“Health care in Canada should be better. The government should stop spending money abroad and use it to fix our health care system at home instead. Right now, Canada pays more on debt interest than on health care transfers.”

“Mr. Speaker, I strongly believe that health care in Canada should be better than what it is right now. I believe the current government should stop its reckless spending on other pet projects outside of the country, bring that money home and invest it in health care services. For example, the debt the government has increased in this country is from interest payments. We are paying more for interest payments than we are for health care transfers. Let us bring that money back home, and let us fix our health care system.”

“I want to split this bill into two parts. I want to pass the ban on assisted dying for mental illness right now, and stop the plan to allow advance requests. People cannot predict years ahead of time if their future life with dementia will still be happy, and this bill does not have enough safety rules to protect them. Existing assisted dying rules already fail to protect people who change their minds, so we should not expand them to people who can no longer speak for themselves.”

“Mr. Speaker, there is a cruel kind of thief that enters a home without breaking a window or turning a lock. It does not steal the family’s silver or the money tucked away for a rainy day. The thief takes something far more precious. It steals memories, familiar faces and little pieces of a lifetime lovingly built together. About 10 years ago, that thief came for my auntie Grace. She arrived in Canada from Holland in her early twenties, stepping off a ship in Halifax with a whole new life ahead of her. She found work as a maid at 24 Sussex Drive for Prime Minister John Diefenbaker, where she even served tea to President Kennedy. Each morning, as she brought Mr. Diefenbaker his tea, he would hand her the newspaper and ask her to read aloud. She was in Canada now, he told her, and learning English was important, and learn she did. She married my uncle John, raised a family and together they built a successful pest control business. When they were not working, they would hitch up their little tent trailer and explore the beautiful country they had made their home. It was a good life, filled with hard work, adventure and love, but Alzheimer’s has a terrible way of unravelling even the most beautiful stories. My uncle cared for her at home until about five years ago, when her needs became more than he could manage alone. Today, at 92, he drives from Langley to Surrey every single day to sit beside his wife, make sure she is eating and see that she is being cared for. I remember him sending me a little video. There she was, happily sorting a tray of mismatched socks into pairs, only to mix them up and begin again. My uncle was so excited to show me how happy she was. These days, she does not recognize the man who has loved her for a lifetime or the children they raised together, but sometimes, when the family sings old, familiar hymns, she quietly hums along. Every once in a while, the faintest glimmer of recognition sparkles in her eyes. How precious those moments are to a husband who has devoted his life to loving his wife. Imagine another scenario. Imagine that, years ago, while my aunt was still the capable woman who had built the business, raised her children and travelled across Canada, she had written down a simple instruction, that if the day ever came when she no longer recognized her husband or children, she did not want to go on living. Perhaps she could not imagine there might still be happiness in a familiar song or contentment in sorting mismatched socks or love in the quiet presence of a husband she could no longer name. Imagine that day has come and someone must decide whether the time has come to act upon her words. There is something deeply troubling about asking someone to predict years in advance what will make their life worth living. When we are healthy and independent, we imagine all things we could not possibly bear. We tell ourselves we could never live without our memories and our independence, but something remarkable happens when people actually live through circumstances they once feared. Researchers call it the disability paradox. In a study of people with disabilities, more than half of those with moderate to serious disabilities described their quality of life as good or excellent. Lives that others might look upon with pity were lives the people living them still very much enjoyed. Researchers in the Netherlands studying advance euthanasia requests among people with Huntington’s disease also found that people making those requests recognized that their wishes might change as their illness progressed. The person writing an advance request is imagining a future they have never lived, but the person living that future may have discovered reasons to treasure it. When the decision is irreversible, that difference matters. I think about my aunt sitting contentedly with her mismatched socks and my uncle watching her, grateful for every smile. What if she had signed an advance