Put the brakes on allowing Medical Assistance in Dying for those with mental illness

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by Harvey Max Chochinov

It’s time to put the brakes on Medical Assistance in Dying (MAiD) in Canada for those whose sole underlying medical condition is mental illness.

The federal government has tasked the Special Joint Committee on Medical Assistance in Dying to determine if Canada is ready to extend MAiD eligibility, starting in March 2024, to patients with mental illness alone. Despite those convinced it is time, and safe, to launch what amounts to ‘psychiatric euthanasia,’ the Special Committee must pay attention to a murmur of protest that has grown to a roar: “Ottawa, we’ve got a problem.”

There are two main reasons to abort this mission. Current MAiD eligibility requires a person have a grievous and irremediable medical condition. Unlike some cancers, and many neurodegenerative disorders, no mental disorder can be described as irremediable. To be sure, there are individuals whose mental affliction won’t improve, despite myriad treatments or psychosocial interventions. But there is currently no way to predict which patients won’t get better.

Studies of prognostic accuracy show psychiatrists are wrong half the time. I have cared for patients struggling with chronic suicidality; patients I worried might one day take their lives. I recall a woman with mind-numbing depression, who teetered precariously between life and death. One day, after years of countless drug trials, hospitalizations, electroconvulsive therapy, and various psychosocial interventions, she arrived for her appointment — three weeks into starting a new antidepressant — with a grin on her face.

 “The door is purple” she declared. I told her the door had always been purple, to which she replied, “I know, but now I care.”

Before that moment, no one — not me, not her friends or family and not anyone on The Special Joint Committee on Medical Assistance in Dying, nor any MAiD assessor — could have predicted her recovery.

Intensive, unwavering, compassionate care and caring – not MAiD — offers the most effective way to address this kind of suffering.

The other reason not to launch psychiatric euthanasia is our inability to determine suicidality from those requesting MAiD whose sole underlying medical condition is mental illness. According to the Canadian Association for Suicide Prevention, someone not dying because of their condition, such as a mental disorder alone, seeking death is, by definition, suicidal.

Similarly, the first item listed by the American Association of Suicidology differentiating physician hastened death and suicide is the patient must be dying. That certainly does not characterize patients who are mentally ill.

Despite this, the Special Joint Committee is being told by some MAiD expansionists, “suicidality and having a reason to want to die are not at all the same.” We can say ‘six’ and ‘half-dozen’ are not the same as many times as we like. If we repeat it frequently, consistently and without equivocation, it might even sound convincing, but that doesn’t make it true.

Patients struggling with suicidality often have a reason to want to die, based on, for example, self-loathing, feeling a burden or becoming worn down pursuing care and support that could sustain them. In those instances, the line between MAiD and suicide simply vanishes.

Most proponents of psychiatric euthanasia are prepared to overlook all of this, claiming failure to expand MAiD to the mentally ill is discriminatory. Avoiding discrimination does not mean everyone is treated the same, but rather, that everyone gets equal access to what they need to thrive.

Claiming a lethal injection for mentally ill patients is a respectful, compassionate, and necessary response to their suffering is akin to arguing the virtue of helping people to the balcony of a burning building so they might choose death, rather than sorting out how to control or extinguish the fire.

Time and again, committee members have asked witnesses when Canada’s psychiatric euthanasia program can be launched. I would suggest they behave like NASA. When a potentially catastrophic problem is identified before blast-off, space engineers don’t set an arbitrary new launch date, no more so than Health Canada announces a random release date of a new drug discovered to have unacceptable side-effects.

Members of the Special Joint Committee must listen and exercise reason, wisdom, and restraint in the face of fierce opposition. 

“Ottawa, we have a problem.”  The federal government would be well advised to scrap this mission. But if it insists on moving forward, launch should proceed only when the problems are solved, and not a moment sooner.   

Dr. Harvey Max Chochinov is a distinguished professor of psychiatry at the University of Manitoba, and author of Dignity in Care: The Human Side of Medicine, recently published by Oxford University Press.

Successful universal pharmacare must address equity in prescription drug access

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by Louise Binder and Dr. Naheed Dosani

The federal government’s commitment to table the Canada Pharmacare Act by the end of March 2024, including the development by the Canadian Drug Agency of a national formulary of essential medicines, may well help at least some of the millions of Canadians without access to prescription medications or with insufficient prescription drug coverage. 

At least in theory.

However, for pharmacare to truly succeed in providing more comprehensive prescription drug coverage for people in Canada, federal, provincial and territorial governments must also work together to address the existing inequities for people actually accessing medications from public reimbursement plans – plans they are theoretically entitled to but cannot access because of practical challenges.

