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Results: 1 - 15 of 67
View Lindsay Mathyssen Profile
NDP (ON)
View Lindsay Mathyssen Profile
2020-03-12 15:35 [p.2027]
Mr. Speaker, I will be splitting my time with the member for Churchill—Keewatinook Aski.
In the days before medicare, we saw our neighbours suffer because they could not afford the health care they needed. We saw people lose their homes, their farms and their businesses as they struggled to pay their medical bills. We saw illness destroy entire families. Today, decades later, as we look across the country we see the pain of inaccessible and unaffordable health care once again.
Millions of families cannot afford to take the medications they need because they have no employer-provided drug coverage. The number of uninsured people forced to skip their medications is growing as more people work on contract, are self-employed or have jobs that just do not come with health benefits. Too many seniors are putting their health at risk because they do not have job coverage and cannot afford to pay out of pocket. One in five Canadians either has no prescription drug coverage at all or has inadequate coverage for medication needs. That is 7.5 million people.
I met one gentleman in my riding of London—Fanshawe who really highlighted this issue for me. He was injured on the job. Thankfully his employer had health benefits that would cover some of his recovery. He wanted and needed to get back to work even though he was not well enough, because he knew that he was up against the clock and his employer's health benefits would soon run out. He would have to make the impossible choice of going back to work, further risking his health and the health and safety of others, or paying out of pocket with money he just did not have, throwing himself into deeper poverty.
Sadly, this story is not anything new. That is why on clinical, ethical and economic grounds universal public drug coverage has been recommended by commissions, committees and advisory councils dating as far back as the 1940s. Health policy experts are clear: A U.S.-style, private patchwork approach will cost more and deliver inferior access to prescription drugs.
It is why New Democrats have always understood that health care must be a right in Canada, not a privilege. We have been calling for universal public drug coverage since our founding convention in 1961.
Today, Canada is the only wealthy country in the world with a universal health care system that lacks universal prescription insurance coverage. We pay the third-highest prices for drugs in the world and have to deal with a patchwork of programs and coverage, if we are lucky enough to have coverage at all.
For 10 years, instead of addressing the growing costs of drug coverage, the Conservatives made the problem worse by reducing health care funding to the provinces and undermining efforts towards a national approach to pharmaceutical pricing. Now, the Liberal government has spent four years stalling, promising lower drug costs but delivering delays and more of the same piecemeal system that is failing Canadians and costing us more.
We see the direct cost of this inaction in our hospitals and our communities. With people unable to get the medicine they need, they turn to our emergency rooms. When patients cannot afford their prescription drugs, they access provincial and territorial health systems more often as their conditions deteriorate. In 2016, about 303,000 Canadians had additional doctor visits, about 93,000 sought care in the emergency department and 26,000 were admitted to hospital after being forced to forgo prescription medication due to cost.
HealthCareCAN, the national voice of health care organizations and hospitals across Canada, estimates that between 5.4% and 6.5% of hospital admissions in Canada are the result of cost-related non-adherence to prescription medication, resulting in costs of approximately $1.6 billion per year.
One in five Canadian households reports a family member who, in the past year, has not taken a prescription medication due to its cost. Nearly three million Canadians per year are unable to afford one or more of their prescription drugs. With a system that still struggles with mental health supports, we see people on the streets and in our correctional systems when what they really need is help.
In London, Victoria Hospital of the London Health Sciences Centre has a significant overcapacity problem, with more mental health patients than beds for 179 of the last 181 days. The hospital's average capacity on any given night was around 111%.
We see the desperate need for a national, single-payer, universal pharmacare program. I believe my colleagues across the way believe that we need one too. I am so glad to hear that they will be supporting our motion today.
Why would Liberals keep promising to bring forward a national pharmacare program for the last 23 years? Why would Liberals propose study after study, after commission, after advisory committee if they did not see a need for pharmacare? That is, unless they are constantly studying the program to make it look like they are considering the issue and have no intention of implementing it. This is my great fear.
Liberals have been promising pharmacare since 1997, but I wonder how long they have been making promises to big pharmaceutical and insurance companies to secure their skyrocketing profits. We know that drug costs have increased every year the Liberals have been in power since 2015, and in that same time the Liberals have met with companies from the pharmaceutical and insurance industries more than 875 times.