request? Who would speak for the woman she is today? Who would notice that she was happy? Who would ask whether the suffering she once feared had actually become the suffering she was experiencing? Who would stop it if someone got that decision terribly wrong? When I turn to Bill C-41, I do not find the protections that would give me confidence that those questions have been answered. There is no requirement to tell a person their life is about to be ended or consult the family who knows them best, or have a dementia specialist examine them when that final decision is made. When the family disagrees, there is no independent court or tribunal required to review the decision before it proceeds. Then, there is the question of intolerable suffering. How can we be certain someone is suffering intolerably when they can no longer tell us what they are feeling? Researchers have spent years developing ways to recognize pain in advanced dementia, yet there is no gold standard assessment tool. A grimace might mean pain. Agitation might mean infection or an unfamiliar environment. These are things we should be trying to understand and treat, yet Bill C-41 would ask practitioners to determine not simply whether someone is suffering, but whether someone is suffering intolerably. How can we ask someone who cannot tell us what they are feeling to bear the consequences of another person’s judgment about whether their life is still worth living? I want to take us now into an Ontario care home on a summer morning this past July. An 83-year-old grandmother named Brigitte Stegemann was lying in her bed. She was someone’s mother and grandmother, and a woman whose family had loved her for a lifetime, but this was the morning she had scheduled to die. According to her granddaughter, just two days earlier, Brigitte had broken down in tears when she learned the date had been set. She said she had made a mistake, but now the day had arrived. Her granddaughter describes a nurse struggling to insert an IV, leaving blood on Brigitte’s nightgown and bedding. When the doctor arrived, Brigitte lay quietly with her eyes closed and her hands clasped tightly together, almost as though she was praying. Perhaps she was praying. Her family does not know. When the doctor asked whether they could proceed, Brigitte gave no answer. She did not open her eyes. She did not nod. She did not speak. Her granddaughter says she felt a wave of relief, believing the procedure would stop without confirmation of her grandmother’s wishes, but it did not, and within minutes, Brigitte was gone. This happened under existing MAID laws, before Parliament had even authorized this new expansion. A granddaughter is left wondering whether their grandmother’s wishes were respected and whether the safeguards meant to protect her worked at all. Now, Parliament is being asked to allow advance requests to be carried out when someone cannot consent nor confirm that they still want to die. If we cannot be certain that consent is being properly respected under today’s system, how can we be confident we will recognize a change of heart in someone who can no longer tell us what they want? The government has chosen to call Bill C-41 the medical assistance in dying safeguards act. What a remarkable name for a bill that purports to protect one group of vulnerable Canadians while opening the door to an entirely new expansion for people who can no longer consent. What troubles me most is what the government chose not to include. When I introduced Bill C-218 to protect Canadians suffering from mental illness, people asked why I had not included more mental health supports. I would have loved to, but as a private member, I was limited to what I could do in my bill. The government has no excuse. Instead of including the treatment, counselling and compassionate care vulnerable Canadians desperately need, the Liberals chose to attach an entirely different expansion of assisted dying. The only reason these two decisions are tied together is for political spite. The government could protect Canadians struggling with mental illness right now by splitting the bill and passing the mental illness exclusion today and then give Parliament the time to properly scrutinize the rest of the bill. With the looming March deadline, the Liberals have made the protection of one vulnerable group conditional on expanding assisted dying to another. As I stand here today, I keep thinking about my uncle John. Tomorrow morning, at 92 years old, he will get into his car and make that familiar drive from Langley to Surrey. He will find his wife and sit beside the woman he has loved for a lifetime. Perhaps she will recognize him. More likely, she will not. Perhaps they will sing an old hymn and she will happily sort her little pile of mismatched socks. My uncle will treasure every minute, because while Alzheimer’s has stolen so much from my aunt, it has not stolen her ability to experience happiness and it has not stolen my uncle’s love for her. Who among us has the wisdom to decide that those moments no longer matter? The thief has already taken her memories. Let us be careful that the law does not take away her tomorrows.”

