Thank you, Madam Chair.
It's interesting to hear people, different members, giving their opinions. I suppose we're all entitled to our opinions. I would hope all of our opinions are informed opinions.
When we're talking about palliative care, which this amendment does, I think it's important to listen to what palliative care doctors have to say. We received a submission—or at least I did, and I'm assuming other members did—from the Canadian Society of Palliative Care Physicians. I just want to draw the members' attention to one of their significant points. It's their first point. They gave our committee several recommendations, and their recommendations help inform, I think, a number of the amendments we're going to deal with.
In particular, on this amendment, their point is that:
Time is often necessary to ensure careful assessment of an illness, proper diagnosis, impeccable symptom management, and appropriate monitoring of treatment interventions that can provide benefit to a person facing a new illness or situation.
We've heard this many times. They continue:
When a new and often complex reality is being faced, an individual may normally experience an existential crisis and question the meaning and value of their life. With time and support, a person can come to a new sense of normal and find meaning in their circumstance.
Now this is the relevant point, Madam Chair. They say:
This may take many months or even years for some people.
Under the provisions of Bill C-7, for the first time ever, Canadians whose death is not reasonably foreseeable can now access assisted dying. What these palliative care doctors are pointing out is that:
Any professional assessing a patient’s request for MAiD must have access to appropriate consultative support for that patient according to their need.
That means the patient's need, and we have, or we should have, a patient-centric system. They continue:
This may include palliative care, psychiatry, chronic pain specialists...physiatry, spiritual care, and services to support people dealing with mental health issues, substance use disorders, disabilities, as well as physical and social isolation.
We're hearing more and more about isolation in the context of COVID right now. They continue:
This would ensure all reasonable treatment options have been provided to manage physical, psychological, social, spiritual, and emotional suffering.
Here is the relevant point. They say:
Simply having information about the available treatment options is not enough; people need the lived experience of care to make an informed decision.
I'm going to repeat that because it is the exact point of Mr. Manly's amendment. Mr. Manly's amendment is directly on point to what we're hearing. Is it from some random person on the street? No, it's from palliative care doctors, people who deal every day with Canadians who are in this situation. How often, when we see an obituary in the newspaper, do we see that it thanks palliative care doctors for the care they got, no matter what hospital they may have been in? What they say, for emphasis, is that simply having information about the available treatment is not enough. They need the lived experience to make an informed decision.
They say that under the two-track system that we now have, the 90-day assessment period, which we'll get to later with another amendment, may:
...not provide sufficient time for a person to receive appropriate palliative care or other supports needed to reduce suffering and live with dignity. Instead, they may feel that a premature death via MAiD is the only option. This may also lead to people “requesting MAiD” to jump the queue to access these needed services.
We're a big, diverse country. We're dealing with, certainly, a topic that we have varied opinions on. I'm hopeful that what unites us as a committee is a desire to protect vulnerable Canadians.
The people who deal with people in their most vulnerable state are palliative care doctors, the specialists who are informing this committee that they do not think it's enough to mention to somebody, or to hand them a brochure, about what may be available to them. They think it's important that we actually have engagement with a specialist.
Even the government saw the wisdom of this, for those on the second track where death is not reasonably foreseeable, requiring that one of the two doctors making an assessment be someone who has a speciality in the individual's condition. When a person is nearing an end-of-life situation or when a person is looking for what options they have, it's having that consultation with a palliative care specialist so they can tell the individual what services can be offered, in a real consultation.
We're talking about life and death. We heard it over and over. It's not a true choice unless the patient is informed in a fulsome way of all of their options.