New Democrats have a clear plan on how to implement pharmacare. In fact, our plan is laid out by the Liberals' own Hoskins report. We are so committed to ensuring this happens that, immediately following the last election, the NDP began working to draft a framework to make a universal, comprehensive and public pharmacare program a reality. It was the first private member's bill that my colleague, the member for New Westminster—Burnaby, put forward and I thank him so much for his hard work. I thank my colleague, the member for Vancouver Kingsway, for the hard work he has done on this file, not only in putting forward this motion today but for his work on the health committee in the last Parliament.
The NDP's national pharmacare act is modelled after the Canada Health Act, again as recommended in the report of former Ontario Liberal health minister Hoskins. After all the studies and commissions, if we read the report, it lays out a very clear path on how to implement pharmacare. A plan should follow the same principles that are the bedrock of our public health care system: universality, comprehensiveness, accessibility, portability and public administration.
What also comes out of the endless reports and studies is that, beyond the positive impacts on health and fighting poverty, pharmacare will save Canadians and businesses money. Universal, comprehensive and public pharmacare will reduce annual system-wide spending on prescription drugs by $5 billion through the negotiation of lower drug prices, increased generic substitution and use of biosimilars and other shifts in prescribing toward lower-cost therapies. It will stimulate our economy by reducing prescription drug costs for businesses and employees by $16.6 billion annually and reduce out-of-pocket costs for families by $6.4 billion, according to that same Hoskins report.
When we consider the average median household income in London—Fanshawe is under $60,000 a year, and $30,000 per individual per year, it is well below the Canadian and Ontario average and this would be a huge boost to people in my riding. I think of the many seniors in London—Fanshawe that I have talked to, either on their doorsteps or in my constituency office. They tell me about how the cost of everyday items continues to increase while their incomes remain the same. The cost of drugs continues to be the fastest-growing expense for people and for families. Average drug costs are increasing by 4% every year. On average, Canadian households spend $450 a year on prescription drugs and $550 on private health plan premiums, which is a combined average of $1,000. Private premiums have risen rapidly in recent years, thanks largely to escalating drug prices, and are taking a growing bite out of workers' take-home pay.
After decades of delay, we have a historic opportunity in this minority Parliament to finally deliver for Canadians. We can come together and deliver, lifting people up in a real way and at the same time creating a healthier Canada. It is time for this Parliament to have the courage to put forward this program, to strengthen our health care system, strengthen our economy and strengthen our communities.
View Jenica Atwin Profile
GP (NB)
View Jenica Atwin Profile
2020-03-11 18:30 [p.1968]
Madam Speaker, I am pleased to stand in the House today as a follow-up to my question on funding for a national framework for mental health. I would like to start today by sharing how mental health has impacted my journey here.
I began my career as an educator. One day, a 14-year-old student got into some trouble in class and was sent down to see me. As we talked, it became clear there was a lot going on. I was aware of some social struggles in the friend group and I knew a bit of family history.
Suddenly and unforgettably, this student for whom I cared deeply, said the words, “I do not want to live anymore.” The student had the means and the motivation to escape this painful experience. The weight of the suffering hung thick in the air. I did what any human would do under the circumstances. I did my best to stumble through the rest of the conversation with empathy, but I recognized very acutely that my colleagues and I were not equipped to navigate the complexities of these conversations with the youth who trusted us the most. I would spend many hours and resources finding the tools to tackle this crisis, and I wish many other Canadians would also have that opportunity.
I am acutely aware of the pain of suicide, as many of us are. We have all lost someone. a cousin, the child of a teammate, a co-worker, a friend, a grandmother. Research shows that approximately 90% of people who die by suicide suffer from mental illness or addiction. Suicide is the second leading cause of death among youth ages 15 to 24. Rates of suicide are three times higher for members of first nations communities than they are for non-indigenous people. Risk factors are directly linked to socio-economic characteristics, including household income, employment status, level of education and family support.
I have shared a story. I have shared the data. I would now like to look to the solution.
Canadian provinces and territories need financial support from the federal government to ensure they can address the mental health crisis impacting families and communities across the nation.
We need to invest in training for professionals across sectors, educators and everyday Canadians to access resources and learning opportunities to support those suffering from mental illness.
We need to invest in a timely diagnosis process. Service providers and families need access to early diagnosis to ensure early intervention.
We need to invest in a national pharmacare system. Canadians should never have the financial anxiety of needing to choose between buying groceries or life-saving medications.
We need to invest in support for sexual assault survivors. This is a massive missing link in this conversation.
We need to invest in support for elders, like intergenerational housing, to avoid isolation and loneliness.
