Wednesday, May 24, 2023

Hon. Ed Fast MP speaks on euthanasia for mental health in Canada's parliament

Hon. Ed Fast MP
Hon. Ed Fast (Abbotsford, CPC) 


Moved that Bill C-314, an act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

For further information about the Bill C-314 debate in parliament (Article Link).

*Sign our petition supporting Bill C314 (Petition Link).

Hon. Ed Fast MP: 

Mr. Speaker, I am pleased to speak to my private member's bill, Bill C-314, the mental health protection act.

In its very essence, this bill is about reaffirming the dignity and worth of each and every human life. It is about recognizing that it is the most vulnerable among us, the disabled and the mentally ill, to whom we owe the greatest duty: to defend and protect their lives and to provide them with every possible opportunity to live life to the fullest.

Medically assisted suicide was legalized in Canada in 2015 by the Supreme Court's Carter decision and later under the Liberal government's Bill C-14. Under this legislation, medical assistance in dying, or MAID, as it is commonly called, was strictly limited to those consenting adults who had an incurable disease that caused enduring, intolerable suffering that could not be alleviated, and where natural death was reasonably foreseeable, which they call the foreseeability test.

At the time, the government and its supportive stakeholders assured Canadians that this was not a slippery slope, where the scope of MAID would continually be expanded to include more and more vulnerable Canadians. However, not surprisingly, in the intervening eight years since the Carter decision, the government has begun to expand Canada's MAID regime to include more and more defenceless Canadians, most particularly those living with disabilities.

In late 2019, a Quebec lower court judge in the Truchon case ruled that the foreseeability test I just mentioned was unconstitutional, requiring Parliament to respond with additional legislation. Sadly, the Liberal government chose not to appeal the Truchon case to the Supreme Court of Canada, presumably because the decision lined up with the Prime Minister's intent to dramatically expand assisted suicide to other vulnerable Canadians. This leaves us with the perverse situation in which the Supreme Court of Canada, the highest court in the country, has never been allowed to opine on whether the reasonable foreseeability test is constitutional.

In any event, the Liberal government responded to Truchon by tabling Bill C-7, which initially eliminated the foreseeability test but expressly excluded mentally ill persons from being caught up in its MAID regime. Here is what the justice minister said at the time:

The fact that there would be risk of ending the life of a person whose symptoms would have improved...is, in part, why we are of the view that it is safest not to permit MAID on the sole basis of mental illness.... There is also ongoing uncertainty and disagreement as to the potential impact on suicide prevention if MAID were made available to this group.

He went on to say:
...there is no consensus among experts on whether and how to proceed with MAID on the basis of mental illness alone. On a question of such importance and with so much uncertainty and expert disagreement, it is incumbent upon us to proceed with caution and prudence.
Those were our justice minister’s views until the unelected Senate suddenly introduced an amendment that expanded MAID to those Canadians whose sole underlying condition is mental illness. Sadly, the justice minister and the government accepted the amendment without protest and, overnight, became zealous proponents of assisted death for the mentally ill. What happened to the caution and prudence the minister was preaching? What about the impact on suicide prevention the minister was so concerned about? What happened to his view that it was safest not to permit MAID on the sole basis of mental illness?

I agree with the Minister of Justice on one thing, which is that, as he has said, this is indeed a complex issue and is deeply personal. It is deeply personal because it involves life, a precious human life.

I would remind the minister and his government that the issue is also profoundly simple; that is, the principle that all life, all human life is precious and worthy of defence and protection, especially for those who do not have the ability to speak for themselves and have no one to speak for them.

One of the primary functions of government is to protect its citizens, to protect life. In fact, the right to life is expressly enshrined in section 7 of our Charter of Rights. Sadly, the government's Bill C-7 fails to protect the lives of our most vulnerable. It removes the critical safeguards that the original euthanasia legislation included in response to the Carter decision. Removing those safeguards will have irreversible consequences for those who suffer from mental illnesses like depression.

What is equally disturbing is that the Liberal government has also signalled its intention to extend the so-called “treatment option” to minor children. That would arguably make Canada the most expansive, most liberal, assisted suicide jurisdiction in the world. Clearly we are on the slippery slope many of us warned about. Canadians have a right to conclude that the Liberal government has gone too far and too fast in its zeal to implement and expand the scope of assisted death.

My bill will reverse this momentum and repeal the government's decision to extend MAID to the mentally ill. It will put a full stop to the expansion of assisted suicide to mentally disordered persons. Let me be clear. My bill does not in any way reverse the rest of Canada’s MAID regime. Assisted death will remain available for those suffering from irremediable, incurable and intolerable illnesses and diseases. My bill is simply focused on reversing the government’s actions in expanding assisted suicide to include the mentally ill. It would arrest Canada’s slide into normalizing assisted death as an alternative treatment option, something so many of us had predicted would happen.

