Regulations for the Monitoring of Medical Assistance in Dying (SOR/2018-166)
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Regulations are current to 2024-10-30 and last amended on 2024-01-01. Previous Versions
SCHEDULE 4.1(Subsections 7(1) and (2) and section 8)Procedural Requirements for Providing Medical Assistance in Dying — Natural Death Not Reasonably Foreseeable
1 An indication of
(a) whether the practitioner was of the opinion that the person who made the request for medical assistance in dying met all of the eligibility criteria;
(b) whether the practitioner ensured that the person’s request was made in writing and was signed and dated by the person or by another person who met the requirements set out in subsection 241.2(4) of the Code;
(c) whether the practitioner ensured that the request was signed and dated after the person was informed by a practitioner that the person had a grievous and irremediable medical condition;
(d) whether the practitioner was satisfied that the request was signed and dated by the person — or by another person who met the requirements set out in subsection 241.2(4) of the Code — before an independent witness who met the requirements set out in subsection 241.2(5) of the Code and who then also signed and dated the request;
(e) whether the practitioner ensured that the person was informed that they may, at any time and in any manner, withdraw their request;
(f) whether the practitioner ensured that another practitioner provided a written opinion confirming that the person met all of the eligibility criteria and, if so, an indication of whether the other practitioner is a medical practitioner or nurse practitioner;
(g) whether the practitioner or the other practitioner referred to in paragraph (f) has expertise in the condition that is causing the person’s suffering and, if so, the nature of that expertise;
(h) if neither the practitioner nor the other practitioner referred to in paragraph (f) has expertise in the condition that is causing the person’s suffering, whether the practitioner ensured that they or the other practitioner referred to in that paragraph consulted with a practitioner who has that expertise and shared with the other the results of that consultation, and if so, the nature of that practitioner’s expertise;
(i) whether the practitioner was satisfied that they and the other practitioner referred to in paragraph (f) were independent within the meaning of subsection 241.2(6) of the Code;
(j) whether the practitioner ensured that the person was 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, if so, which means were discussed;
(k) whether the practitioner ensured that the person was offered consultations with relevant professionals who provide the services or the care referred to in paragraph (j) and, if so, which consultations were offered;
(l) whether the practitioner ensured that they and the other practitioner referred to in paragraph (f) discussed with the person the reasonable and available means to relieve the person’s suffering;
(m) whether the practitioner and the other practitioner referred to in paragraph (f) agreed with the person that the person had given serious consideration to the reasonable and available means to relieve their suffering and, if so, the reason they were in agreement;
(n) whether the practitioner ensured that
(i) there were at least 90 clear days between the day on which the first assessment of whether the person met the eligibility criteria began and the day on which medical assistance in dying was provided to them, or
(ii) in the case where a shorter period was considered appropriate in the circumstances, the assessments were completed and they and the other practitioner referred to in paragraph (f) were both of the opinion that the loss of the person’s capacity to provide consent to receive medical assistance in dying was imminent;
(o) whether the practitioner, immediately before providing medical assistance in dying, gave the person an opportunity to withdraw their request and ensured that the person gave express consent to receive medical assistance in dying;
(p) whether, in the case where the person had difficulty communicating, the practitioner took all necessary measures to provide a reliable means by which the person could have understood the information that was provided to them and communicated their decision and, if so, the means provided; and
(q) whether the practitioner informed a pharmacist, before the pharmacist dispensed the substance that the practitioner prescribed or obtained for the person, that the substance was intended for the purpose of providing medical assistance in dying.
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