That is why on February 26, I asked the Minister of Finance if the budget would include funding for a national framework on mental health so the provinces and territories could work together to find solutions to address this crisis. I look forward to hearing the response from the hon. member as to how we might come together to restore hope for Canadians across the country.
View Gudie Hutchings Profile
Lib. (NL)
View Gudie Hutchings Profile
2020-03-11 18:33 [p.1969]
Madam Speaker, I would like to thank the member first and foremost for sharing her story and for providing the House with this opportunity to speak about mental health.
According to Statistics Canada, one in three Canadians will be affected by a mental illness in their lifetime. Mental health is influenced by a number of factors, including life experience and social and economic conditions. Our government recognizes the need for a comprehensive approach to mental health, one that embraces promotion and prevention alongside treatment and recovery.
For this reason, we have worked with our partners and stakeholders to put in place community-based programs and initiatives that promote mental health and contribute to the prevention of mental illness.
Our government is also committed to increasing the availability of high-quality mental health services for all Canadians. Through budget 2017, we provided provinces and territories with $5 billion over 10 years to improve access to mental health and addiction services. These targeted investments will address specific gaps in the availability of mental health services, including those for children and youth.
Allow me to illustrate, through concrete examples, how these investments are expected to directly help Canadians suffering from mental illness.
With this funding, in my province of Newfoundland and Labrador we will add new community crisis houses to provide a safe place for people experiencing a mental health crisis. Several models will be explored for these beds, based on the emerging needs of each of the province's regional health authorities.
Quebec will improve accommodation and community retention services to provide psychiatric hospitalizations and reduce psychiatric ward stays.
The Northwest Territories will contract an itinerant private counselling team that will provide surge capacity assistance to individuals struggling with mental illness through timely crisis supports when local resources are either unavailable or overwhelmed.
Saskatchewan will establish residential options that include intensive supports for individuals with serious and persistent mental health issues.
With federal funds, Ontario has committed to develop and provide new services in supportive units, such as daily living supports and case management for those living with mental illness, those with addictions, and those who are at risk of becoming homeless.
In Ontario, as well as in New Brunswick, Prince Edward Island, and Nova Scotia, federal investments will also support other initiatives that integrate mental health and addictions services into supportive housing programs, justice services, and education settings, all of which will have a particular focus on youth.
To provide support for those struggling with suicidal thoughts, our government is also investing close to $3 million over five years to support the development of the Canada suicide prevention service through Crisis Services Canada. This service connects people in Canada to confidential 24/7 crisis support and resources through trained responders.
Finally, to promote child and youth mental health, our government is also investing $1.1 million in 2019-20, $4.7 million in 2020-21 and $4.9 million from 2021-22 and onwards through the mental health promotion innovation fund. The fund will support the development of new and promising interventions that aim to address the underlying determinants of mental health in children and young people throughout Canada.
To sum up, mental health is a priority for the federal government, and we will continue to work with all our partners to make improvements in this area.
View Jenica Atwin Profile
GP (NB)
View Jenica Atwin Profile
2020-03-11 18:37 [p.1970]
Madam Speaker, I thank the member for that really wonderful response. There are lots of great initiatives taking place in Canada. I feel we have come a very long way.
I do want to highlight that there are still some missing pieces. Mental health has long been recognized as a fundamental aspect of one's health; however, under our current health regime, the majority of mental health services do not meet the eligibility requirement of “medically necessary”.
I feel we need to have another look at this, and that is why I am asking for a national legislation framework. There is a patchwork of provincial and regional initiatives, but I feel we need a more unified approach. I am thinking of a story of a constituent who is searching for their son across provincial lines and is having a lot of difficulty because there is not a lot of collaboration and communication that occurs.
I am asking for a national strategy to be looked at and funded by the government.
View Gudie Hutchings Profile
Lib. (NL)
View Gudie Hutchings Profile
2020-03-11 18:38 [p.1970]
Madam Speaker, I know my hon. colleague is passionate about this issue and I encourage her to reach out and work with all the departments.
I am sure the member knows that the provinces determine where most of the federal money given to them goes. That is why we were so adamant in earmarking that money for mental health initiatives.
We are committed to a comprehensive approach to mental health, one that embraces promotion, prevention, treatment and recovery. We are investing in a range of culturally appropriate mental health initiatives and programs that take into account social, economic and environmental factors, such as income, housing and education. We are also working with our provincial and territorial partners to improve access to mental health services for Canadians.
