moved that Bill , be read the second time and referred to a committee.
She said: Mr. Speaker, I want members to imagine someone's son. He is in his forties and life has worn him down. He lives with a painful illness that leaves him sick, exhausted and often unable to leave the house. On top of that, he struggles with addictions, depression and anxiety, which have taken more from him than anyone can see from the outside. Some days, he can barely hold it together. He relies on his family for a place to live, food and help getting through the week. They are doing their best, and he is doing his best, but the weight of it is crushing.
One day, he finally meets a psychiatrist. He goes, hoping that this might finally be the start of real help. His addictions still have not been treated, and his mental health care has not truly begun. He is vulnerable, scared and hanging on by a thread.
At that appointment, instead of being offered a plan to get him stable, MAID is raised as an option. The assessment moves ahead, and before he ever receives proper support for his mental health or addictions, he is approved. His MAID provider is the one who drives him to the place where his life is ended. This is someone's son who needed help, not a final exit.
Believe it or not, this actually happened here in Canada, and this is where we are headed if we do not act. Unless this Parliament chooses a different path, Canada will allow MAID for people whose only condition is mental illness. That means men and women struggling with depression, trauma or overwhelming psychological pain could be steered toward death by a system that too often cannot offer timely treatment, consistent follow-up or even basic support. This is why I brought forward Bill , the right to recover act. It is simple. It asks Parliament to stop, consider what we have learned and act responsibly before people are irretrievably harmed.
I often think of my grandparents, who immigrated here after World War II with very little. They chose Canada because it was a place where people had endless opportunities to better themselves, where neighbours watched out for each other and communities worked in unison to make a better life for all. They built a Canada where the vulnerable were cared for and the less privileged in society were valued and treated with equal care. Those fundamental values attracted millions of immigrants over the years.
Today, many Canadians fear we are losing those values. Canadians themselves remain some of the most compassionate people anyone will ever meet, but our system is overwhelmed, stretched thin and unable to meet the needs of people who are suffering.
When people fall through the cracks, the easy temptation is to accept that failure is inevitable. When that happens, people facing mental illness can end up alone, waiting months, or sometimes years, for specialized treatment, and when help does not come, they lose hope. That moment of hopelessness should never be treated as an opportunity for the state to end their lives through MAID.
When the House last debated MAID, mental illness was not a part of the core discussion. It was added in a last-minute Senate amendment to Bill . The implications were not fully considered or understood by the House.
Since then, we have learned a lot more. Psychiatrists across Canada, including the chairs of psychiatry at all 17 medical schools, have told us plainly that there is no reliable way to predict when a mental illness is irremediable, which is a requirement in the MAID law. People get worse, but they also get better, and most do. There is no test, scan or clinical tool that can reliably tell us that someone will never recover. All people deserve the opportunity to get better. No one should be encouraged to give up on themselves.
As legislators, we need to listen to what so many medical professionals are telling us, which is how hard it is to distinguish between suicidal ideation and MAID. The feelings behind them, such as hopelessness, loneliness, fear and the belief that one is a burden, are the same. For decades, clinicians have understood that, when someone feels hopeless or sees themselves in a very negative way, it can look like they are thinking clearly, that they are rational, even when their judgment is clouded by despair.
In 2021, most of us did not have the evidence we now have about how MAID assessment functions in the real world or the specific dangers of expanding MAID to mental illness. We now know there is no reliable way to determine when a mental illness is truly irremediable. Suicide prevention experts, including the Canadian Association for Suicide Prevention, warn that how we talk about these issues shapes the choices people make. Suggesting that death is a solution to suffering undermines hope. It puts people at real risk.
The expansion of MAID to mental illness forces Canada into a huge contradiction. On one hand, we invest in suicide prevention. We train professionals to intervene, listen and pull back people from the edge. On the other hand, with the expansion of MAID, we would invite those same vulnerable people to consider state-facilitated death.
We must ask, who receives suicide prevention and who is guided toward MAID? If a person suffering from depression calls a crisis line tonight, do we encourage them to hold on or do we quietly redirect them to an assessor? What principle decides the answer? What medical test? What ethical standard? There is none. That is because the very feelings that drive someone to seek MAID, hopelessness, despair or the belief that they are a burden, are the same signals that every suicide prevention worker is trained to treat as a cry for help.