Provinces and territories determine not only the drugs to be reimbursed in their jurisdiction but also the conditions under which people can access them. These conditions often include co-pays, premiums and deductibles – in other words, some money to be paid out-of-pocket by the person needing the medications.

For people with low to modest incomes, any premiums, deductibles and copayments can make many medicines unaffordable. In fact, one in five Canadians struggle to pay for prescription drugs.

Thus a person’s employment, age, income and province of residence can determine their prescription drug access as a result of their ability or inability to contribute to public reimbursement coverage. This sets up inequities in access that can have serious consequences.

To cope, some people delay, skip or cut doses of prescribed medicines in half to make them last longer. Others cut back on food and heating costs to afford the medication and some simply go without and do not fill needed prescriptions.

Three million Canadians have reported not filling their prescriptions because they could not afford the cost. None of these options is acceptable. All are required for good health including prescription drugs essential for treating and managing many illnesses and health conditions.

Skipping or delaying medications for chronic diseases such as diabetes can have catastrophic consequences leading to hospitalization or even death.

Another example of inequity in practical access to drugs is in the area of cancer treatments. Most provinces pay for take home cancer treatments while a few do not. Two patients with the same type of cancer in a province that does not cover oral cancer treatments could have vastly different out-of-pocket expenses if one is offered an intravenous drug in hospital, while the other receives a prescription for a take-home oral medication. 

While most jurisdictions have implemented catastrophic drug coverage for those not able to access public plans who face high out-of-pocket prescription drug expenses in relation to their income, the annual deductibles required — often a percentage of household net income — can still render the prescription unaffordable.

To eliminate barriers, federal and provincial/territorial governments must co-operate on finding solutions and be willing to fund them adequately. The federal government’s recent $35-million agreement with Prince Edward Island to help the province lower co-payments for certain medications under its provincial drug plan, reduce the deductible for its catastrophic drug program, and expand the number of drugs covered under its public health plan, shows how governments can work together to reduce inequities in access.

We need to see more partnerships like this.

Provincial and territorial governments must also work together to harmonize the medications they cover under their public health plans — a national formulary may well help with this — and to close the gaps in coverage between medications taken in hospital versus those taken at home.

All people in Canada deserve access to lifesaving medications regardless of where they live and how much they earn.

In reforming drug coverage, it is essential that governments consult with relevant stakeholders, including those with lived experience, those who serve them, and experts in health equity, who understand the problems and have solutions to fix them. 

By working together, we can build a strong universal pharmacare program that does not leave anyone behind.

Louise Binder is the health policy consultant for Save Your Skin Foundation. Dr. Naheed Dosani is a palliative care physician and health justice activist.

Set the CBC free

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by Peter MacLeod

The closing months of 2023 have not been kind to CBC/Radio Canada. Despite steady increases to its budget since the Liberal government was elected in 2015, CBC/SRC president Catherine Tait announced the loss of 600 jobs — fully 10 per cent of its workforce — on a budget shortfall of $125 million. 

Canada’s public broadcaster is struggling alongside most other broadcasters and media organizations as new technologies and viewing habits make mincemeat of forecasts and strategic plans. 

But the current cuts are just a taste of what will happen if the Conservatives form the next federal government. Pierre Poilievre has promised to defund the CBC and Radio-Canada too.

In response, the Heritage Minister, Pascal St. Onge has suggested that it may be time to review the CBC’s mandate to ensure it is still fit-for-purpose. Cue the summoning of expert panels to grind through a dispiriting Solomon’s choice: local and national news or popular entertainment, as though a self-respecting country and G7 economy can’t have both. 

Perhaps the real question is whether 88 years since its founding there is still a legitimate role for any government in determining the focus, much less the existence, of Canada’s public broadcaster?

After all, following what were critical and often overdue reforms, few today believe that governments should have a role in setting interest rates or involve themselves in the work of the judiciary or police investigations. The reason is understood: some public institutions work better — or can only work at all — when insulated from political interference. Why isn’t the same true for public broadcasting?


Despite various safeguards that protect journalists from management and management from government, the federal government’s budgetary control of CBC/SRC remains almost absolute. This is why, as CBC/SRC approaches its Centennial, the time has come to set it free.

On its own, CBC/SRC’s budget might seem lavish — a cool $1.4 billion. But according to a 2018 report, compared to 20 international peers, the federal funding is miserly. Per capita, we spend about $33 on our public broadcaster each year. The international average is closer to $90.

The fact is that Canada has been massively underspending on its public broadcaster for decades.

Now that the bottom has fallen out of the media industry, the federal government has offered various forms of support, including the Journalism Labour Tax Credit and the Online News Act, which require social media and search platforms to pay up for the news they display.