As mentioned, through our commitment of $5 billion over 10 years in budget 2017, investments have been made in appropriate and cost-effective mental health services for Canadians. We will ensure that the provinces continue to do so.
The challenge of addressing mental health issues requires the combined efforts of all levels of government and many stakeholders, as well as all members in this House.
View John Williamson Profile
CPC (NB)
Madam Speaker, the national revenue minister brought in changes to the disability tax credit in 2017. The government said this was to improve accessibility.
Three years later, constituents from my riding with lifelong mental disabilities are still waiting for access. They are still denied eligibility even after providing legitimate medical documentation. One family was even forced to go to tax court before the government conceded that mental health issues are eligible.
When will the government stop discriminating against Canadians with mental health disabilities so they can receive this tax credit?
View Diane Lebouthillier Profile
Lib. (QC)
Madam Speaker, our government is introducing measures to help ensure the long-term financial security and independence of people with disabilities. In 2017, our government reinstated the disability advisory committee, which was dismantled by the Harper Conservatives in 2006. We thank the members of the committee for working hard to make recommendations to the Canada Revenue Agency concerning better support for people with disabilities. Our government is working on implementing most of the recommendations. The report released last spring will inform our future discussions.
View Arif Virani Profile
Lib. (ON)
View Arif Virani Profile
2020-02-27 10:38 [p.1652]
Mr. Speaker, I want to point out four matters and lower the tone a bit. We need to talk about facts as opposed to emotional arguments.
My first point is to clarify that depressed individuals are not subject to this regime. We have specifically included a carve out for mental illness as a sole condition.
My second point is that the data collection the member seeks is being beefed up by this very bill.
My third point is that hyperbole has entered into this debate about people being “killed right away”. The notion of having a written consent witnessed by an independent witness and then the eligibility being verified by two independent practitioners, and that occurring in a matter of minutes or hours, is categorically false. That is not the way the system currently operates.
My fourth point is that it is an absolute red herring to raise a case based in Holland, which as has advanced directives for ailments such as dementia. We do not have dementia within the penumbra of ailments subject to this regime. We are also not proposing advanced directives; we are proposing advanced consent.
The member has raised, in some instances, concerns about what he perceives to be patients who are suffering or doctors who are acting aggressively. Those are important cases. If the member has cases, he should have those cases brought to the attention of either disciplinary bodies, regulated physicians or to law enforcement, because those should be enforced.
In fact, what we have is evidence to the contrary, that doctors are not practising this overly aggressively. In fact, there is a small of pool of doctors that—
View Garnett Genuis Profile
CPC (AB)
Mr. Speaker, the member should know that the last legislation included a good faith exception, that a doctor who did not follow all the rules, but still acted in “good faith” would escape prosecution. Cases have been referred to disciplinary bodies, but there is a limited capacity to actually prosecute people who are, in the case, described as going into a nursing home and taking someone's life, without any consultation with the surrounding staff. These cases raise significant concern.
The member says that we should lower the tone and avoid hyperbole and then criticizes me for bringing up specific cases in Canada and in other countries that have similar legal regimes. The government should look at these cases and consider them before moving forward.
It is right to bring up the Dutch case, and I acknowledge the differences in the proposed regime in Canada from the Dutch regime. However, I pointed out very specifically that there was no requirement in the existing legislation for the person to be asked in the moment. I would beg the government to introduce that additional requirement for some contemporaneous consultation with the patients. After all, what does it have to lose? There very much is the possibility of someone being killed right away under the proposed legislation.
If the parliamentary secretary is so opposed to that characterization of the legislation, then why not leave in some waiting period? If he says that because of all the administrative requirements, inevitably there would be some delay, then leave the waiting period to consider—
View Patty Hajdu Profile
Lib. (ON)
Mr. Speaker, I am very pleased to rise in the House today to address Bill C-7 and to speak to our proposed changes to Canada's medical assistance in dying legislation.
The proposed measures respond to the Superior Court of Quebec's Truchon decision, in which it ruled that it is unconstitutional to deny access to medical assistance in dying to individuals who meet all the other eligibility criteria but are not near the end of life.
In responding to this ruling, the Government of Canada has had the opportunity to consider some additional measures for which there is strong support. That is why we are proposing changes that will help clarify and add precision to Canada's medical assistance in dying legislation.