We would never tell a struggling teenager that their wish to die is rational. We would not tell a grieving spouse that their darkest moment is a reasonable exit point. We would reach out. We would support them. We would insist that their lives still matter. Why should that change simply because despair is given a different label? When someone feels worthless, our duty is not to agree with them. It is to stand with them until the light returns. Canada must decide: Are suicidal citizens people in need of protection or candidates for state-sanctioned death? We cannot pretend that they are both. Besides all this is the fact that we already know the current safeguards are failing.
Let us be absolutely clear about what an expansion of MAID to mental illness would mean. If Canada cannot protect vulnerable people under the current rules, then expanding eligibility to those whose very illness clouds judgment, hope and decision-making will lead directly to preventable deaths. We are already witnessing cases where safeguards fail, where capacity is misjudged and where people are assessed in moments of confusion, exhaustion or pressure. If the system cannot uphold basic protections now, it will not and cannot protect those suffering from severe psychological distress. An expansion would be reckless.
The evidence is already in front of us. A recent article about Ontario's MAID death review committee's findings lays out, in plain and troubling terms, cases that would worry every Canadian. They describe a man who had cancer. I will call him Bill. Earlier in his illness, he had briefly mentioned MAID, as frightened patients tend to do. By the time he was assessed, he was delirious, confused and heavily sedated. His own medical team made it clear that he no longer had the capacity to make major decisions, yet a MAID assessor shook him awake, took the faint motion of lips as consent, withheld sedation, obtained a rushed virtual second opinion and ended his life that same day. Bill was not stable. Bill was not capable. He did not understand what was happening.
In another case, a woman, whom we will call Margaret, wanted palliative care. She said so the day before her death, but she did not qualify for hospice. Her husband, worn down by caregiver exhaustion, arranged for an urgent MAID assessment instead. The day before she had told him she wanted to die with proper palliative support, but the next day two assessments were rushed through. Her final wishes were overshadowed by the strain of a caregiver who could no longer cope.
Another woman, whom we will call Alice, was living with advanced dementia and unable to communicate her wishes in any meaningful way. Her family brought MAID forward twice with minimal documentation, little clarity and no clear expression of consent, yet she was approved.
All of these examples were drawn from the auditor's report. These are stories about real people, who are family members, friends, neighbours and fellow citizens, the people to whom we owe a duty of care. They demonstrate that vulnerable Canadians are already at risk under the current MAID regime. People who are confused, pressured, exhausted or unable to communicate are slipping through the safeguards that were supposed to protect them. If safeguards fail for patients with physical illness, where assessing capacity is clear and verifiable, what will happen when the only condition is a mental illness which, by definition, clouds judgment and hope? To offer death at that moment will place some of the most vulnerable people in this country directly in harm's way.
Today, a person deemed unable to manage their finances must undergo rigorous capacity assessments, interviews, documentation, expert review, collateral information and verification because we recognize the risk of exploitation, yet for MAID, a situation of life or death, a brief conversation can suffice, with no thorough evaluation, and when the safeguards fail, there seem to be few consequences. We now live in a country where we protect bank accounts better than we protect a human life.
We also know of families across Canada that were deeply shaken by how MAID was carried out for a loved one. They describe decisions that felt rushed and were influenced by poverty, loneliness or a lack of access to proper treatment, not by a calm and informed choice. These experiences are warnings from the very people who lived through the consequences.
Canadians are uneasy. Polls show a clear majority do not support MAID for mental illness alone. Provinces are asking Ottawa to reconsider. They are calling for a stop. Quebec, one of the most permissive MAID jurisdictions in the world, has banned it by law.
International human rights experts have raised the alarm, including the UN Committee on the Rights of Persons with Disabilities, which has urged Canada to step back. It warns that our trajectory risks discriminating against people with disabilities and mental illness and recommends repealing this expansion entirely. This is what Bill would do.