So, it’s not only CBC/SRC that is supported by federal tax dollars. An additional $600 million now flows annually to privately owned media companies — and still, layoffs are coming from all directions.

The hard truth is that even with these new dollars, we are just barely hanging on to local and national news in this country, much less to high quality cultural and entertainment programming in both official languages.

This is at a time when Canadians find themselves inundated by misinformation and exposed to deceptive campaigns sponsored by hostile foreign governments. Rapid advances in artificial intelligence are poised to make this situation much worse which is why ensuring quality information in our media ecosystem has become so critical.

So, what happens when a future opposition leader threatens to defund not only the CBC/SRC but decides to pull public support for private media too? In a democracy, some institutions belong above the political fray, especially when the market fails to deliver key public goods. The fifth estate is one of them.

This is why we need a radical new approach — an end to annual appropriations and ministerial oversight for the CBC/SRC in exchange for an endowment fund that would see public and private media adequately supported in perpetuity.

A newly established Canadian Media Trust could operate independently from government and abide by a charter that would ensure that its resources were spent on high quality journalism, cultural programming and entertainment. Additional revenue, like those from the Online News Act could flow into the Trust to grow its endowment over time.

Let future governments woo voters by promising to top up the endowment and strengthen Canadian media, or else to withhold new investments and diminish but not dismantle it.  The underlying question of whether Canada needs a strong, independent mix of public and private media, much less a public broadcaster, would be settled.

Canada would be stronger for it.Peter MacLeod is the principal of MASS LBP and chair of the Canadian Citizens’ Assemblies on Democratic Expression which called for sustained public investment in high quality media.

We need to talk about patient safety

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Jennifer Zelmer, QUOI Media

When someone says, “we need to talk,” it’s rarely a good sign.  Well, we need to talk about patient safety.

Patient safety trends have moved in the wrong direction in recent years in Canada and elsewhere.

When we are sick or injured, we turn to the healthcare system for help. Most receive safe care, but that’s not true for everyone. For instance, new data from the Canadian Institute for Health Information (CIHI) show that one in 17 people admitted to hospital in 2022-2023 was unintentionally harmed during their stay. They experienced problems with medications, post-surgery infections, pressure injuries, falls or other issues.

Patient safety has always been important, but the COVID-19 pandemic exposed and exacerbated safety gaps in healthcare. Last year was the third year in a row with a rate of potentially preventable harm at or close to six per cent in Canada. That’s up from rates of 5.3 and 5.4 per cent in the six years before the pandemic began.

The conditions of care and the conditions of work go hand in hand.

Patient safety and the physical and psychological safety of the people who work in healthcare are deeply intertwined.  The pandemic added incredible strain to people who provide care. At the same time, as CIHI data show rates of potentially preventable harm to patients rising, there were higher staff absences, more overtime work and increased use of agency staff to fill gaps.

We need to talk about these tough realities.  And, as we move ahead, talking about safety is also an important part of the solution.

That’s true for individual patients and families. For example, we’ve worked with dozens of organizations across the country to improve the safety of care transitions, such as from hospital to home. They introduced discharge summaries designed with patients for patients, used teach-back approaches between patients and healthcare providers to ensure care plans and next steps for treatment were clear, actively involved patients and families throughout the process, and had formal plans for post-transition follow-up.

The result? Both patients and healthcare providers report better care transition experiences, and fewer patients were readmitted to hospital.

It’s also true for healthcare teams. Regular safety conversations allow staff to work together to prevent problems before they occur.

Research shows that places with positive safety cultures tend to have less patient harm and higher staff satisfaction. Staff from organizations we partnered with to implement regular safety huddles, for instance, looked forward to them as opportunities to come together to proactively discuss how to make care safer for all those involved. They told us that being involved in safety gives meaning to their work and gives value day-to-day.

We can build positive safety cultures at the health system level too.

In the past, the focus has usually been on measuring and responding to past harm. But safety is not just about the absence of harm. While we still need to ask how safe care was in the past, we also need to ask whether care is safe today and how it could be safer tomorrow. In doing so, we need to consider all forms of harm – such as over- or under-treatment, delayed or incorrect diagnoses and psychological harm caused by culturally unsafe care – not just physical harm.

Everyone involved in care contributes to safety – patients, families and other care partners, healthcare providers, and leaders. So we can all be part of building positive safety cultures. To get started, Healthcare Excellence Canada has a free Rethinking Patient Safety Discussion Guide and safety conversation resources for patients and providers.

Now is the time to talk about healthcare safety. By redoubling our efforts to promote safety with and for patients and healthcare workers, everyone benefits.

