Marginal note:2016, c. 3, s. 3
1 (1) Subsection 241.2(2) of the Criminal Code is amended by adding “and” at the end of paragraph (b), by striking out “and” at the end of paragraph (c) and by repealing paragraph (d).
(2) Section 241.2 of the Act is amended by adding the following after subsection (2):
Marginal note:Exclusion
(2.1) For the purposes of paragraph (2)(a), a mental illness is not considered to be an illness, disease or disability.
(2.1) Subsection 241.2(2.1) of the Act is repealed.
Marginal note:2016, c. 3, s. 3
(3) The portion of subsection 241.2(3) of the Act before paragraph (a) is replaced by the following:
Marginal note:Safeguards — natural death foreseeable
(3) Subject to subsection (3.2), before a medical practitioner or nurse practitioner provides medical assistance in dying to a person whose natural death is reasonably foreseeable, taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time that they have remaining, the medical practitioner or nurse practitioner must
Marginal note:2016, c. 3, s. 3
(4) Paragraph 241.2(3)(c) of the Act is replaced by the following:
(c) be satisfied that the request was signed and dated by the person — or by another person under subsection (4) — before an independent witness who then also signed and dated the request;
Marginal note:2016, c. 3, s. 3
(5) Paragraph 241.2(3)(g) of the Act is replaced by the following:
(g) if the person has difficulty communicating, take all necessary measures to provide a reliable means by which the person may understand the information that is provided to them and communicate their decision; and
Marginal note:2016, c. 3, s. 3
(6) Subsection 241.2(3) of the Act is amended by striking out “and” at the end of paragraph (h) and by repealing paragraph (i).
(7) Section 241.2 of the Act is amended by adding the following after subsection (3):
Marginal note:Safeguards — natural death not foreseeable
(3.1) Before a medical practitioner or nurse practitioner provides medical assistance in dying to a person whose natural death is not reasonably foreseeable, taking into account all of their medical circumstances, the medical practitioner or nurse practitioner must
(a) be of the opinion that the person meets all of the criteria set out in subsection (1);
(b) ensure that the person’s request for medical assistance in dying was
(i) made in writing and signed and dated by the person or by another person under subsection (4), and
(ii) signed and dated after the person was informed by a medical practitioner or nurse practitioner that the person has a grievous and irremediable medical condition;
(c) be satisfied that the request was signed and dated by the person — or by another person under subsection (4) — before an independent witness who then also signed and dated the request;
(d) ensure that the person has been informed that the person may, at any time and in any manner, withdraw their request;
(e) ensure that another medical practitioner or nurse practitioner has provided a written opinion confirming that the person meets all of the criteria set out in subsection (1);
(e.1) if neither they nor the other medical practitioner or nurse practitioner referred to in paragraph (e) has expertise in the condition that is causing the person’s suffering, ensure that they or the medical practitioner or nurse practitioner referred to in paragraph (e) consult with a medical practitioner or nurse practitioner who has that expertise and share the results of that consultation with the other practitioner;
(f) be satisfied that they and the medical practitioner or nurse practitioner referred to in paragraph (e) are independent;
(g) ensure that the person has been informed of the means available to relieve their suffering, including, where appropriate, counselling services, mental health and disability support services, community services and palliative care and has been offered consultations with relevant professionals who provide those services or that care;
(h) ensure that they and the medical practitioner or nurse practitioner referred to in paragraph (e) have discussed with the person the reasonable and available means to relieve the person’s suffering and they and the medical practitioner or nurse practitioner referred to in paragraph (e) agree with the person that the person has given serious consideration to those means;
(i) ensure that there are at least 90 clear days between the day on which the first assessment under this subsection of whether the person meets the criteria set out in subsection (1) begins and the day on which medical assistance in dying is provided to them or — if the assessments have been completed and they and the medical practitioner or nurse practitioner referred to in paragraph (e) are both of the opinion that the loss of the person’s capacity to provide consent to receive medical assistance in dying is imminent — any shorter period that the first medical practitioner or nurse practitioner considers appropriate in the circumstances;
(j) if the person has difficulty communicating, take all necessary measures to provide a reliable means by which the person may understand the information that is provided to them and communicate their decision; and
(k) immediately before providing the medical assistance in dying, give the person an opportunity to withdraw their request and ensure that the person gives express consent to receive medical assistance in dying.