We must remember a crucial truth, which is that recovery from mental illness is not rare, but common. Time and again, people who once felt utterly hopeless have rebuilt their lives once they received proper care and stable support. Every one of us knows someone, whether it was a neighbour, a colleague or a family member, who walked through a very dark season and is now grateful to be alive.
These stories matter because they show us what is at stake. Sadly, that is not true in every case, but there is no reliable way to know in advance who will recover and who will not. There is no test, no scan, no certainty. I respectfully suggest that, when someone's judgment is clouded by psychological distress, our duty is to offer treatment, protection and time, not an irreversible decision based on guesswork.
If MAID is expanded, we will be forced into an impossible paradox. A suicidal person calling a crisis line is urged to hold on, yet if they request MAID, that same despair may be treated as justification for death. This is why Bill is necessary. It would stop the 2027 expansion to mental illness because the evidence cannot support it and the safeguards cannot sustain it. Vulnerable Canadians are already at risk. Expanding eligibility now is reckless. A strong country does not turn its back on those who suffer, but believes in their future and gives them time and care to heal.
I urge every member in the House to support Bill so Canada would remain a nation that protects the vulnerable, offers treatment before despair and gives every person the chance to recover. Let us take this responsibility seriously. Let us listen to the warnings of those who are assessing the failures in the system. Let us listen to the families who have lived through the consequences of MAID and to those who survived mental illness and rebuilt their lives. Let us remember the kind of country we claim to be, one that protects the vulnerable and gives people the time, care and dignity they need to heal.
:
Mr. Speaker, I appreciate the opportunity to rise today to speak to Bill , which proposes further amendments to Canada's federal legal framework for medical assistance in dying. Specifically, this bill aims to indefinitely exclude those patients whose only health condition is a mental disorder from being eligible for MAID.
This is an issue which is unquestionably complex and can be deeply personal. It continues to challenge parliamentarians, health care providers, experts and people in Canada alike. It is important for us to recognize that medical assistance in dying has been allowed in Canada for close to 10 years now. It is also important to remember that it is the provinces and territories that must put in place the tools and supports that clinicians need to deliver MAID safely and appropriately. Whenever we make changes to the federal legal framework for MAID, we must be cognizant of the impact that those changes have on our partners in the provinces and territories.
As the Supreme Court of Canada recognized in Carter, striking the right balance in this complex area of social policy, where competing social values are at play, is not an easy task. As legislators, we must balance respect for personal autonomy and dignity with our responsibility to those who may be vulnerable.
Today, I will speak to three key elements: first, the objectives of Bill ; second, the findings of major expert studies on MAID where mental illness is the sole underlying condition; and third, the federal government's support for provincial and territorial work to improve access to mental health services.
Bill seeks to make changes restricting eligibility for MAID indefinitely in cases where a mental disorder is the only medical condition involved. There have been concerns expressed by some stakeholders about whether there are sufficient safeguards in place, and whether health care providers have the tools and resources they need to provide MAID safely and appropriately when it comes to mental illness. These concerns are not new, nor are they trivial, and their desire for caution is laudable.
At the same time, we must also recognize that Parliament has debated this question repeatedly over several years. Our legislative framework has evolved in response to court decisions, expert analysis and extensive public engagement. A special joint parliamentary committee has carefully considered the issue at length and provided advice and recommendations on whether to proceed. That committee also reinforced the importance of provincial and territorial health system readiness.
Bill invites us to consider whether the appropriate balance has been struck with the upcoming lifting of the mental illness exclusion in 2027, or whether another legislative change is necessary at this time. To answer that, it is essential that we understand what the experts have already told us. Significant studies have been completed on the specific question of MAID eligibility where mental illness is the sole underlying condition, including by the Council of Canadian Academies and the expert panel on MAID and mental illness, among others. Taken together, they provide a rich body of evidence.
The Council of Canadian Academies, the CCA, examined Canada's legal and clinical landscape, along with international approaches. The CCA's work highlighted the core clinical challenge: Mental illnesses can be unpredictable in their course and determining irremediability is far more complex than in many physical illnesses. The CCA was not tasked with providing recommendations for or against eligibility, and the members of the working group that dealt with mental illness had a spectrum of views on the matter.