Over the past few months, I have had the honour of listening to many Canadians, and it was important for me as the Minister of Health to hear first-hand what they had to say. My colleagues and I hosted a series of round tables and heard from more than 125 experts, academics, ethicists, doctors, nurse practitioners, members of the disability community, indigenous groups and key stakeholders. I also engaged my provincial and territorial colleagues, and my officials worked closely with their counterparts across the country.
In January, I was in Calgary and spoke to Cynthia Clark, who saw her husband through the process of medically assisted death last summer. Her perspective, as well as those of so many others with first-hand experience were invaluable.
I also listened to practitioners who have been providing medical assistance in death in a very thoughtful, compassionate way over the last four years. They had a lot to say about what was working well but also about what was not working well.
We heard many personal stories like Cynthia's, and they helped shape the changes that we are proposing today. In addition, the feedback received from our online consultation was astounding. In two weeks we had more than 300,000 responses.
It is clear that certain aspects could be improved in order to facilitate access, protect the vulnerable and respect personal choice.
With this bill, I think we have achieved a balanced approach that reflects the best interests of all Canadians.
Protecting the safety of vulnerable people while respecting the autonomy of Canadians remains our central objective. That is why the bill proposes a two-track approach to safeguards, based on whether or not a person's death is reasonably foreseeable.
Reasonable foreseeability of natural death would no longer be a requirement for determining whether a person can access medical assistance in dying. It would, however, be used to guide practitioners in determining which safeguards to apply. This is consistent with what we heard at the round table meetings.
Providers involved in assessing the eligibility of applicants for a medically assisted death told us they have a good understanding of the concept and are comfortable applying it. Under the amended law, they would use reasonable foreseeability of natural death to determine not eligibility, but rather which safeguards would apply.
For those whose death is reasonably foreseeable, we would ease some of the pre-existing safeguards. Under the current system, there is a requirement for a 10-day reflection period. We are proposing to eliminate this reflection period. For those who are at the end of their life, the decision to request medical assistance in dying is well considered, and this additional period only serves to prolong suffering unnecessarily.
The current system also requires that two independent witnesses confirm that the person who has signed a request for medical assistance in dying is who they claim to be and that no fraud has occurred, such as the forging of someone's signature. During our consultations, we heard that this requirement was a significant barrier for many people at the end of their life.
We propose requiring only one witness and allowing this witness to be a paid personal or health care provider. These individuals naturally would be excluded from acting as a witness if they are a beneficiary of the person's will or if they would receive a financial or material benefit from the person's death. Anyone involved in assessing or providing medical assistance in dying would continue to be ineligible to serve as a witness.
For those whose death is not reasonably foreseeable, we would create a new, more robust set of safeguards. We think it is important, even while improving access, to ensure that people who are suffering but who are not dying are given full and careful consideration as they assess whether or not to pursue an assisted death.
Strengthened safeguards would also serve to protect vulnerable individuals. For example, the bill proposes a minimum period of 90 days for assessing a MAID request in the case of a non-imminent death. This period would allow for exploration, discussion and consideration of options to alleviate suffering by the person seeking medical assistance in dying and with the practitioner.
The bill would also require that the person requesting MAID be provided with information on available counselling, mental health supports, disability supports and palliative care as part of the informed consent process.
We know that the majority of practitioners are already ensuring that their patients are aware of all of the supports and options that are available to them. This provision underscores the importance of the doctor-patient relationship. It allows for a practitioner and a patient to decide whether medical assistance in dying is the right step and provides sufficient time for the patient to discuss and consider other treatment options, which is crucial for patients weighing this kind of decision. This provision supports fully informed decision-making and individual autonomy.
Under the current legislation, those who become incapacitated lose their eligibility for medical assistance in dying because the person must give their consent immediately before the procedure. This means that some individuals deemed eligible for medical assistance in dying have chosen to end their lives earlier than they wanted out of fear of losing the opportunity to receive this service.
That is why we are proposing to include a waiver of final consent for persons whose death is reasonably foreseeable and who have been assessed and approved to receive medical assistance in dying. Individuals at the end of their life who risk losing their decision-making capacity before their chosen date would have an avenue to receive MAID without worrying that loss of their decision-making capacity before their chosen date would disqualify them. Support for this amendment is strong among stakeholders, Canadians and health practitioners.
Canada has had four years to reflect on the current MAID legislation passed in June 2016, and there are many complex issues that require further study.
In December of 2016, the Government of Canada asked the Council of Canadian Academies to conduct independent reviews on three specific types of requests for medical assistance in dying that are currently outside of the scope of the law: requests by mature minors, advance requests and requests where a mental disorder is the sole underlying medical condition.
