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Bill C-7 (Medical Assistance in Dying) - Motion in Amendment

Hon. Tony Dean: Honourable senators, I support the government’s message, which is responsive to Senator Kutcher’s amendment on mental health, albeit with a longer 24-month phase-in period. The longer timeline continues the government’s cautious approach in responding to the Supreme Court’s landmark 2015 decision.

I’m also, of course, delighted to see Senator Jaffer’s proposal on expanded data collection in the message.

I’m comfortable with the government’s proposal to establish an independent expert committee to consider protocols and safeguards associated with mental health applications. I’m also glad to see that the committee will focus on finding a balance between constitutional rights and associated safeguards that the Supreme Court talked about in 2015.

This has been one of the central themes in our debates in the past weeks. In this respect, I’m pleased that this independent committee will be focusing on how and not whether.

The Supreme Court ruled in 2015 that the criminal law must permit some form of physician-assisted dying, and it held that the task of crafting an appropriate response was one for Parliament.

The court stated that there was a need for “a carefully-designed system imposing stringent limits” to protect vulnerable individuals, and that such complex regulatory regimes are better crafted by Parliament than the courts. That’s what we’ve been doing here.

It recognized Parliament’s difficult task of balancing the competing interests of those who would seek access to physician-assisted dying and of those who may be put at risk by its legalization.

Colleagues, we’ve been finding out just how difficult that task is.

Having spoken with psychiatrists who are also MAID assessors and who have been working for some time on the sort of protocols that would be necessary for mental health assessments, I was already content that a very strict and cautious approach would be taken in assessing mental health applicants for MAID, which, of course, would be in addition to the requirement to meet the test of a grievous and irremediable medical condition or a serious and incurable illness, disease or a disability and enduring physical or psychological suffering that is intolerable to them. Having these matters considered by an independent expert committee will add further due diligence in finding the right balance between rights and safeguards.

Colleagues, psychiatrists with expertise in medical ethics who have experience with MAID assessments have already suggested that as the profession eases into this, mental health assessments would lean toward long-term or even lifelong suffering alongside the other tough criteria in the MAID regime. This could result in a small number of applications being approved annually, and that is, perhaps, as it should be.

I also join with other senators here in applauding the government’s acceptance of the proposal for a joint parliamentary review of the Criminal Code as it relates to MAID, which will also consider mental illness together with the issue of mature minors, advance requests, the state of palliative care in Canada and protections for people with disabilities.

Colleagues, this parliamentary committee, like the independent expert committee, will focus, among other things, on the appropriate safeguards that should accompany access to MAID.

In this respect, the proposed committee is as responsive to concerns raised by representatives of the disability community as it is by advocates for the sort of advance requests proposed by Senator Wallin in her amendment, which is, unfortunately, absent from the message.

I commend Minister Lametti and his office and officials for their openness to hearing our best advice. I thank the bill’s sponsor again, Senator Petitclerc, and its critic, Senator Carignan, both of whom spoke forcefully on this legislation. As well, we saw Senator Jaffer’s superb job in chairing the Legal and Constitutional Affairs Committee’s careful review of the bill with the help of scores of witnesses representing every possible viewpoint.

I’m grateful to these senators and to all senators who have contributed to our debates, especially those that were on their own assessment of the issues as opposed to along party and group lines.

Congratulations and thanks as well to Senator Kutcher, whose job was not easy in advancing what he truly believed in, but he stayed the course. We have all to some extent been rewarded for that as would those people who would seek, from their mental health perspective, to make applications for MAID.

Honourable colleagues, we fulfilled our responsibilities to uphold the Constitution as well as considering the safeguards which are sometimes required alongside important rights. We’ve done this in a deliberate, planned and timetabled fashion, with organized debates that have made our discussions accessible to Canadians, just as some of you did in considering Bill C-14 in 2015 and cannabis reform in 2017 and 2018.

We need more of this planning and organization if we’re going to meet the expectations of Canadians. Participating in these organized debates has been a privilege, but this privilege could and should be a daily one and a daily practice, so let’s learn from this.

Colleagues, I support the message. It is reasonable and it reflects important amendments from the Senate, which will enhance the efforts in finding the right balance between important rights and necessary safeguards. Thank you.