Jennifer Zelmer is President and CEO at Healthcare Excellence Canada, a not-for-profit charity funded primarily by Health Canada, focused on improving the quality and safety of healthcare.

Substance only gets you so far

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Peter MacLeod

One of the surprising aspects of the Trudeau government is that according to its earliest critics, the lightweight Prime Minister would prove to be all style and no substance. Nine years later, it turns out the reverse might be more accurate. 

Like it or loathe it, the government has proved itself substantial on many fronts: reducing child poverty with a targeted benefit and extending affordable childcare across the country,  introducing and successfully defending a world-leading approach to carbon pricing, hammering out a new funding agreement for health care, renewing the free trade agreement in the face of an erratic American presidency, and steering the country through a once in a century pandemic. 

Yes, there have been failures, delays and missteps. Pharmacare and electoral reform are broken promises. The longstanding consensus on ambitious immigration quotas is straining against a deepening housing crisis. The carbon pricing pause is a genuine self-own.

What’s missing, however, is not principally a lack of policy ambition but a lack of cultural imagination — of the kind that pulls communities and people together.

Despite the promise of sunny ways, the government’s nine years have passed with few uplifting or unifying cultural touchstones. 

Of course, no Prime Minister chooses their time, and Trudeau’s tenure has been marked by many calamities: from the pandemic to the slow-to-come recognition of unmarked graves at residential schools in many parts of the country, to harrowing wildfires that first burned Fort McMurray, then Lytton before blackening skies across the country this summer.

Whether by disinclination or in part because of these events, there have been few inventive, generous moments that have helped Canadians connect with one another and see themselves in a new and positive light. 

After all, Canada is the country that in 1967 showed the world how transformative a major event like a Centennial can be. Yet, the government’s lackluster Canada150 celebrations passed without any lasting memory or impact. 

Despite initially naming himself Youth Minister and establishing the Canada Service Corps to give young people a chance to explore the country and serve communities, at most just 5,000 people — in a country with more than 7 million 15-29-year-olds — participate in its programs each year.

Canada’s prized and internationally admired citizenship ceremonies have begun migrating online — as though a mouse-click ‘virtual attestation’ can replace the memories and goodwill that flow from the thousands of community events and oath-swearing ceremonies that take place each year. 

Incredibly, for almost a decade major new sports centres and cultural venues have gone unbuilt. Even the Prime Minister’s residence, 24 Sussex, has been left to rot.

This stands in contrast to the cultural ambition of the Prime Minister’s father, Pierre Elliot Trudeau, who along with Prime Minister Lester B. Pearson before him, gave Canadians nothing less than a new anthem, flag and national honours system alongside dozens of new cultural programs and institutions.

It’s too easy to say this was simply the spirit of the times. But in a country as vast as Canada, we will always need to create both iconography and opportunities that supersede our geography so that we can share experiences that kindle pride, belonging and optimism.

One moment that did stir Canadian hearts came during the early days of the Syrian refugee response when more than 100,000 Canadians volunteered to help newcomers escape their war-torn country.  At its height, Toronto Pearson reopened its infield terminal to help handle daily flights. The Prime Minister and other dignitaries — including opposition MPs — welcomed refugees as their children got fitted with snowsuits alongside the other necessities of life in Canada. 

Here was a moment that brought a purposeful culture — in the form of mass volunteerism — and policy together, and which illustrates what’s possible when governments support the capabilities of publics to do big things.

This was also the lesson of the 25,000 volunteers who ultimately brought the 2010 Vancouver Olympics to life, and the lesson we recite each fall as four million Canadians lace up their sneakers to support the Terry Fox Foundation.

Purposeful and participatory, not passive and remote: this is the style of a high energy, popular politics that brings people together and provides an antidote to the belief that strangers can no longer find common ground or that good policies are all a country needs.

Peter MacLeod is the principal of MASS LBP, a democracy organization based in Toronto.

To solve the housing crisis, we need to do something about ‘mom-and-pop’ investors

Jon Shell, QUOI Media

A recent Bank of Canada report made waves when it revealed that 30 per cent of residential home purchases in the first three months of 2023 were made by investors and not people who intended to occupy those homes. The figure was less than 20 per cent in 2014.

Growth in investor demand is pouring jet fuel on our housing crisis.

Real estate investors have put upward pressure on prices and crowded out first-time homebuyers who, over that same time period, have declined to 42.5 per cent from 50 per cent of home sales.

But while there finally seems to be broad political consensus for an ambitious program to increase the supply of housing in Canada, a comprehensive demand strategy that addresses the overabundance of investors has been conspicuously absent.