The Council of Canadian Academies convened a multidisciplinary panel of 43 experts to review an extensive body of evidence, including Canadian and international academic and policy research.
We tabled those reports in Parliament in December 2018. They provide us with a thorough, thoughtful examination of these very difficult subjects. I encourage all members to read those reports as we continue our deliberations on the proposed legislative amendments and the parliamentary review that will be conducted later this year.
There is agreement among experts that allowing advance requests for people with illnesses such as Alzheimer's disease well before they would otherwise be deemed eligible is very complex and will require careful consideration and consultation before it could be included in legislation.
During the round tables I heard directly from health care providers who expressed discomfort because they have seen patients who, as their position progressed, might not have the same desire for medical assistance in dying as when they were first diagnosed. The Council of Canadian Academies' expert panel report on advance requests came to the same conclusion.
At the same time, we know that many Canadians have expressed an interest in advance requests so that they could have the comfort of knowing that they could avoid extreme suffering at some future date.
For all these reasons, we believe this issue deserves deeper examination through parliamentary review. That will be our opportunity to tackle questions that are profound and difficult to answer, even for practitioners who have been providing this service over the past four years.
The proposed changes to the medical assistance in dying legislation would exclude persons if mental illness is the sole underlying medical condition.
This does not mean that people with mental illness are ineligible; it means that mental illness cannot be the sole underlying condition. This is another complex aspect that warrants a more thorough discussion.
Since the federal legislation came into force in 2016, Health Canada has released four federal interim reports that provide more information on how the legislation is being implemented across the country.
In November 2018, we implemented regulations that resulted in the creation of a permanent monitoring regime that sets out obligations for reporting on medical assistance in dying cases by doctors, nurse practitioners and pharmacists. The first monitoring report under these regulations is expected to be released in spring 2020 .
Since MAID legislation was enacted in 2016, more than 13,000 Canadians have chosen this option of a medically assisted death. This is not unexpected. We have seen a gradual increase in the numbers over the last three years. The number of MAID deaths in Canada, slightly under 2% of all deaths, is in line with international regimes. The increasing use of MAID is largely a result of enhanced awareness of it as a legal option and greater acceptance by Canadians.
The federal government recognizes that public reporting is critical to ensuring transparency and also to ensuring public trust in the legislation. That is why we are proposing changes to expand data collection to help provide a more complete picture of medical assistance in dying in Canada.
Under the current legislation, only practitioners who receive a written request for MAID and pharmacists who dispense a MAID substance are required to provide information, but it has become clear that capturing information based solely on written requests for MAID received by physicians and nurse practitioners has resulted in an incomplete picture on who is requesting MAID across the country, and why.
The amended legislation would authorize new regulations to be developed in partnership with provinces and territories to allow for the collection of data on all assessments for MAID, and this would include those undertaken by other health professionals on the care team. It also clearly aligns with the original intent of the legislation to collect information on all requests for, and cases of, MAID in Canada.
I think we can agree that Canadians with life-limiting illnesses deserve the best quality of life possible as they approach the end of their lives. Palliative care and end-of-life care provide patients with relief from the pain and distress associated with a life-threatening illness. Supporting home care and palliative care is a key priority in our ongoing efforts to improve our health care system.
Through budget 2017, we made historic new investments in health care to improve access to mental health and addiction services, as well as home and community care, including palliative care.
To further support access to palliative care across the country, the government worked closely with provinces, territories, and stakeholders to develop the framework on palliative care in Canada, which we tabled in Parliament in 2018. We have released an action plan to support each of the priority areas identified in the framework.
I want to assure the House that the proposed bill responds to concerns identified by practitioners and experts through the round table discussions.
I will continue to work closely with the provinces, territories and key partners to support the implementation of the proposed legislative amendments, if they pass in Parliament.
This includes working with provinces, territories, health system partners and regulatory bodies to support best practices and information sharing on clinical guidance and other aspects of implementation, which includes training and retrospective reviews.
I have a great deal of respect for the practitioners who have been providing this service over the last four years with immense diligence and a huge amount of compassion. Their experiences have helped us craft legislation that much better meets the needs of Canadians. This law is constructed in a way that supports autonomy, but it includes the flexibility to allow a practitioner and a patient to work more closely together.
Medical assistance in dying is a complex and deeply personal issue. In tabling these changes, our government has considered carefully the need for personal autonomy and the protection of vulnerable people.