The expert panel on MAID and mental illness, which was mandated by the former Bill , took this analysis further. Its mandate was not to recommend whether eligibility for MAID should be expanded to permit the provision of MAID based on mental illness alone, but rather to recommend protocols, guidance and safeguards for such cases. The panel concluded that the existing Criminal Code safeguards, when supported by the development of MAID practices standards and the implementation of other recommendations, are adequate to allow for safe provision of MAID to people whose sole underlying medical condition is a mental illness.
Both these expert reviews, along with the testimony received through parliamentary committee work, reinforce the same overarching message: MAID in cases involving mental illness requires exceptional caution, but it is not impossible to implement safely. At the same time, clinical readiness, clear standards and comprehensive training are essential.
Following these studies in 2023, a model MAID practice standard was published, and a Canadian-made curriculum was developed. In addition, the federal government is currently supporting the Canadian Psychiatric Association to develop clinical practice guidelines for assessing suicidality and irremediability. Through a federal, provincial and territorial assistant deputy minister-level committee, policy leaders are also considering a range of issues related to MAID, particularly with respect to complex cases, including mental illness.
We have heard from these expert reviews and from a broad range of stakeholders on the importance of provincial and territorial health systems' being ready for the lifting of the exclusion. This includes provincial and territorial efforts to improve access to mental health services and supports across Canada. No one should ever feel that MAID is the only option available to them.
The federal government remains committed to supporting provinces and territories to improve access to health care for Canadians, which includes strengthening mental health services. In 2023 the Government of Canada announced the working together to improve health care in Canada plan, a historic investment of close to $200 billion over 10 years to support provincial and territorial health systems to deliver health care to Canadians. This includes an investment of $25 billion through bilateral health agreements with the provinces and territories to support shared priority areas, including improving access to mental health and substance use services.
The federal government has also expanded support for youth mental health initiatives, recognizing that early access to therapy, counselling and culturally safe care can alter the trajectory of a person's entire life. We have also funded indigenous-led mental wellness programs, which acknowledge the need for approaches that are culturally relevant, trauma-informed and community-based, rather than one-size-fits-all solutions. Provinces and territories have taken significant steps to improve access to mental health services in Canada with federal supports over the past 10 years.
Questions related to MAID in the context of mental illness are among the most sensitive we confront as parliamentarians. Our decisions affect people in Canada at their most vulnerable moment, and our work must reflect both humility and resolve. Bill asks us to confront difficult but deeply important questions.
Deciding whether medical assistance in dying should be available when a mental illness is the sole underlying condition is not a choice that lends itself to simple answers. Reasonable people may come to different conclusions. The Supreme Court of Canada has recognized this complexity, affirming that Parliament is owed a broad margin of deference when navigating challenging social policy issues such as this.
We will have the opportunity to consider next steps further and to study the state of progress during the parliamentary review that will be held in 2026. I look forward to hearing from colleagues as well as from experts, stakeholders and regular people, including those with lived experience with mental illness, as we continue this important debate.
:
Mr. Speaker, you will not be surprised to learn that the Bloc Québécois will not be supporting Bill . Although we do not support this bill, it is not because we are unconcerned with the issue of medical assistance in dying for people with mental disorders. It is because it is not up to a political party to decide whether to implement a medical assistance in dying procedure for people with mental health issues. This is a societal issue, a societal debate, but also a clinical debate.
The reason it is not yet in effect is that there is no clinical and scientific consensus on how to regulate consent for MAID from a person whose only medical problem is a serious mental health disorder. There is no consensus and that is why Bill , which was passed, excluded people with mental disorders from receiving MAID.
However, the bill provides that in 2027, the joint committee of senators and MPs will be reconvened to assess whether psychiatrists, psychologists and mental health professionals have made progress in their analysis of the future framework for MAID for people with mental health disorders. It is possible that, in 2027, government departments, scientists and psychiatrists will conclude that we are not ready, that it is too difficult to determine the “how” and the “when”, and that it is too difficult to analyze the clinical framework for authorizing or not authorizing medical assistance in dying.