This needs to change.

The opportunity is huge. The impact of cutting investors’ share of future home sales in half, to a level not significantly lower than it was 10 years ago, would be both immediate and dramatic. It would open up about 75,000 homes next year for first-time homebuyers and, as the supply of homes ramps up, could make upward of a million available over the next decade. All with no additional shovels, and no additional costs.

If we do nothing on that front, too many new homes will go to investors, reducing the impact of a much-needed housing supply strategy.

So, why hasn’t this been tackled already?

This issue is largely political. The biggest investors – by far – in residential real estate are individual Canadians, or so-called “mom-and-pop” investors. According to Statistics Canada, they own 23 per cent of all condos and 11.2 per cent of all houses in Ontario, which is more than both corporate and foreign investors combined. Other provinces have similar rates.

Mom-and-pop investors tend to be older, wealthier – and more likely to vote. That’s why politicians (who are also often investors themselves) tend to focus on easier targets, such as foreign investors and corporations.

It’s perhaps no surprise that’s not working so well so far. This year’s ban on foreign investors has not made a dent in overall investment activity.

However, our housing crisis is quickly shifting political calculations.

A recent Pluriel Research poll showed that 80 per cent of Canadians believe investors are driving up the cost of housing, and 75 per cent blame mom-and-pop investors specifically. Continued failure to dampen demand may now hold real political risk, as 65 per cent of Canadians support policies to limit investment in residential housing. Results are consistent across regions, political leanings and age groups. Even moms and pops want government to reckon with “mom and pop.”

Politics aside, a more practical consideration is the role these investors play in providing rental accommodation. As Canada largely stopped building permanent rental units over the past few decades, smaller investors stepped in. But this approach is now widely seen as a catastrophic policy failure leading to massive increases in rental prices and squeezing young Canadians out of home ownership.

Commitments to large public investments in affordable apartments and the recent HST cut for building purpose-built rentals indicate a major policy shift. Mom-and-pop investors should be a lot less important to the supply of rental accommodation going forward.

The impact of the crisis on young Canadians has been profound. In a Pluriel poll, when asked what emotion they feel when it comes to housing, 88 per cent of Canadians under 35 say worry, 80 per cent say anger and 79 per cent say despair. More than half – 61 per cent – say the housing crisis is affecting their mental health, according to a recent Abacus poll.

These feelings are entirely justified. Despite better education and jobs than their parents, many young people may never be able to join them in home ownership.

Straightforward policy options are available for reducing the number of real estate investors: Increasing down-payment requirements and land-transfer taxes for investment properties would dampen future investor demand. Taxing capital gains on investment property at the same rate as income would reduce speculation, with less impact on investors focused on retirement income. Some measures could be applied progressively, becoming steeper for wealthier Canadians and with each additional property, and should be accompanied by similar strategies to reduce foreign and corporate demand.

In the past, an ambitious supply-only program might have been enough. But soaring residential investor demand threatens any housing strategy that doesn’t tackle it head on. Now that it’s clear that politicians would be rewarded – not punished – for action to dampen demand, it’s time to be honest about mom and pop.

Jon Shell is managing director of Social Capital Partners, a non-profit focused on broadening access to home and business ownership.

Carbon pricing is a conservative policy that works

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Catherine McKenna

Canadians know that extreme weather caused by climate change — devastating wildfires, storms, floods — is already costing us billions of dollars. Canadians can also see we are now in a global race with the United States, Europe and China to attract investment in clean energy that creates growth and good jobs.

So you would think that serious politicians would at last agree that carbon pollution can’t be free — that it should be priced with predictable increases to encourage people and businesses to choose cleaner, less expensive energy solutions that also create good jobs and grow our economy.

You would be wrong.

But then life is full of ironies. Using pricing to change behaviour is a strategy drawn from any conservative playbook. By setting a price, a market can work its magic and people can make the best choices for their businesses and families.

This is the logic at the heart of Canada’s approach to meeting its climate commitments and driving carbon pollution out of our economy and environment.

But because I’m not a conservative and know that markets often hurt people who can least afford it, I made sure that the federal approach to carbon pricing had a special protection built-in: it’s revenue neutral. This means that the money raised by putting a price on carbon is transparently rebated in the form of a quarterly Climate Action Incentive rebate made directly to Canadians’ bank accounts.

This can seem complicated but it’s not. Yes, the price of fossil fuels will rise, but most Canadian families are better off with rebates and the choice really is theirs: use the money to offset rising energy prices or use it, alongside other government incentives, to save more money long term by switching to less costly forms of heating and transportation.