The evidence from mental health experts is very clear. Contrary to what our justice minister is now saying, there is absolutely no consensus in Canada that the mentally ill should be covered by Canada’s medically assisted death regime. In fact, here is what experts and other stakeholders in the mental health community are saying. John Maher, psychiatrist with Canadian Mental Health Association, states that:
Inducement to suicide while simultaneously denying mental health care to two-thirds of Canadians who urgently need it is an unconscionable failing.

Directly undermining suicide prevention efforts is an insidious and ablest perversion of our mental health care duty.
Dr Ramona Coelho
Drs. Ramona Coelho and Catherine Ferrier, co-founders of Physicians Together with Vulnerable Canadian, penned a statement that was endorsed by over 1,000 physicians. This is part of what it said, 
“Given that there is no medical evidence to reliably predict which patients with a mental illness will not get better, MAID for mental illness will end the lives of patients who would have recovered…Medicine …would fail in its mission if it were to deliberately end the lives of patients living with mental illness… Legislators must work towards safeguarding the lives of the most vulnerable including those placed at a greater disadvantage because of mental illness.”
Dr Sonu Gaind
Dr. Sonu Gaind, chief of the Department of Psychiatry at Sunnybrook Hospital, Toronto, stated, 
“The Ministers have provided false reassurances that we can somehow separate people who are suicidal from those who are seeking psychiatric euthanasia. That is simply not true. In my opinion, that is dangerous misinformation coming from our federal Minister of Justice and our federal Minister of Mental Health and Addictions providing a false sense of safety that does not exist.”
Trudo Lemmens
Trudo Lemmens, professor and chair in health law at the University of Toronto, said, 
“I urge Parliament to take very seriously how offering MAID for mental illness deprives disabled persons, particularly those with mental illness, from equal protection against premature death. Persons experiencing mental illness deserve to be protected against premature death by an unreserved focus on ensuring access to all required health care and social support services. Facilitating their death does exactly the opposite.”
Sephora Tang
Finally, Sephora Tang, psychiatrist and assistant professor in the Department of Psychiatry at University of Ottawa, said, 
“One cannot prevent suicide while at the same time facilitating it. Placing expectations upon mental health professionals to do both undermines the effective delivery of recovery-oriented mental health care. Canadians deserve to live in a country that is committed to safeguarding the right to life and security of every person. Current MAID legislation fails to achieve this overarching social good.”
Even Canada's justice minister has publicly acknowledged the fact that issues such as irremediability, competency and suicidality are not anywhere close to being resolved to justify such a major policy shift in favour of death. Furthermore, medically assisted death flies in the face of the government’s own promotion of suicide prevention programs, including the recent creation of a national 988 suicide hotline.

It cannot be both ways. It cannot claim, as the Liberal government has, that it wants to prevent suicide deaths on the one hand, when it actively promotes assisted suicide for the mentally ill on the other. Over the last eight years, many of us have expressed our concern and expectation that the Carter decision and Bill C-14 would be expanded by future court decisions, and that these decisions would leave more and more vulnerable populations exposed to the reach of medically assisted suicide.

Our concerns were pooh-poohed. We were accused of fearmongering and of misrepresenting the intentions of this Liberal government. Yet, today, the Truchon decision and the travesty of Bill C-7 bear out our concerns. That is why more and more disability groups have set the alarm bells ringing and are vehemently opposing this legislation. They argue that this legislation amounts to a deadly form of discrimination, making it easier for persons with disabilities to die than to live.

We are hearing more and more reports of the poor and homeless approaching food banks to ask for assisted death, not because they are suffering from a grievous illness but because they do not want to go hungry and homeless. The headline in the British magazine The Spectator asked last year, “Why is Canada euthanising the poor?”

The response from some bioethicists appears to be, “Well, why not?” In fact, a new paper by two bioethicists at the University of Toronto makes the case that euthanizing the poor should be socially acceptable. That is indicative of the path on which our country finds itself. It is terrifying.

We also have verified reports of veterans suffering from PTSD who are being counselled by the Liberal government to consider medical assistance in dying rather than being provided with the treatment and supports they need to recover.
These are the vulnerable that the Liberal government promised to protect. Canadians have the right to ask whether this government is exercising the requisite caution and care to avoid unnecessary overreach and ensure that MAID is not abused or misapplied.

Let me conclude. My private member's bill, Bill C-314 gives all of us parliamentarians an opportunity to take a deep breath and reconsider the perilous road we have embarked upon. As I mentioned, my bill simply reverses the expansion of Canada’s assisted death laws to the mentally ill. At the very least, I would ask my colleagues to allow my bill, at second reading, to go to committee where there could be more discussion.

Have we gone too far and too fast with Canada's assisted suicide program? Will we evolve into a culture of death as the preferred option for those who suffer from mental illness or will we choose life?

I implore my colleagues to choose life. I wish them much wisdom as they make that choice.

1 comment:

Concerned American said...

LIFE is a Gift from GOD! PLEASE! Do NOT misuse government power to abuse it!