We need to approach this bill with care. This is a societal debate that should not be politicized. We in Quebec have already taken a position on medical assistance in dying. Quebec is one province where this question has been debated at great length. A commission travelled everywhere across the province. A clinical and scientific consensus, as well as consensus in civil society, were reached on medical assistance in dying.
For people whose only illness is a major mental health disorder, medical assistance in dying was also rejected by Quebec for the same reasons it was rejected when Bill C-62 was passed, namely, the absence of a scientific and clinical consensus. We also need to give the experts time to reflect, consult, examine practices and evolve so they can make recommendations to the joint committee in 2027. Once the joint committee receives these recommendations, it will have to decide whether to move forward or put off the decision once again, which is not an easy thing to do. However, what is plain to see is the the seriousness and scientific rigour surrounding the decision to allow or withdraw permission for medical assistance in dying for people with mental health conditions.
I think it is worthwhile for me to read recommendation 1 of the Special Joint Committee on Medical Assistance in Dying, in which all parties and senators participated. They were quite wise, because they recommended the following:
That [medical assistance in dying where mental disorder is the sole underlying medical condition] should not be made available in Canada until the Minister of Health and the Minister of Justice are satisfied, based on recommendations from their respective departments and in consultation with their provincial and territorial counterparts and with Indigenous Peoples, that it can be safely and adequately provided; and
That one year prior to the date on which it is anticipated that the law will permit [medical assistance in dying where mental disorder is the sole underlying medical condition], pursuant to subparagraph (a), the House of Commons and the Senate re-establish the Special Joint Committee on Medical Assistance in Dying in order to verify the degree of preparedness attained for a safe and adequate application of [medical assistance in dying where mental disorder is the sole underlying medical condition].
My colleague gave several examples. I was surprised to hear her often say the words “depression” and “suicidal”. When I look at what the joint committee discussed and debated, I see that it talked about untreatable mental illnesses, such as schizophrenia. I do not know whether anyone here has ever met a person with schizophrenia who suffers from auditory or visual hallucinations with paranoid thoughts. Their reality may be that they are so medicated that they can no longer enjoy a social life or contact with others. They may be isolated from their family and live in difficult conditions. They likely have to see their psychiatrist regularly and may have tried several types of therapy with no success. This may have been their reality for the past 10 or 20 years. That person lives in a state and conditions that no one here in Parliament would ever want to experience.
We are talking about incurable illnesses that people have to learn to live with and for which they have to be medicated. A person with severe schizophrenia could get all the psychotherapy available, but they are still dealing with an extremely difficult illness. I do not want my words to be misinterpreted. I am not saying that everyone with schizophrenia would want to request medical assistance in dying. I am simply trying to provide some clarification in response to my colleague, who was talking about temporary depression, situational depression or maybe even serious depression. She is right in saying that a person can get through those things with help, psychotherapy, support from local health centres and loved ones. That is true. She is right. Those cases would never constitute a legitimate reason for obtaining medical assistance in dying.
I would also like to point out that there are some very important things in the preamble. Basically, what it calls for is justified, even legitimate: Anyone struggling with mental health issues should have the right to receive the services they need, whether that means consultations, emergency services, support, home care or assistance. In my riding, we have organizations that work in the area of mental health. One that comes to mind is Le Tournant, a transition resource that provides real-time service. A suicidal person can call, and someone can go directly to their home to support them and help them through this distressing time.
My colleague is right to point out that in Quebec, as in other provinces, there is still a lot of room for improvement in this area. Unfortunately, it is not for lack of interest that the provinces are not offering these services, but because they do not have the means to do so. Over the past few years, health services, and particularly social services, have gotten shortchanged because health problems are so significant that social problems have fallen by the wayside a bit. The provinces have to do more with less. A good solution to support people would be to give the provinces the financial resources they need to establish much more intensive services for people struggling with mental health problems. In my riding, there are all kinds of services, including intensive home care services. These services exist, but perhaps not at the same level as the needs require.