This isn’t something I expect our political opponents to advertise, but it doesn’t stop it from being true. Nor does it change the fact that Canada’s carbon pricing system follows the same approach successfully pioneered by conservative politicians.

Think Prime Minister Brian Mulroney and acid rain or Premier Gordon Campbell who created Canada’s first carbon pricing system in British Columbia. Quebec Premier Jean Charest made common cause with the all-American Republican governor Arnold Schwarzenegger to set up a carbon market that, despite opposition in Quebec and California, propels both economies forward.

So on one hand we have today’s Conservatives who refuse to take lessons from their own. On the other, let’s remember that while we are in a fossil fuel climate crisis, the oil and gas industry is playing a double game. They are generating massive profits that they return to their shareholders while charging consumers exorbitant prices. At the same time, they are demanding huge public subsidies to clean up the pollution they cause, while walking away from their already modest climate commitments.

This, incidentally, is why an oil and gas windfall tax is long overdue. It would address the climate crisis and improve affordability by helping families transition to lower cost, clean energy. According to the Parliamentary Budget Office, if the same windfall tax currently paid by Canadian banks and insurance companies was paid by the largest Canadian oil and gas companies, proceeds would reach $4.2 billion in just five years.

Let’s not lose focus. The problem here isn’t carbon pricing. It’s our reliance on outmoded carbon intensive technologies, including home heating systems. As Clean Energy Canada has made clear, “fossil fuel inflation is the culprit for skyrocketing heating oil prices.”  The sooner heating systems relying on oil and gas are switched out — everywhere — for cold-climate heat pumps, the better for consumers and for the planet.

A windfall tax can help Canadians get it done.

Though we might not always like it, the bottom line is governments exist to do hard things and fighting climate change is about as hard as it gets. Voluntary action and goodwill aren’t enough. Neither is magical thinking or the willful ignorance of scientific fact — or, in this case, basic economics. 

Not only do today’s Conservative politicians want to eliminate the most effective and efficient policy that actually works, the reality is that behind their rhetoric it is clear they have no credible plan to tackle climate change.

Canada is a country that can do hard things. We don’t shrink from a fight or shirk our responsibilities. Climate change is the fight of all our lives. We have to hold the line on across-the-board carbon pricing and keep moving forward. Pierre Poilievre and the federal Conservatives have no credible plan — only to pass on the biggest environmental and economic debt ever to our kids and grandkids.

Catherine McKenna is the former Minister of Environment and Climate Change.  In 2017, she introduced Canada’s national carbon pricing system. This system was subsequently upheld by the Supreme Court of Canada in 2021, which deemed greenhouse gas a matter of national concern. In 2022, as Chair of the United Nations High-Level Expert Group on Net Zero, she issued a global report on bringing greater integrity to net zero commitments by business, financial institutions, cities and regions.

It’s time to transform the culture of charitable giving

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Lisa Wolverton

QUOI Media

We are entering a new era of charitable giving – and it’s long overdue. 

Many major philanthropic donors of Canadian and global charities are turning away from traditional ways of giving, such as funding large charities that serve marginalized groups from afar or restricting how funds can be spent.  It’s an attempt to give communities more direct control over their own futures. This trend is part of a larger movement to “decolonize” philanthropy that has been publicly embraced by Canadian donors like The McConnell Foundation and Inspirit Foundation, among others. 

And it’s not just private philanthropists who are making such moves. The Canadian government recently awarded $200 million to the Fund for Black Communities to administer the Black-led Philanthropic Endowment Fund, dedicated to supporting Black-led, Black-focused and Black-serving non-profit organizations.

It’s time more donors put funds directly into the hands of local leaders, giving them crucial decision-making power. This means leaving behind some restrictions and requirements while       enabling community leaders to manage and distribute funds as they see fit.

This kind of bold step requires donors to believe that for money to be truly impactful, it must be accompanied by trust and autonomy — a belief that has the potential to change lives and transform our culture of giving.

This new age of philanthropic giving is not just about how we give but who we give funding to. 

Some donors are making large gifts to groups that have historically had very little autonomy over resources. We’re witnessing large foundations like The McConnell Foundation transferring unprecedented amounts of capital to Indigenous-led foundations, for example. Others are investing in collaborative funds like the Freedom Fund, Equality Fund Canada or Co-Impact, which address issues like gender injustice or human trafficking through funding grassroots groups.

This movement has great potential.

Donors are going beyond solely talking about “shifting power” to actively creating new giving structures, processes and expectations in order to build trust and reduce the power imbalance that is so inherent in philanthropy. They are reconsidering their roles in working towards tangible social change and building markedly different relationships with those they fund: mutually enriching partnerships built on trust, honesty and shared decision-making.