“We must act before March 17 to stop medically assisted dying from expanding to mental illness. Instead of passing a simple bill to do that, the government tied it to another expansion of assisted dying. They are using the deadline to force us to pass changes we have not studied properly. The government should split the bill and protect people with mental illness right away.”

“Mr. Speaker, the political gamesmanship here is absolutely shameful. The government knows full well that Parliament has to act before March 17 to prevent MAID from expanding to mental illness alone. However, instead of introducing a straightforward bill to do exactly that, the Liberals have tied it to an entirely separate expansion of assisted dying. They are using an approaching deadline to pressure Parliament into accepting something it has not properly studied. They are holding the protection of one vulnerable group hostage against the expansion of MAID for another. If the government genuinely wants to protect Canadians struggling with mental illness, there is a very simple solution: split the bill and pass that protection immediately.”

“We must vote against this bill. It will let every province make its own rules, so people will just travel between provinces to get around them. It will create a total mess.”

“Mr. Speaker, the translation was a bit cut off, so I am not totally sure I understood his question. The challenge, as my other colleague spoke about, is we are going to have a patchwork of law. Every province can have its own bill. People will be able to travel from province to province. It is an absolute dog’s breakfast. We need to say no to this bill.”

“I oppose this bill. For ten years, even Justin Trudeau refused to allow advance requests for medically assisted death. He knew it could lead to killing people based on old documents that do not match what they want now. The current Prime Minister wants to go even further, and I want to know why.”

“Mr. Speaker, I thank my colleague for her excellent speech tonight. My friend across the way pointed out that this debate has been going on for a very long time. He said since the 1990s. I would say versions of this debate have been going on since the dawn of time, actually. It is notable that in 10 years, and through multiple phases of expansion, Prime Minister Justin Trudeau chose not to bring in advance directives. There were people in this House and elsewhere pushing for it at the time, but there were also grave concerns about how advance directives would lead to somebody in the future choosing to kill someone based on a document they signed in the past that may be ambiguous, may not be clear, or may not relate to their present lived experience or present preferences. Justin Trudeau thought that was a bridge too far. Now we have a Prime Minister who actually wants to go further in the expansion than Justin Trudeau did. Further, he is trying to deviously tie it to another issue. The core point on advance directives is this was considered for 10 years by a previous Liberal government, and Justin Trudeau was not exactly a moderate on these issues. It was too far, yet the Prime Minister has chosen to go even further. Why is that?”

“The Liberals voted down a bill to permanently stop assisted dying for people with only a mental illness. Twenty days later, they brought in their own bill with that same rule, but added a new expansion to assisted dying. A committee already told them to make this rule in June. They did not need a whole new bill.”

“Mr. Speaker, let us talk about the government’s record here. Bill C-218 would have permanently prevented MAID from expanding to people whose sole underlying condition is mental illness. The Liberals voted it down on October 7. Twenty days later, they introduced their own legislation containing the same protection, but attached an entirely different expansion of MAID. The parliamentary committee had already recommended the permanent exclusion in June. The Liberals cannot pretend this is some new sudden revelation that requires an entirely new legislative package. They had the evidence. They had the recommendation. They had the bill before them. We could have addressed all the issues. They chose to defeat it and now they want to dictate the terms of protecting the very people they refused to protect three weeks ago.”

“I want to split this bill in two. Mental illness and advance requests are two different issues, and both need a full debate.”

“Madam Speaker, we have heard more than once this evening and throughout the day that Conservatives would like to see the bill split in two. We believe there are two separate issues. There is the mental illness component and there is the advance request component. I am wondering what my colleague thinks about this. Would he agree that there are two separate issues and that both deserve a fulsome debate, specifically the advance requests?”

“I oppose this bill. Last year, 692 people asked for medically assisted death and then changed their minds. This bill lets someone be helped to die based on an old form, without checking if they still want it at the time.”