My colleague notes in the preamble that this issue falls largely within provincial jurisdiction. I strongly suggest that she join forces with her colleagues to demand that the government do more and provide the provinces with the resources they need to order to implement all the necessary services for people struggling with mental health issues. In the meantime, the Bloc Québécois trusts that the House of Commons will take the time to thoroughly examine the issue of MAID for mental health disorders.
:
Mr. Speaker, it is a great honour to rise and speak to Bill .
In less than a week, it will be 15 years since I almost lost my life to suicide. I overdosed. I was in the hospital for seven weeks. For much of it, I was on life support and had to be resuscitated multiple times. Over Christmas, my parents did not know if they would have me as their son, moving forward. It was the culmination of a very dark time in my life that spanned many years, a time in which I felt at multiple times, although not as seriously as I did that horribly dark and sad December day in 2010, that I would be better off dead than alive.
There are many reasons I am so proud to be standing here in this chamber, but one of them is knowing where I have been and where I came from and the fact that there was a time in my life when I never in a million years would have believed that I could ever have the life I have now: a career that I am proud of, an amazing wife whom I love so dearly, these tremendous colleagues and friends I work with every day, and this trust that has been placed in me by the people I represent. None of that would have been possible had I been successful when I attempted to end my life.
I think of my own experience and the experience of many others like me when I reflect on the fact that in just 15 months' time, someone who was in the place I was in 15 years ago will be able to have not only the state's permission but the state's help to end their life by suicide. In March 2027, the criteria for medical assistance in dying are expanding, so someone with only a mental illness, with no physical ailment whatsoever, will be eligible for MAID.
This is a profound expansion and a fundamental inversion of the message that we have spent so much money and so much airtime and so much effort and energy telling Canadians for years, through countless campaigns aimed at ending the stigma surrounding suicide; through more programming, funding and resources to support people with mental illness; and through campaigns telling people that they are better off alive, that they do have a future. They are efforts that we all extend in our own lives to those around us to give messages of hope to those who need it. To put a fine point on this, and to make it personal, because it is personal, if the laws that are coming into force in 15 months had been there 15 years ago, I would probably be dead right now. I say that with full gratitude that I am not.
I did not want to extend a cry for help. I actually had access to resources and treatment. I had a support system. I had a family who loved me. I had these privileges that so many others who struggle with mental illness did not have. Even with all of those available to me, I felt like there was no future. The proverbial light at the end of the tunnel did not exist. I did not want to get better. It was not that I had not tried; I had not tried enough, clearly. However, I felt like I had done my time. I felt like I had put in enough effort to try to get better and when I did not, I had made my decision that I was going to end it. It was not impulsive; it was quite rational, actually. I decided it weeks out. Believe it or not, as silly as it sounds, I had it on my calendar, and I scheduled the day because I had appointments and meetings before it that I did not want to miss, as though that makes any sense at all, as though it would matter if I missed a meeting, given that I was planning on not sticking around.
This is how, when a person is struggling with mental illness, as I was so very seriously, it plays tricks on them. By design, a mental illness is a distortion of the person's ability to see clearly and think clearly about what they are in the midst of. It clouds their judgment. If I had ever gone to a health care worker and said, “I am planning to end my life,” they would have not just a moral but a legal obligation to stop me. They would have legal authority to detain me, because that is how sacrosanct it is that people have a right to recover, that they have a right to live and that medical practitioners must do no harm and protect them from harming themselves. We have a duty to help people.
I talk about my own story, and I have heard so many others like it. After my colleague from introduced her bill, I launched the “I got better” campaign, in which I shared my testimony and invited Canadians to share their own. I would like to share some of those in the House today.
A lawyer from here in Ottawa said that they wondered if they would have used MAID if it had been available when they were in their darkest days, or if they would use it in the dark days yet to come.
A man reached out and said he struggles with personal family issues and mental illness. He has very bad days. He has tried attempting suicide before, and he is worried that he will not be stopped in the future if he has more of those dark days and MAID is available to him.
On a more positive note, a woman who was in an abusive relationship for 22 years and wanted to die said, “If MAID had been around then, I would not be here now, and I am damn happy it was not.” I will ask members to pardon the unparliamentary language. She continued, saying, “I am happy now. I have had a fantastic career caring for seniors. I have grandbabies and kids I love. I have a wonderful husband now who means the world to me.”