This is not just the right thing to do from a theoretical perspective. Throughout history, attempts to solve societal problems in a dictatorial fashion, without directly involving affected communities, have proven ineffective, unsustainable and even harmful. We know that philanthropy — and really, any attempt at social change — works best when we understand that people with lived experience of a problem are best-placed to design and implement solutions.

Often, what they need most are resources, both financial and otherwise, the support of power holders and the freedom and space to try.

Sometimes just small shifts in donor mindsets and behaviour make a big difference.

At The Philanthropy Workshop, we encourage our donor members to consider the practices and principles that are critical to trust-based funding. We help them to explore questions like: who are you trying to help, what do you bring to the table and who should sit beside you to make decisions about where your money goes? How can you make sure you are funding organizations that are authentically rooted in lived experience? How can you end a funding relationship while minimizing harm to a community?

We also need to document the lessons learned so that other donors can replicate what works.

The Freedom Fund provides a positive model.  Building on a decade of partnering with more than 100 community-led organizations to address modern slavery, the Freedom Fund has launched an essential online resource to encourage other funders to fund frontline groups. From sharing key principles and challenges in frontline grant making, to offering a wide range of case studies, templates and tools, Funding Frontline Impact contains the type of transparent, nuts-and-bolts guidance many donors and charities could learn from. 

One thing is certain: philanthropy cannot continue as it always has.

From governments to foundations to individuals, we all have the ability to ensure that our money is giving communities the power to define their own futures and to encourage others to do the same. We have much further to go, but we’ll know we’re there when this type of giving is the norm, not just something we hear about in big, flashy announcements.

Lisa Wolverton is President of The Philanthropy Workshop Canada.

Healthy aging strategies can help Canada cope with its growing senior population

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John Muscedere

Canada is growing. In June, our population reached 40 million — but we are not only getting bigger, we are getting older.

There are now over 7.3 million Canadians who are 65 years or older and that number is climbing as the Baby Boomers age. By 2051, seniors are expected to make up 25 per cent of the population, with the number of seniors over 85 years tripling to 2.5 million.

This rapidly expanding demographic will have a profound effect on our society. While many younger seniors remain healthy and active in their communities, working and volunteering, a significant proportion of older seniors have complex health-related issues and many require the supports of long-term care settings. 

Seniors in Canada account for almost half of all health care spending.

As they continue to grow in numbers, older Canadians could overwhelm our healthcare and social services budgets unless we change the way we view aging and make the necessary investments in programs, technologies, and research that foster healthy aging or aging in place.

Fortunately, we are starting to see changes. In the wake of the COVID-19 pandemic and its devastating effect on older Canadians, governments and other organizations are becoming increasingly interested in healthy aging. For instance, last fall, Kingston, Ontario became home to the first centre for healthy aging in Canada and this past spring, the federal government held public consultations on how to better support seniors living in their own homes.

What is healthy aging?

It is about creating environments and opportunities that enable people to maintain their functional abilities as they get older. It challenges the mindset that as we age, we inevitably will have more diseases and health conditions, lose mental and physical capacity, and have a reduced quality of life.

While older people are more susceptible to many diseases and illnesses, there are things we can do to reduce this and increase their healthspan, or the time that they are in good health, can live independently on their own, engage in social relationships, and contribute to society.

Healthy aging covers a range of strategies. It includes things like getting regular exercise and doing strength training, eating a healthy diet, keeping vaccinations up to date, limiting medications to only what is necessary, and staying socially connected to others.

There is a lot that governments and other organizations can do to encourage and support these behaviours. Examples include funding community centres so that they can offer senior-focused exercise and nutrition classes, making vaccination more accessible through local community hubs, and offering more opportunities for seniors to engage with others either through community-based programs or online.

Healthy aging is also about finding ways to make it easier for seniors to continue to live at home or in their community. Governments and communities need to ensure that there are more and better home care options, not just to meet healthcare needs, but also to help seniors maintain their homes.

Governments should also consider financial support for unpaid caregivers, more flexible public transportation choices, and investing in a range of housing options that truly meet seniors’ needs.

Technology is also an important tool in healthy aging. During the early months of the COVID-19 pandemic, we saw how vital cell phones and tablets were for families trying to stay connected to their older relatives and how important telemedicine was for seniors to connect with their doctors.

Other technology innovations such as smart or wearable devices, virtual reality, and artificial intelligence, can help seniors set and monitor health goals, track medication use, and participate in physiotherapy and other activities to retain or regain physical function.

Research into the biology of aging and disease is also essential for healthy aging. Health researchers in the field of geroscience are working to understand the genetic, molecular, and cellular biological mechanisms and determinants of aging and the diseases and conditions that are more prevalent as we get older.

