Speech on Medical Assistance in Dying (February 26, 2024)

I thank Senator Kutcher for his work and for his remarks.

Honourable senators, the government’s decision to delay puts politics ahead of people, and it has devastating consequences for all those who have worked to see the law recognized and respected and assured for all Canadians. It is heartbreaking for those who face a life of mental illness.

This was, I will remind you, a government commitment. Making those with mental illness as a sole underlying condition was your priority. The government chose that over and above, for example, the issue of advanced requests. I’m still fighting for that. The government said this was its priority and gave hope to all those waiting. Then it delayed a year. And now in spite of facts and evidence to the contrary, you have delayed until after the next election.

The undermining of the joint committee process allowed the whole issue of MAID to be reopened, not just the question of mental illness. Now we are once again relitigating MAID in the public sphere because the government could not muster the courage of its convictions on this particular issue, nor could it take the advice of those who have studied this and who have concluded there is a state of readiness.

In a democracy, people are elected to make the hard decisions, not the easy ones. Anybody can do that. And if the government thinks by putting this off that you will be able to lay blame for backsliding at the opposition’s door, I think you are mistaken.

The Conservatives have long stated their disagreement with this, and we can all read the polls. The Conservatives have a reasonable chance of forming a government, so we know that means refighting this battle repeatedly. It was the government that lost its nerve and now tries to shift blame. This puts politics above life and death and the suffering of ill Canadians.

I disagree with the position of the official opposition, but at least they have been consistent in reflecting religious or moral concern, and they vote their conscience. The government has done a one-eighty. It looks political because it is. It was a government minister who said this will be put off until after the next election, and when you play with people’s lives, people, families and professionals will remember the consequences.

For me, the issue of MAID is and has always been about choice. It was for the Supreme Court of Canada, as well, when they ruled, and for the government when they made it the law of the land.

Choice — it’s all anybody asked for. The government says it believes in choice for abortion, gender or contraception, but what about choice for end-of-life care? And why will choice be denied just for certain groups?

The “better safe than sorry” argument was the debate three or four years ago before we had the training, standards, practitioners and experience with MAID provision, before MAID providers and medical experts declared readiness.

Of course, next week, next month, next year, more doctors and nurses will join those who have been trained and accredited, and the numbers will grow, but to say because only 40 are ready today that we can’t go ahead, well, that is specious. We don’t have enough doctors, oncologists, nurses or surgeons for dozens of procedures, but we don’t deny care until everyone has access. It has never been how the medical system operates.

We are told repeatedly by Senator Gold that The Centre for Addiction and Mental Health, or CAMH, wants clinical standards. What most Canadians want is a CAMH facility in every city and province, but we don’t have that. That doesn’t mean we don’t treat the mentally ill, it means we do the best we can with the resources and facilities available. We cannot let perfection or equity be the enemy of common sense. Let’s do what we can now for those in need now.

But the arguments for the delays are still ill-conceived and more about politics than life struggles facing our citizens. The government says it agrees that mental illness is equivalent to physical illness, but it then proceeds to argue that those with mental illness — or even dementia or Alzheimer’s — must be denied the right to access MAID. It is the law of the land. Because some have yet to be defined as ready doesn’t mean we will deny readiness for all.

We are living and experiencing a health care system in crisis, and we do not have enough of anybody or anything, but we do not deny treatment until that problem is solved.

The provinces and health ministers’ job is to fund and safeguard our health care system, but not to judge or overrule the daily decision making of medical professionals who have direct patient experience and training needed to make safe judgments about medical procedures.

The readiness or preparedness criteria was met according to the experts the government appointed and who testified at the joint committee, and now once again the bar has been moved. What is the new bar? What are the new criteria that the government is adding to the list of four we were all asked to evaluate?

The government is unable to explain what would constitute readiness other than to say health ministers have to agree. Well, on no other file does this government seek unanimity from provinces before proceeding with the policy — energy; carbon taxes; even actual funding for health care. In fact, when governments embraced MAID, they most certainly did not have the backing of all provinces, health ministers, medical professionals or doctors.

As for the undue haste in passing the bill to delay the deadline of March 17, the government clearly, in advance, understood that time might be needed for proper debate. They have written right into the bill that should it not be finally passed by March 17, it will apply retroactively so there can be no accidental provisions of MAID. To be frank, no doctor in his or her right mind will provide MAID while it is still subject to the Criminal Code or retroactively subject to the Criminal Code, and, of course, there is the further 90-day waiting period as part of the assessment process.

Why sow this fear among the public so gratuitously? Here in this chamber, on the evening of the Committee of the Whole, we witnessed exactly why all bills should be subject to the rigorous standard of Senate standing committees and not this process.

The ministers, political creatures that they are and must be, treat it like a press conference with annoying reporters asking questions. Many senators had no chance to follow up their questions or press for substantive answers. I was one of the lucky ones, so when talking points were served up as answers, I, at least, had a brief chance to drill down. That is why our committee process works and why the Committee of the Whole works for them, but not for us.

I will give the ministers this: They are both new to their jobs and may have not had time to understand the level of debate that has occurred in this country. Yes, it is a nuanced debate. But it is a time now where we have moved well beyond that in this country. The public is ready. The system is ready. Only the government is not ready.

We have built high fences to ensure safety in the provision of MAID. It offers reassurance for families, and it offers protection for the individuals.

This delay — the denial of rights for some and the deliberate misrepresentation by government ministers of the state of readiness, and of the evidence and testimony heard — is truly troubling. I know this to be true because I sat through the testimony. Witnesses were questioned directly and repeatedly. These witnesses were people like Dr. Mona Gupta, the Chair of the Expert Panel on MAID and Mental Illness, who — among others — has been directly involved in the process of developing the regulations and guidelines for MAID assessors and providers. You may have seen the letter she sent to all of us.

As others have mentioned, this is also a sad fact, and part of this debate, that not one individual suffering from a mental disorder or who has been waiting to exercise their right to simply apply for MAID was consulted.

The government ignores those whose lives hang in the balance. It ignores the testimony of its own chosen experts and then tries to argue it was a lack of consensus on the issue. There will never be a consensus on issues that are so personal. But, then again, no consensus was sought. We were looking for a state of readiness, preparedness, and we were told by the providers that the system was ready.

All I can say to you tonight, colleagues, is please go back and read the letter sent on February 12, 2024, from 127 medical professionals. It says in their concluding paragraph:

We urge the Senate to review all of the evidence submitted to AMAD by the people actually involved in getting the Canadian MAiD system and healthcare professionals ready . . . to understand that there are many clinicians who support the implementation . . . .

It’s too late for to Senate because our process has been overridden, but I ask you all, as individuals, to take a moment to read the testimony and hear the advice of the professionals. Do it for the sake of the Canadians who live with mental illness every day of their lives.

Thank you.