“Madam Speaker, in the “Sixth Annual Report on Medical Assistance in Dying in Canada”, from Health Canada, detailed data was gathered on MAID requests and on the number of requests that were carried out. Strikingly, in one year, 692 people made and then withdrew a request for MAID. This is interesting. These are people who, because of where they were at and because of whatever aspects of their circumstances, made that request and then decided they did not want it. That is 692 people in one year. Very clearly, if we had a system of advance requests, a person could be killed later based on a document they signed before, without being asked about that contemporaneously at the time they are being killed. That is in this bill. The bill would not require that they be asked anything at the time their life is ended. Someone could carry that out based on what they said before. Where would that leave the 692 people in one year who, using their autonomy, made one decision but later, also using their autonomy, made a different decision to undo their previous decision?”

“I support banning medically assisted dying for mental illness alone, but I oppose the rest of this bill. It is meant to expand assisted dying by letting people ask for it in advance. The proposed rules will not protect vulnerable people, and doctors already face too little oversight. I want the committee to remove the parts that expand assisted dying and focus only on strict national safeguards.”

“Madam Speaker, I am sharing my time with the member for Battlefords—Lloydminster—Meadow Lake. I rise today on behalf of the caring Canadians in the compassionate riding of Algonquin—Renfrew—Pembroke to speak to Bill C-41, the medical assistance in dying safeguards act. I want to begin by thanking the co-chairs and the elected members of the Special Joint Committee on Medical Assistance in Dying for their work in reviewing calls to expand medical assistance in dying to those who are not dying but instead suffering from mental illness. The committee is bipartisan. It recommended to permanently exclude mental illness as a sole condition for receiving medical assistance in dying, which is welcomed by my constituents and the vast majority of Canadians who have survived mental illness or who are currently living with severe mental illness. My Conservative colleagues on the special joint committee included a number of supplementary recommendations that I believe should be highlighted before the bill is brought to committee. The first recommendation was to call on the government to support the member for Cloverdale—Langley City’s private member’s bill to permanently exclude mental illness as a condition to access medical assistance in dying. Sadly, the government rejected the recommendation and voted down the bill. Instead, the government brought forward a bill expanding medical assistance in dying to allow advance requests, which had not been studied by the special joint committee. While the bill does include the permanent repeal of mental illness as an eligible condition by including it in the legislation to expand access to MAID and voting against a clean bill, the government has politicized this sensitive issue. This was a regrettable decision by the government, but I truly hope we can return to a more collegial approach when it goes to committee. While the government has given this bill the short title of it being the medical assistance in dying safeguards act, its purpose is not to create safeguards but to allow advance requests. In setting out the criteria for advance requests, the government reveals how difficult any safeguards for advance requests would be. The bill states: if, by virtue of subsection (6), medical assistance in dying on the basis of the advance request was previously not provided because there was doubt as to whether the person’s words, sounds or gestures constituted a demonstration of refusal or resistance, ensure that there are at least 30 clear days between the day on which the words, sounds or gestures were observed by a medical practitioner or nurse practitioner and the day on which the medical assistance in dying on the basis of that request is provided; What the bill is saying is that anyone who has given an advance request on the basis of having an illness where death is reasonably foreseeable can later refuse to go through with it. If there is any subjective doubt felt by the medical practitioner as to whether their patient has refused, the medical practitioner must wait 30 days before trying to administer a substance that would cause death. This alone calls into question any diagnosis that death was reasonably foreseeable. It creates that perverse incentive where a medical practitioner must decide if they doubt the patient’s attempt at refusal or they doubt their own medical judgment. No Canadian’s life should be lost to confirmation bias. Even the criteria for administering MAID following an advance request includes a subjective opinion by the medical practitioner that the person who has lost the capacity to consent is experiencing intolerable physical or psychological suffering. If a person has lost the capacity to consent, how can their psychological suffering be