Another woman said she wanted to end her life many times, but looking back, she is so happy she has a life now where she is happier than she ever was before.
I will share one more about a woman who described two years of agony, with damage to her liver, hospitalizations, dozens of failed medications and a compilation of diagnoses without any real clarity, but she was given a second chance. She had been labelled as chronically unstable and told she had a poor prognosis, was unable to thrive independently and would likely revolve through the system for the rest of her life. She had attempted suicide several times.
There was one doctor who would not give up on her. As she said, “Recovery takes one person, not one pill. It takes one person who believes in you and forces uncomfortable treatment onto you for the sake of the future life that's awaiting you.” That woman went to university, became a social worker to help others, is happily married and, more importantly, is happy.
None of these stories could ever be guaranteed if we were to do what the government is doing in 15 months, which is to license giving up on people at their most vulnerable moments, at their darkest and lowest points.
Of those who die by suicide, 90% are people who have diagnosable mental illness. Physicians have testified before Parliament and its committees that suicide is often contemplated and planned over a long period of time by people who would very easily, as I am confident I would have, go to a doctor to make a rational, logical case that they have tried all of the treatments and they believe that they are better off dead than alive. There was a consensus among psychiatric experts who have testified and spoken about this elsewhere that there is no clear way to separate suicidal ideation as a symptom from a request for a health care practitioner to help in ending one's life.
Dr. John Maher testified before Parliament that 7% of those who attempt suicide die by suicide. That means that 93% of people who, at one or multiple points, want to end their life eventually get over that. The success rate of MAID is 100%. By design, this is a policy that will give up on people.
There are very few things in this chamber that we can say are genuinely life-and-death issues. This is one of them. A few weeks ago we saw that, in 2024, MAID accounted for 5.1% of the deaths in Canada. That is a 1,520% increase over 2016 when it became legal. We are seeing a massive expansion to people who, in the vast majority of cases, will get better. About 50% to 60% of people with mental illness will actually recover with no treatment, and that number is even higher for people who do have treatment available.
I would not be here today had I been successful. I would not be here today had I not gotten over the darkest, worst feelings of my life, which anyone could encounter. That is something I believe needs to be understood by those who believe this is an abstract question of legal theory and legal rights. These are real people. There are faces to this. If Bill does not pass, people will die. We have a right and a duty to stand up for those who need it. I will be proudly supporting this bill, and I thank my colleague so much for introducing it.
:
Mr. Speaker, medical assistance in dying is a complex and deeply personal issue. It touches patients living with unbearable suffering, their family and friends, and the health care professionals who care for them.
Today, as we begin consideration of Bill , I want to speak to how we got here, what the bill proposes and some of the questions I have concerning this bill.
Let me begin by briefly reviewing the path Parliament has taken over the last decade. Understanding the evolution of the law helps us understand the importance of moving carefully when changes are proposed.
First, in 2015, in the Carter decision, the Supreme Court of Canada struck down the blanket prohibition on physician-assisted dying because it violated section 7 of the charter. The court suspended its ruling so Parliament could craft a new framework, one that balanced individual autonomy and dignity with the sanctity of life and the need to protect vulnerable people. It also recognized that Parliament is owed a high degree of deference given the complexity of the issue and the competing societal values involved.
Second, in December 2015, the Special Joint Committee on Physician-Assisted Dying, which was made up of MPs and senators, was tasked with making recommendations on the legal framework to respond to the Carter decision. That committee heard from 61 witnesses, received 132 briefs and published its recommendations in February 2016.
Third, also in 2016, Parliament passed Bill , which legalized the provision of MAID. It did so by creating a MAID framework in the Criminal Code made up of eligibility criteria to determine who can obtain MAID, procedural safeguards to ensure MAID is provided safely and exemptions to criminal offences such as murder for practitioners who provide MAID in accordance with these requirements. Eligibility for MAID was originally restricted to competent adults whose natural death was reasonably foreseeable.