There is strong public support for change, and I believe we have found an approach that reflects the best interests of all Canadians. I urge all members of the House to support the proposed changes.
View Kyle Seeback Profile
CPC (ON)
View Kyle Seeback Profile
2020-02-27 11:09 [p.1657]
Mr. Speaker, the minister mentioned there are safeguards in place for the mentally ill or people who only suffer from mental health issues. What specific protections have been put in place? From my review, there is no requirement that an assessment by a psychiatrist be done on someone who might be experiencing, for example, severe depression.
View Patty Hajdu Profile
Lib. (ON)
Mr. Speaker, the proposed legislation excludes people whose sole condition is an underlying mental illness. That is because we still do not know enough about how a desire to receive medical assistance in dying might interact with a mental illness. This in no way negates the suffering felt by people who are struggling with mental illness. I have personally worked with people who have severe mental illness and I fully understand that their suffering can be immense. However, we know that, as part of the expression of a variety of different mental illnesses, the desire to end one's life is one of those components.
For that reason, we believe this is deserving of extra review through the parliamentary review scheduled in June.
View Kyle Seeback Profile
CPC (ON)
View Kyle Seeback Profile
2020-02-27 11:14 [p.1658]
Mr. Speaker, I am happy to stand today to add my voice to this debate. I think it is a particularly important debate. It is an important subject, and I think there are a lot of issues that need to be discussed.
I am going to confine my comments to issues I have with the bill, things I am concerned about, and my genuine belief that the government will take a very collaborative approach to this legislation. If we take a collaborative approach to this legislation, Canadians will have trust and faith that we developed legislation to actually address their needs and protect their concerns.
Speaking of concerns, I have a number of them. I will start off by talking about what I consider to be a significant lack of consultation.
This legislation will come up for review in June. It is the five-year mandated review of the legislation. My understanding is that the government has applied for a four-month extension with respect to the implementation of this legislation, which the Quebec court struck down.
If we have this four-month extension and have the mandated review of the legislation scheduled in June, what is the rush? Why have we rushed to introduce legislation prior to that mandatory review, which would, of course, be extensive and broad and far more in depth than any consultation that has been done with respect to the current legislation? My understanding is that there was only about two weeks of public consultation for this legislation. In my opinion, that is woefully deficient given the gravity of the topic we are discussing today.
This is my first real concern. What is the hurry? What is the rush? The court has given us more time to do this, and I believe we should be taking the time to go through the mandatory review and consult with Canadians, and then decide on the path forward. That is my number one concern.
I want to mention that I will be sharing my time with the member for Langley—Aldergrove. My thanks to the page for bringing that to my attention. She is doing an excellent job.
The next thing I want to talk about is palliative care. The minister has made comments in the House today espousing the great investments that are being made by the government in health care, but has not really talked about any specific investments with respect to palliative care. I think that is a critical thing to look at when we discuss this legislation. I want to remind the minister that Bill C-277, an act providing for the development of a framework on palliative care in Canada, was passed in the previous Parliament in 2017, and clearly states in the preamble:
Whereas the Final Report stated that a request for physician-assisted death cannot be truly voluntary if the option of proper palliative care is not available to alleviate a person’s suffering;
This was passed by Parliament, so if we are looking to expand the scope of medically assisted death without also expanding the availability of palliative care, we are doing an incredible disservice to Canadians, because the availability of palliative care in this country is poor at best. I am going to speak about this personally just for a moment.
Both of my parents suffered from terminal cancer. My mother was not able to get into a palliative care facility because there was no palliative care facility available for her, so she passed away in the hospital. My father was also not able to get into palliative care, but fortunately his illness was longer than my mother's, or unfortunately, depending on how one looks at it, and we were able to get private home care that eased his suffering and made sure he was being taken care of. However, there was no way that he was going to be able to get into palliative care within the scope of his illness.
This is affecting Canadians from coast to coast to coast, and the minister has rushed to introduce this bill. Why would the minister not have introduced corollary legislation, or legislation in tandem, or announced increases in funding for palliative care?
In my riding of Dufferin—Caledon, there is a fantastic hospice for palliative care. It is called Bethell Hospice. It only has approximately 15 beds. That is the palliative care option in my riding. For approximately 200,000 people, there are 15 palliative care beds.
Members can imagine that there is a significant number of people who are not able to get into palliative care. Therefore, the option of medically assisted death becomes far more attractive for someone who is not able to enter into a palliative care facility.