Marginal note:Final consent — waiver
(3.2) For the purposes of subsection (3), the medical practitioner or nurse practitioner may administer a substance to a person to cause their death without meeting the requirement set out in paragraph (3)(h) if
(a) before the person loses the capacity to consent to receiving medical assistance in dying,
(i) they met all of the criteria set out in subsection (1) and all other safeguards set out in subsection (3) were met,
(ii) they entered into an arrangement in writing with the medical practitioner or nurse practitioner that the medical practitioner or nurse practitioner would administer a substance to cause their death on a specified day,
(iii) they were informed by the medical practitioner or nurse practitioner of the risk of losing the capacity to consent to receiving medical assistance in dying prior to the day specified in the arrangement, and
(iv) in the written arrangement, they consented to the administration by the medical practitioner or nurse practitioner of a substance to cause their death on or before the day specified in the arrangement if they lost their capacity to consent to receiving medical assistance in dying prior to that day;
(b) the person has lost the capacity to consent to receiving medical assistance in dying;
(c) the person does not demonstrate, by words, sounds or gestures, refusal to have the substance administered or resistance to its administration; and
(d) the substance is administered to the person in accordance with the terms of the arrangement.
Marginal note:For greater certainty
(3.3) For greater certainty, involuntary words, sounds or gestures made in response to contact do not constitute a demonstration of refusal or resistance for the purposes of paragraph (3.2)(c).
Marginal note:Advance consent invalidated
(3.4) Once a person demonstrates, by words, sounds or gestures, in accordance with subsection (3.2), refusal to have the substance administered or resistance to its administration, medical assistance in dying can no longer be provided to them on the basis of the consent given by them under subparagraph (3.2)(a)(iv).
Marginal note:Advance consent — self-administration
(3.5) In the case of a person who loses the capacity to consent to receiving medical assistance in dying after self-administering a substance, provided to them under this section, so as to cause their own death, a medical practitioner or nurse practitioner may administer a substance to cause the death of that person if
(a) before the person loses the capacity to consent to receiving medical assistance in dying, they and the medical practitioner or nurse practitioner entered into an arrangement in writing providing that the medical practitioner or nurse practitioner would
(i) be present at the time the person self-administered the first substance, and
(ii) administer a second substance to cause the person’s death if, after self-administering the first substance, the person lost the capacity to consent to receiving medical assistance in dying and did not die within a specified period;
(b) the person self-administers the first substance, does not die within the period specified in the arrangement and loses the capacity to consent to receiving medical assistance in dying; and
(c) the second substance is administered to the person in accordance with the terms of the arrangement.
(8) Section 241.2 of the Act is amended by adding the following after subsection (5):
Marginal note:Exception
(5.1) Despite paragraphs (5)(c) and (d), a person who provides health care services or personal care as their primary occupation and who is paid to provide that care to the person requesting medical assistance in dying is permitted to act as an independent witness, except for
(a) the medical practitioner or nurse practitioner who will provide medical assistance in dying to the person; and
(b) the medical practitioner or nurse practitioner who provided an opinion under paragraph (3)(e) or (3.1)(e), as the case may be, in respect of the person.
Marginal note:2016, c. 3, s. 3
(9) The portion of subsection 241.2(6) of the Act before paragraph (a) is replaced by the following:
Marginal note:Independence — medical practitioners and nurse practitioners
(6) The medical practitioner or nurse practitioner providing medical assistance in dying and the medical practitioner or nurse practitioner who provides the opinion referred to in paragraph (3)(e) or (3.1)(e) are independent if they
(10) Paragraph 241.2(6)(b) of the English version of the Act is amended by replacing “or” with “and” at the end of that paragraph.