Expanding MAID is not a solution to solvable mental health care issues

Speaker: Ms. May
Time: 13/02/2023 19:52:07
Context: Debate

Ms. Elizabeth May (Saanich—Gulf Islands, GP): Mr. Speaker, the thoughtful speech by the hon. member for Kitchener Centre anticipates much of what I would say.

We have not done enough in the year that we have had since Bill C-7 passed to know, with any degree of certainty, that we have moved up to our obligations when passing that act to fully study what it would mean to extend medical assistance in dying to those who are dealing with deep suffering that comes from a mental health issue, but not from a medical diagnosis of traditional medicines, such as ALS, cancer or the other cases that moved us forward on a trajectory.

I want to briefly canvass what brought us here in terms of the way in which the Parliament of Canada and the Supreme Court of Canada have dealt with medical assistance in dying and I want to suggest, in closing, that when one looks to the Supreme Court of Canada for guidance, I do not believe we can say that the Supreme Court of Canada’s guidance take us to the availability of MAID in cases of deep mental health distress.

Going way back, as the member of Parliament for Saanich—Gulf Islands, I want to reflect on one of the champions, heroes, one might even say a martyr on the issue of access to medical assistance in dying. I speak of Sue Rodriguez. She lived in North Saanich, in the electoral districts that I am honoured to represent. She had ALS. She famously said, “whose body is this? Who owns my life?” She went all the way to the Supreme Court of Canada back in 1993 in an effort to get access to the alleviation of suffering for a disease that would kill her. This was not in doubt. The Supreme Court of Canada, in 1993, denied her request.

As others have mentioned in this place over the last couple of days of discussion, a colleague and friend of many of us and a dear friend of mine, Svend Robinson, stayed with Sue Rodriguez when a doctor assisted her illegally and she took her own life, probably the first public case in Canada. The courts took a long time to change and that decision in 1993 was not changed until 2015 in the Carter case.

In the Carter case, the Supreme Court of Canada found, taking a different view of it, that the charter rights in section 7 to life, liberty and security of the person were violated by not allowing a person to make such a decision and having access to medical assistance in dying. The Carter case changed things by putting it squarely to the Parliament of Canada that it had to deal with this now.

I will quote from the Carter case. The Supreme Court of Canada said, “competent adults who seek such assistance as a result of a grievous and irremediable medical condition that causes enduring and intolerable suffering”. That was the basis for creating legal access to medical assistance in dying.

When Bill C-14 went through, I tried so hard. I put forward amendments saying we have to allow advance directives, that it is not right not to allow someone who knows that they are terminally ill and are facing incredible suffering, that it is their choice and they should be able to access medical assistance in dying with an advance directive. Back when Bill C-14 went through, my amendments were rejected in the House and similar amendments then were passed in the Senate, and we will all recall it came back here without accepting those amendments.

Bill C-7 repaired that, but opened the door to something entirely different. I do think it is entirely different to say that when people are suffering, incredible, intolerable suffering, due to a deep, chronic and unsolvable mental health condition, they should also have access to medical assistance in dying.

I will go back and say what the political promises were when we started down this road. I first want to address the medical conditions. When Bill C-14 was first debated, we had a lot of members in this place asking about palliative care and if people would choose medical assistance in dying if they had the option for palliative care. We heard many promises from the government benches that we would see increased funding for palliative care. That has not happened. That is one thing that concerns me greatly.

We have also heard, since we passed Bill C-7, that there would be more supports for mental health. That has not happened either.

What would we do if we were serious about making sure that every Canadian could exercise, fully, their rights, under section 7 of the charter, to life, liberty and security of the person?

At least, one would know that the health care system should be working well. I am pleased to see that the premiers accepted the federal offer today. I hope that the federal government will defend our public health care system with every ounce of its energy and make sure that the deals with the provinces are specific and tied to outcomes and results.

However, our health care system is in trouble. I was just talking to an incredible indigenous woman. I will not say her name. It was a private conversation. She is Cree. She lost a dear friend recently because that Cree dear friend could not get access to medical care in time to diagnose and treat her cancer. She leaves two small children behind.

The health care system in the country is not equal any more than the litany of deeply racist and distressing conditions in which the system works against justice for indigenous peoples. We all know it. In the context of the health care system, how can we not know it? We know it.

In terms of mental health care supports, we know it even more deeply, that the suicide rates among youth in this country are a huge source of concern. We know that mental health issues have been worsened among our youth, through the pandemic, through isolation, through all kinds of things, through being preyed on by social media.

We know that our schools, universities and post-graduate programs are failing young people because they cannot get the mental health supports that they need when they need them. They need help to avoid addictions and to kick addictions. Our young people need so much help and we are failing them.

Opening up MAID is not a solution to solvable mental health care issues where we are just falling down on the job because we are not providing the mental health supports that we have promised over the years.

What would we do if we wanted to be serious about section 7 rights? We would bring in a guaranteed livable income, to ensure that no Canadian is living in poverty, poverty being the number-one social determinant of ill health, in terms of physical health and mental health. We address poverty and end it through guaranteed livable income.

We could do more, as I mentioned, for the end-of-life issues, access to palliative care. There is such a thing as having a good death. We do not like talking about death in our society. We are all supposed to be young and preferably sexy forever. Let us face it: people get old and it is a lovely experience. It is a good thing to be healthy in old age and enjoy it right up to the moment when it is whatever one thinks is going to happen to oneself, meet one’s makers or feed the worms, whatever. A good death is a good thing.

Medical assistance in dying does give people that option of a good death, surrounded by family, feeling loved. I am very supportive of the work that we have done in Bill C-14 and half of what we did in Bill C-7, but where are the mental health supports?

Again, to the point that the hon. member for Timmins—James Bay made, I totally agree. Yes, housing. Yes, supports. Yes, ending poverty.

However, I do think that we have to explore and open up. In the next year, let us get serious at looking at non-traditional therapies for people dealing with what appears to be irremediable depression. Do psychedelics make a difference? I am not going to prescribe. As the hon. member for Timmins—James Bay said, do not take health advice from politicians.

However, the evidence is coming in on using such products as psilocybin to actually trigger something that results not just in a bit less suffering and mental health conditions. There are certainly papers out there that are peer-reviewed and very interesting, that one can cure depression. I certainly would not want to turn my back on a potential cure and then embrace medical assistance in dying for people who could be cured.

Neither do I want to turn my back on people who are suffering and saying that we are making them wait another year and asking why we are doing that. These are not easy issues but these issues, life and death issues, are at the heart of the sacred and they are at the heart of our work in Parliament.