I will repeat that it is clearly a violation of legislation that was passed by the House. When people do not have the option for proper palliative care, their consent for a medically assisted death is significantly in question. I am extraordinarily concerned by the lack of any plan by the government to deal with investments in palliative care.
The minister has suggested that there are significant safeguards in place for people who suffer from any type of mental illness. However, I am not sure what those safeguards are. She suggested that just having that condition would exclude someone from obtaining a medically assisted death. What is the definition of that? How are we proving that is the only issue?
There is no requirement for individuals to go to a psychiatrist in order to assess that they are not suffering from a severe bout of depression. In my own life, I have gone through extraordinary stages and phases of depression during which I actually did not want to live anymore. I was not seeing a psychiatrist at the time. Would I have then been able to avail myself of these services while I was in a period of particular darkness? We know that mental health is an issue that is rampant throughout this country.
Again, I will go back to my first point, which is: Why are we rushing to do this? Why are we not taking the time to go through the five-year review? We need to take the time to find ways to make sure we are safeguarding all Canadians in providing them the option of medically assisted death, if they want it, but also ensuring that people who are choosing this, maybe because of a lack of palliative care, or maybe because of underlying mental health issues, are going to be protected.
These are some of the major concerns I have with respect to this piece of legislation.
Going back to the consultation, two weeks for online submissions with respect to concerns by Canadians is not anywhere near a sufficient amount of consultation. My understanding is that it was mostly online submissions. This is not a way to get the pulse of Canadians with respect to a very significant issue that is going on in this country. I will continue to ask why there was not a longer or broader consultation.
I know this matter will be studied at committee, but having been a member of Parliament now for going on five and a half years, I understand the extreme limitations at committee. We will often have a panel of six witnesses. Those six witnesses will each get their 10-minute statement, and then members of Parliament might get a six-minute intervention to try and raise an issue.
If one is going to suggest that a committee study will be far broader in scope, or somewhat more encompassing than the mandatory statutory five-year review, I will respectfully disagree with that submission.
Committees absolutely do great work, but they also suffer from an extreme pressure of legislation and time. To suggest that one or two weeks or three meetings at committee is sufficient time to analyze, debate and discuss this legislation, I do not think that is the correct answer. We should be putting this legislation off until we have the mandatory five-year review in June, which would allow us to have a far more expansive discussion with respect to all of the issues that are being discussed in the legislation.
These are my comments and concerns with respect to the legislation. I certainly hope the government will listen to these concerns, act collaboratively and co-operatively, and not try to drive this legislation through without listening to legitimate concerns that are being raised by members of the opposition.
View Luc Thériault Profile
BQ (QC)
View Luc Thériault Profile
2020-02-27 11:26 [p.1660]
Mr. Speaker, I would like to reassure my Conservative colleague.
A psychiatrist must absolutely conduct a mental health assessment of the person who is dying or suffering. Family doctors are able to prescribe antidepressants to treat depression. Sometimes, a doctor may have to tell a patient that there are no further treatments available and then refer that patient to palliative care to ease their suffering. If the patient immediately says that they want to access MAID, the doctor will prescribe antidepressants, because there are steps to go through long before a patient can access MAID.
I have a hard time understanding the problem my Conservative colleague sees, since the bill excludes mental illness.
Everyone thinks that pain relief in palliative care is common practice, regardless of whether the patient is receiving care. This is called a good medical practice. Relief is provided for pain. No terminal patient receiving good care that manages pain is forced to ask for medical assistance in dying. Patients who request it do so by choice. This choice is necessary, and for there to be a choice, there need to be options.
View Kyle Seeback Profile
CPC (ON)
View Kyle Seeback Profile
2020-02-27 11:27 [p.1660]
Mr. Speaker, I am not disputing that people should have options. That is certainly the whole point of the legislation. I am not arguing against that. What I am suggesting is that there are not sufficient safeguards in place, from my perspective.
While the member might say that going to see a family doctor to talk about depression is an excellent way to be treated for depression, I can say from my experience that it is absolutely not a good option. My family doctor and most family doctors are completely incapable of treating someone for depression. Yes, they might be able to prescribe a medication, but medication is not the answer to all depression.
My concern, and we are here to raise concerns, is that this is not properly addressed in this legislation. I do not believe there are proper safeguards in place. That is something we should be discussing here during debate, at committee and certainly in the five-year review that will take place in June.
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