Francis Scarpaleggia
Francis Scarpaleggia
Member of Parliament for Lac-Saint-Louis
Speech : MAID in cases of serious mental illness
February 15, 2024

Mr. Speaker, I am rising for the second time this week to speak to this issue. As I said at the beginning of my speech at second reading, I was so interested in this issue that I offered to sit on the Special Joint Committee on Medical Assistance in Dying when it dealt with the question of mental illness. I felt it was my duty to take part in a debate that is so important for our society. This is a crucial and extremely complex social debate. As a legislator, I wanted to learn more about this hot-button public policy issue that is so important to my constituents. Many of them have written to me about this.

I attended much of the debate on the issue this week, and I was very impressed by the tone. It is true that emotions can sometimes get the better of us, but that is to be expected when we are debating such a crucial matter, a matter of life and death. I must say that I was impressed that the debate was conducted in a respectful manner. That is impressive, and we should adopt that same tone when we discuss the many other issues addressed here in the House.

I heard arguments that I do not want to call fallacious, because that is a pejorative term and I do not want to criticize anyone, but let us just say that I heard a few contradictions during certain speeches.

First, someone claimed that we could have simply amended Bill C-62 to include advance requests. I do not think we are ready to make a hasty amendment to open the door to something as complex—if not more—as medical assistance in dying, namely, medical assistance in dying for persons with a mental illness. It took much effort, much debate, much discussion and several committee meetings for us to be able to talk about medical assistance in dying for patients with a mental illness.

Moreover, the idea that we can move an amendment in committee is wrong, because such an amendment would certainly be ruled out of order, since the scope of the bill is not that broad. The bill deals with a specific question, namely, medical assistance in dying for persons with a mental illness.

People claim we are taking too much time to debate this issue, that it has already been three years and that we should end the debate. We are not talking about policies like affordability or the need to build housing as quickly as possible. We are talking about something very serious. We really are going beyond the more practical issues, and I think it will take the time it takes because there is no consensus among the experts. If there is no consensus, we cannot force the issue, suddenly demand consensus and insist we move forward because time is running out. The issue of how long it will take to reach a good conclusion is unfortunately not a problem for me.

As I was saying, this is not simply a technical medical issue, it is a moral and ethical issue for society, certainly.

The matter of caution was also raised. Some claim that the government is too cautious, too timid, on this issue, that it is not acting as quickly as people would like, that it has not addressed the issue fast enough or lacks political will. It does in fact lack political will because there are too many uncertainties. In this case, it is not a bad thing to lack political will in order to forge ahead as soon as possible.

However, on this idea of being too cautious, I would say that this is true even for the Bloc Québécois, because it has accepted the framework we have established. For the moment, we are not implementing this framework. Nevertheless, under the framework, not everyone who requests medical assistance in dying on the grounds of a mental illness will receive it. We are talking about a mere 5% acceptance rate. Even if we went ahead, we would do so with a lot of caution, given the 95% of people who would request medical assistance in dying on those grounds.

We should then not talk as if caution were not an issue. Caution is an issue, even if we agree to move forward. I would like to ask my colleagues who keep disparaging the government for its caution whether it would be too cautious to require that, in these cases, a psychiatrist be involved in assessing the person’s request. Right now, it is not necessary for a psychiatrist to be involved in the assessment. In the Netherlands, where medical assistance in dying is legal, a psychiatrist must give an opinion on the request. There is caution built into the process, but it is not unreasonable. I would say that my colleagues in the Bloc Québécois agree that some caution is required.

There is also talk about freedom. Some say that this is a matter of freedom, as if they were talking about absolute freedom. It is not a matter of absolute freedom, because 95% of those requesting medical assistance in dying would not have access to it on the grounds of a mental illness. We need to make things clear and add nuance to this debate to avoid giving the impression we are talking about absolute concepts.

Then they bring up the issue of the Quebec nation. I listened carefully to my friend, the hon. member from Joliette, with whom I enjoyed working on election reform. He is a seasoned parliamentarian who makes excellent speeches in the House. He said that there were many nations in Canada. Indeed, there is the Quebec nation, but there are also indigenous nations. There are indigenous nations within the Quebec nation as well. What I understand is that indigenous nations are not too keen to move this issue forward at this time. They say that they have not been consulted enough. They have concerns about the systemic racism that exists in health care systems across the country. Among other things, they are afraid that not enough thought will be put into processing the requests.

We should not focus too much on the idea of community when it comes to medical assistance in dying. When people get to that point, when they are on their death bed, I do not think they dwell too much on the community. Each person is a soul facing infinity alone. That is why we should not talk too much about nations when we are discussing medical assistance in dying. It is not a matter of being part of a community. I agree that it is a matter of individual rights. That is where it gets complicated, because we do not want people to suffer.

However, we do not want people to do things that have not been assessed with the utmost caution, because it is a matter of life and death.

I will stop here and await my colleagues’ questions.

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