Our goal is to find ways to prevent, diagnose, and treat age-related diseases and conditions so that aging does not have to be synonymous with illness and frailty.

Geroscientists are pursing many promising research avenues that could profoundly change how we view and treat aging – but they need policy makers to help put those ideas into widespread action. With research advances and more investments in healthy aging initiatives, older Canadians can live healthier, more independent lives longer, to all of society’s benefit.

John Muscedere is CEO of the Canadian Frailty Network and a Professor in the School of Medicine at Queen’s University.

Rebooting Canada’s broken innovation system

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Andrea Nemtin and Tim Draimin

QUOI Media

The most common themes about Canada’s growth-oriented innovation system are that it is unwieldy, expensive and underperforming. The latest WIPO 2023 report notes that Canada’s innovation inputs dramatically exceed its outputs. But these critiques miss the mark.

Innovation is traditionally understood as science and technological advances resulting in the development and commercialization of improved products and services. It thrives on efficiency, competition and market-driven solutions. Think of Silicon Valley’s tech giants, continuously pushing the boundaries of what’s possible with gadgets and software — smartphones, electric vehicles and the Internet, transforming the ways we live and work.

Success is measured in economic growth which can create much needed jobs. Too often however, innovation fails to create prosperity for Canadians or drive social or environmental outcomes. 

Canada’s innovation policy framework needs a new paradigm and a fundamental reboot. 

Increasingly governments are identifying the need to apply innovation to social and environmental challenges through what is known variously as social innovation, inclusive innovation, mission innovation, or most recently, transformation innovation. These terms all mean innovation that tackles societal challenges with creative solutions that aim to improve the well-being of communities, people and the environment.

Social innovation seeks to address issues like poverty, healthcare access, climate change, education inequality and affordable housing. It works to address the root causes of complex challenges with a portfolio of solutions that together create systemic change. Social innovation fosters positive social and environmental outcomes that drive local economic growth.  

While both traditional innovation and social innovation aim to drive progress and change, understanding the nuances between the two forms is crucial, as it not only helps us appreciate their roles in society but also sheds light on the imperative for prioritizing social innovation. 

So, what do we need to do to make social innovation a reality?

In an era of poly-crisis, social innovation offers Canada the potential for transformation, but it will require policy shifts to get us there. The recent publication from the Brookfield Institutes, Canada’s Moonshot, Solving Grand Challenges Through Transformational Innovation categorically states: “Canada’s innovation policy framework does not sufficiently align innovation with solving the most pressing social, economic, and environmental problems that Canada and the world face today.”  

The report identifies five basic principles for designing enabling policy for transformative innovations or “moonshots.”  We would do well to heed them:

            •           Select “grand challenges” that have clear, bold, measurable and time-limited goals that are sector-, discipline-, and technology-agnostic and that align with top government priorities.

            •           Seek a lean, agile and independent governance structure.

            •           Coordinate end-to-end support using a wide range of policy instruments to help scale the most promising ideas and help them reach their intended markets.

            •           Create meaningful engagement with willing stakeholders, including existing innovation ecosystem actors, leading industry and research experts, communities and the wider public. 

            •           Use a portfolio approach to managing risk, a high tolerance for failure, and an evaluation framework focused on learning and adaptation.

The resulting policies should address needs that are unmet and of little interest to public or private investment due to their complexity or because there’s no profit to be made.  The policies also create the environment for collaboration between different actors — from academia, industry, government, communities or civil society (NGOs or non-profit organizations).  

Mariana Mazzucato recently published, Inclusive and Sustainable British Columbia: A Mission-oriented Approach to a Renewed Economy that identifies a complementary approach to the development of enabling an innovative policy framework based on four questions:

            •           Overall Objectives: Do the overall aims of innovation policy involve more than economic growth?

            •           Direction of innovation: Whose needs are being met?

            •           Participation in innovation: Who participates in innovation?

            •           Governance of innovation: Who sets priorities and how are the outcomes of innovation managed?

Bringing these questions to bear on Canada’s innovation policy would be highly disruptive — and necessary.

Between the legacy of a still-smoldering pandemic, the dramatically rising costs of climate change and the deteriorating indicators of social well-being (mental health, housing, income inequality, etc.), innovation goals must now be directly aligned with the social and environmental needs of Canadians. 

By prioritizing social innovation, we can create a more equitable and sustainable future for all.

Andrea Nemtin is currently the CEO of Social Innovation Canada. Tim Draimin is Senior Fellow at Community Foundations of Canada and board member of Social Innovation Canada, Trico Charitable Foundation and Green Economy Canada.