Fourth, in 2021, Parliament adopted Bill , which expanded eligibility for MAID to those whose natural death is not reasonably foreseeable. It also added additional safeguards to address the increased complexity of providing MAID in those situations. At the same time, Parliament temporarily excluded for two years the eligibility of MAID for individuals whose only health condition was mental illness. Importantly, this was not due to stigma or stereotyping about mental illness, but because experts made it clear that unique considerations, including how to assess whether a mental illness is irremediable, required further study and that further health care system preparation was needed.
Bill also required Parliament to establish the new Special Joint Committee on Medical Assistance in Dying, which heard from more than 150 witnesses, received hundreds of written briefs and submitted three reports. In addition, the bill called for the ministers of justice and health to initiate an independent expert review to recommend protocols, guidance and safeguards for MAID for mental illness, which they did.
Fifth, in 2023, Parliament adopted Bill , which extended the temporary exclusion of mental illness by one year to allow time for federal, provincial and territorial governments, in collaboration with professional bodies, to prepare standards and training and to consider any recommendations from the special joint committee.
Most recently, in early 2024, the special joint committee and several provincial and territorial ministers of health called for more time for provincial and territorial health systems to prepare for the lifting of the exclusion. Parliament passed Bill , which extended the temporary exclusion to March 2027.
At the same time, Parliament also mandated that further review be undertaken by a special joint committee of Parliament, which is to begin by February 28, 2026. The committee is expected to provide a further assessment by Parliament on the readiness of provincial and territorial health systems for the expansion of MAID eligibility to those whose only underlying condition is mental illness. I look forward to its findings and recommendations.
We must also remember that when we speak of medical assistance in dying, we are speaking of a health service that doctors and nurse practitioners deliver as a part of end-of-life care. Changes to the legal framework for MAID would have significant repercussions for provincial and territorial health systems, and changes should be informed by the experience of the people responsible for health care in Canada.
This brings me to the private member's bill, Bill . At its core, the bill proposes two notable changes: number one, to replace the term “mental illness” with “mental disorder”; and number two, to change the structure of the exclusion provision. At first glance these may seem like technical adjustments, but the first change in particular could have significant consequences for eligibility for MAID and how the law is interpreted.
The term “mental disorder” is used in the clinical world, but it covers a far broader range of conditions than “mental illness” is intended to capture. “Mental illness” refers mainly to conditions that fall within the domain of psychiatry; the term does not include neurocognitive or neurodevelopmental disorders, such as Parkinson's disease, which is typically treated by other medical specialists. Under Bill , however, this condition would now be captured by the exclusion, because it falls under the broader category of mental disorder.
Currently, individuals whose sole underlying medical condition is a neurocognitive disorder are eligible for MAID. This leads me to an important question: Why broaden the exclusion to include conditions like Parkinson's disease that are currently eligible for MAID? If this was not the intent of the bill, then further clarity is needed.
My second concern relates to the proposed change in Bill of the definition of “grievous and irremediable medical condition”. The Criminal Code's definition of this term includes three components: “a serious and incurable illness, disease or disability”, “an advanced state of irreversible decline in capability”, and “enduring physical or psychological suffering” that is due to the person's medical situation.
Currently a mental illness is not considered to be an illness, disease or disability, for the purpose of MAID eligibility. This means that a mental illness cannot meet the first requirement of a grievous and irremediable condition. Bill proposes something different; it states, “a mental disorder is not a grievous and irremediable medical condition.” The question is, why? What problem does it aim to solve that the current exclusion does not already address? Could this change be perceived as saying that a mental illness cannot result in enduring suffering?
When it comes to MAID, caution is essential; that is why the government has repeatedly committed to ensuring that provincial and territorial health systems are ready before any expansion would take effect. That includes training assessors and providers, developing and implementing clinical guidelines and supports, and strengthening oversight systems for MAID.
Bill raises important questions, but before we move forward, we must ensure that its effects are clearly understood and aligned with the careful work Parliament has been doing for nearly a decade. The way Canada approaches MAID speaks to some of our most deeply held values: respect for personal autonomy and dignity, compassion for those who suffer, and a firm commitment to protecting vulnerable people. We owe it to Canadians—