assessed? Not only are the limited measures in the bill an insufficient safeguard, the government is downloading the job onto the provinces. That the government would take this approach so soon after the Ontario government gutted its own MAID review panel is all the more troubling. The fact that Ontario’s MAID review panel is run by the coroner’s office only highlights the lack of safeguards. This is why Conservatives made a different recommendation, which states: The government should work with provinces and territories to establish minimum national standards for MAID oversight to ensure the effectiveness and enforceability of MAID safeguards. Those standards should include prospective review mechanisms capable of pausing or stopping a provision where serious compliance concerns arise before death, stronger review of prior records and assessments, clear referral pathways for potential Criminal Code violations, and greater independence of oversight bodies from MAID delivery systems. Given the irreversibility of MAID, genuine safeguards would ensure a case could be stopped before proceeding. Families should not be forced to go to court to protect their loved ones. Doctors should not be assessing patients for MAID in a Tim Hortons parking lot, then driving the patient to the clinic to be killed, as Dr. James MacLean did. Dr. MacLean only received a slap on the wrist from the College of Physicians and Surgeons of Ontario for his drive-through MAID. The bill provides no safeguards for the kind of doctor shopping that saw an Ontario man denied MAID in this province seek out Ellen Wiebe in B.C., who assisted in his suicide for irritable bowel syndrome. That man’s family was not as lucky as the family of an Alberta woman who also was denied MAID in her province but was approved for MAID after a zoom call with Ellen Wiebe. That family secured a court injunction, and the woman stopped seeking MAID. Those are just two examples of cases where the current safeguards failed to stop a doctor and MAID activist like Ellen Wiebe. That a court found Dr. Wiebe to be mistaken in granting a track 2 MAID approval called into question the current lack of safeguards. That no criminal charges have followed the court findings proves the safeguards are insufficient. Does anyone believe that doctors such as Ellen Wiebe or James MacLean would have any doubts if a patient who gave an advance request unclearly indicates a refusal? Conservatives recommended a full review of the effectiveness and enforceability of current MAID safeguards to prevent vulnerable Canadians from being assisted in committing suicide, but instead of listening to our recommendations, the bill would expand MAID to advance requests. Fortunately, it is not too late. We can delete the clauses expanding MAID and turn the bill into a real set of nationally enforceable safeguards. While the government was playing politics and voting down my colleague’s clean bill earlier, we can put that aside to transform this bill from one that would expand MAID to one that would provide real safeguards. Elected parliamentarians from the Liberal Party and the Conservative Party worked together on the special joint committee to find common ground in rejecting the expansion of MAID to people solely suffering from mental illness. While we may disagree on expanding MAID to include advance requests, the majority of people on both sides of this debate are motivated by compassion, yet when it comes to mental illness, or it comes to those who are suffering but whose deaths are not reasonably foreseeable, offering MAID is not compassion, but an admission of our failure to provide the compassion required to live a life of meaning and purpose. Tomorrow, the government will undoubtedly table a budget filled with more compassion for investors and corporations than for those suffering in silence, and while the government gives hundreds of millions of dollars to fake spaceports and fraudulent electric buses, Canadians linger in hospital hallways. We do not need half measures like five-year funding formulas that add marginal capacity to mental health services. We need bold moves like the Manhattan Project to fight mental illness. If we are not successful in eradicating mental illness, the effort alone could be the hope so many people need. Killing is not compassion. Fighting for everyone to enjoy a life of meaning and purpose is compassion. If we do not take this opportunity to increase the safeguards and effectively roll back track 2 for all but the most extreme cases, then all we would be doing is greasing the slippery slope. Ever since the Supreme Court overturned precedent and invented a right to death, we have witnessed exactly what so many predicted would happen. Advocates keep on pushing to expand it. First it was those without terminal illness. Then it was those with only mental illness. Now we have doctors asking for the power to decide if an infant’s life is worth living. They will not stop pushing it until they find a court to allow it. Nine unelected judges should never decide whose life has value and whose does not. It falls to Parliament to fight for life. Do not go gentle into that good night. Rage, rage against the dying of the light.”