous consent with advance consent. Of course, advance consent is inevitably less clear in practice than contemporaneous consent. In the signing of an advance directive, a person would be making a prediction about how they think they would feel under certain future circumstances that they likely have not experienced before. They would be making a prediction about how their future self would feel and what their future self would want. They would be judging the situation from the outside without lived experience. In practice, people would likely be presented with pro forma advance directives based on a common template and told that typically people in such a situation sign something like this or want something like that, etc. We already know these kinds of proposals to people who are not asking for them are occurring. Perhaps these pro forma advance directives would be given to people right after a new diagnosis is given, when a person is understandably scared about the unknown and about what they would feel under new circumstances, and they would trust authority figures and sign these pro forma documents. This would then provide those same authority figures with options, but certainly not clarity. They would later look at a patient and compare that pro forma directive with their assessment of the patient’s current condition. Do they seem happy, content? Is their life worth living? How does what they wrote or signed on the page compare to what we guess might be going on in their head today? Certainly in so many cases there would be a variety of different interpretations. Perhaps the burnt-out spouse and caregiver would think the conditions of the advance directive are met, while the adult children would think otherwise. Importantly, the law as written would not require the patient to be asked or informed again once they have written the advance directive. One day the clinician changes the substance of what is in the patient’s IV, and the patient dies. “It was her wishes,” says the doctor. “No, it wasn’t”, say the grandchildren, but at the end of the day, she is dead, because someone killed her based on their interpretation of a piece of paper that she signed years ago. Welcome to Canada. Maybe grandmother was a bit of a people pleaser. Maybe she talked about her illness in slightly different ways to different people, depending on what she thought they wanted to hear. This is very normal, of course. All of us are people pleasers to some extent, but Bill C-41 would require other people to interpret her feelings, her sufferings and her wishes, and to turn them into their own judgments about whether she should be killed, again with no obligation to talk to her about it once the initial paper had been signed. Families would inevitably be deeply divided over who decided to kill Grandma and whether the conditions of the signed document were met. Confusion is inevitable. The ambiguities are legion, involved in assessing someone else’s suffering based on a directive made long ago by a person who at the time had no experience of the illness. This means in practice that someone else would decide when and whether someone dies, and they will not ask before they kill them. Underneath these practical problems is a deeper moral question about advance directives. Can I bind my future self in matters as weighty as life and death? Can I make a choice that would permit someone to kill my future self, especially when that self may not remember or be conscious of the previous decision? When we allow advance requests today, it is purely in the case of a negative, a person signing an order to not have something done to them. Signing an advance request to not have something done to me is very different from a directive that licenses someone to do something to me when I am not aware of what is happening and under nebulous, difficult-to-define circumstances. Not only do we not allow this type of definitive advance determination, generally speaking, but we have done painstaking work to correct a grave moral error of the past in this regard, the idea that consent, once given, is given forever. The most obvious context in which this applies is sexual consent. Recognizing the need for contemporaneous consent in every sexual encounter was a real and important moral development. Previous but clearly flawed legal doctrines of the past regarded consent to marriage as furnishing a definitive future consent to sexual relations, and thus did not prosecute the offence of marital rape. It was a critically important and clearly positive moral development to recognize the importance of contemporaneous consent in every sexual encounter, that receiving consent in the moment is necessary, regardless of a past commitment. Everyone in the House agrees, I am sure, that marital rape should be prosecuted. It is hard for me to understand, then, why some members would regard advance consent in matters of death as permissible, while rejecting it in matters of sexuality. Introducing the idea of violating a person’s autonomy on the basis of a piece of paper signed in the past would seem to be a step in undoing the moral progress that has been made in this regard. A person also cannot consent to slavery. Some, though certainly not all, systems of slavery are based on the idea that a person can sell themselves, an act through which the present self binds the future self. Today we would understand such systems as grossly immoral and as representing a denial of human dignity and of autonomy, yet death is more final than slavery. If the past self cannot bind the future self in the case of slavery, then why would it be so in the case of death? What began in the name of autonomy has lost the plot by now denying the autonomy of the present self to adapt to new circumstances and to make new choices. The practical and philosophical problems inherent in the operationalization of advance directives for MAID likely informed the decision of members of the Conservative Party of Canada to explicitly adopt a position opposing advance directives for MAID. I am proud to be part of a party that officially opposes this expansion in its member-driven policy document. These problems have led virtually every other country in the world to also reject going down this road. Most notably, I think the problems with such advance requests also informed the decision of the Justin Trudeau Liberal government to reject calls to implement a system of advance requests for MAID. In each past stage, there were those who argued for advance directives, yet the Trudeau Liberal government evidently decided, based on the moral and/or practical risks associated with them, that it was not going to go down this road. However, now we have the new Prime Minister, who is hell-bent on pushing Canada’s MAID regime further than Justin Trudeau by pursuing an expansion that even Justin Trudeau rejected. As a fellow Catholic, while not expecting that a shared religious identity would lead us to agree on every issue, I did expect better from the Prime Minister. I expected that he would at least have some sensitivity to the idea of universal human dignity, the need to prevent the devaluing of the lives of people with disabilities and the need to avoid further MAID expansion. It is difficult for me to reconcile his stated convictions with his decision to advance legislation that would allow a patient to be killed in their bed without even being asked for contemporaneous consent. Canada already has the most radical MAID regime in the world, and the Prime Minister, the Catholic Prime Minister, is now wilfully presiding over the further expansion of a MAID system that is already the most radical in the world. It is frankly hard to tell what the Prime Minister believes at all, even if his frequent reversals of conviction have brought him some measure of political success thus far. All of these events call to mind the alleged remark of Pope Urban VIII following the death of Cardinal Richelieu. He quipped, “If there is a God, the Cardinal de Richelieu will have much to answer for. If not...well, he had a successful life.” This is worth contrasting with the observation of St. Teresa of Calcutta, who said that we are not called to be successful, but faithful. The point is one of general application, regardless of fundamental beliefs or philosophical commitments; that is, to be a statesman is to stand for something. Our calling as members of Parliament is to faithfully defend the national interest of Canada and the common good, to defend it from the shame that it already faces as a global pariah and embarrassment when it comes to the fundamental rights of people with disabilities. On that basis, I will fiercely oppose this expansion, as it would turn my country into a place where patients are killed without even being asked, based on a document that they signed years ago. As a brief final coda, I note that Bill C-41 contains provisions around limiting the application of MAID in the cases of mental health. These provisions on mental health are supported by over 90% of MPs and could easily be proposed separately and adopted rapidly. That debate has thankfully already been won, but it is the height of cynicism for the government to tie those provisions to its radical new expansion of MAID. We must defeat this bad, cynical bill. Of course, I agree with the mental health provisions in the bill, but those could easily be passed in a separate bill in 48 hours. No one should fall for this devious legislative trick. That is why we must oppose the expansion in Bill C-41.”

“I want this bill stopped. It allows advance requests for assisted dying, which takes away a person's choice when their condition gets worse. People should have to give consent at the time their life is ended.”

“Mr. Speaker, my speech in the debate tonight was about advance requests for MAID, which are not about autonomy. Advance requests deny autonomy because they prevent a person whose condition has deteriorated from having a choice. They would involve the past self making predictions about the future self and binding the future self under conditions in this legislation where, incredibly, it would not be required that they be told what is happening to them when their life is being ended. That would be a denial of autonomy, a denial of the ability of a present individual to consent. The requirement of contemporaneous consent, as I discussed, is fundamental in law and in practice. This would be a denial of autonomy, of contemporaneous consent. On that basis, as well as others, the bill must be opposed.”