Regulations for the Monitoring of Medical Assistance in Dying
SOR/2018-166
Registration 2018-07-27
Regulations for the Monitoring of Medical Assistance in Dying
Whereas the Minister of Health considers it necessary that the annexed Regulations be made;
Therefore, the Minister of Health, pursuant to subsection 241.31(3)Footnote a of the Criminal CodeFootnote b, makes the annexed Regulations for the Monitoring of Medical Assistance in Dying.
Return to footnote aS.C. 2016, c. 3, s. 4
Return to footnote bR.S., c. C-46
Ottawa, July 25, 2018
La ministre de la Santé  Ginette Petitpas Taylor Minister of Health |
Interpretation
Marginal note:Definitions
1 The following definitions apply in these Regulations.
- care coordination service
care coordination service means a service that facilitates access to medical assistance in dying. (service de coordination de soins)
- Code
Code means the Criminal Code. (Code)
- eligibility criteria
eligibility criteria means the criteria set out in subsections 241.2(1) and (2) of the Code. (critères d’admissibilité)
- medical certificate of death
medical certificate of death includes, in the Province of Quebec, an attestation of death. (certificat médical de décès)
- patient
patient[Repealed, SOR/2022-222, s. 1]
- personal information
personal information has the same meaning as in section 3 of the Privacy Act. (renseignements personnels)
- practitioner
practitioner means a medical practitioner or nurse practitioner. (praticien)
- preliminary assessor
preliminary assessor means a person who has the responsibility to carry out preliminary assessments of whether a person who has requested medical assistance in dying meets the eligibility criteria. (responsable des évaluations préliminaires)
- refer
refer[Repealed, SOR/2022-222, s. 1]
- residential care facility
residential care facility means a residential facility that provides health care services, including professional health monitoring and nursing care, on a continuous basis for persons who require assistance with activities of daily living. (établissement de soins pour bénéficiaires internes)
Provision of Information
Designation of Recipients of Information
Marginal note:Designation — Minister of Health
2 (1) The Minister of Health is designated as the recipient of information for the purposes of subsections 241.31(1) to (2) of the Code.
Marginal note:Designation — other recipients
(2) However, the following persons are designated as the recipients of information for the purposes of subsections 241.31(1) to (2) of the Code in respect of the following information:
(a) the Chief Coroner for Ontario, in respect of the information to be provided under paragraph 7(2)(b) or subsection 8(2);
(a.1) the Deputy Minister of Health and Social Services of Quebec, in respect of the information to be provided by a preliminary assessor in Quebec or by a practitioner who carries out an assessment there of whether a person who has made a request for medical assistance in dying meets the eligibility criteria, by a practitioner who receives a written request there for medical assistance in dying, by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying or by a pharmacy technician who dispenses a substance there to aid a practitioner with the provision of medical assistance in dying;
(b) the Deputy Minister of Health of British Columbia, in respect of the information to be provided by a preliminary assessor in British Columbia or by a practitioner who carries out an assessment there of whether a person who has made a request for medical assistance in dying meets the eligibility criteria, by a practitioner who receives a written request there for medical assistance in dying, by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying or by a pharmacy technician who dispenses a substance there to aid a practitioner with the provision of medical assistance in dying;
(c) the Chief Executive Officer of the Saskatchewan Health Authority, in respect of the information to be provided by a preliminary assessor in Saskatchewan or by a practitioner who carries out an assessment there of whether a person who has made a request for medical assistance in dying meets the eligibility criteria, by a practitioner who receives a written request there for medical assistance in dying, by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying or by a pharmacy technician who dispenses a substance there to aid a practitioner with the provision of medical assistance in dying;
(d) the President and Chief Executive Officer of Alberta Health Services, in respect of the information to be provided by a preliminary assessor in Alberta or by a practitioner who carries out an assessment there of whether a person who has made a request for medical assistance in dying meets the eligibility criteria, by a practitioner who receives a written request there for medical assistance in dying, by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying or by a pharmacy technician who dispenses a substance there to aid a practitioner with the provision of medical assistance in dying;
(e) the Deputy Minister of Health and Social Services of the Northwest Territories, in respect of the information to be provided by a preliminary assessor in the Northwest Territories or by a practitioner who carries out an assessment there of whether a person who has made a request for medical assistance in dying meets the eligibility criteria, by a practitioner who receives a written request there for medical assistance in dying, by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying or by a pharmacy technician who dispenses a substance there to aid a practitioner with the provision of medical assistance in dying; and
(f) the Minister of Health of Nunavut, in respect of the information to be provided by a preliminary assessor in Nunavut or by a practitioner who carries out an assessment there of whether a person who has made a request for medical assistance in dying meets the eligibility criteria, by a practitioner who receives a written request there for medical assistance in dying, by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying or by a pharmacy technician who dispenses a substance there to aid a practitioner with the provision of medical assistance in dying.
Practitioners and Other Persons
Marginal note:Exception — no information required
3 The following practitioners are not, in respect of a person’s request for medical assistance in dying, required to provide information under subsection 5(1), 6(1) or 6.1(1) or section 9:
(a) a practitioner who has received a person’s request for medical assistance in dying from the person directly or another person on their behalf or from another practitioner or a care coordination service in order to obtain the practitioner’s written opinion, for the purposes of paragraph 241.2(3)(e) or (3.1)(e) of the Code, regarding whether the person meets all of the eligibility criteria; and
(b) a practitioner who has been consulted, for the purposes of paragraph 241.2(3.1)(e.1) of the Code, by another practitioner because they have expertise in the condition that is causing the person’s suffering and they have shared the results of that consultation with the other practitioner.
4 [Repealed, SOR/2022-222, s. 2]
Marginal note:Withdrawal of request
5 (1) A practitioner must provide the following information to the applicable recipient designated under section 2 within 30 days after the day on which the practitioner becomes aware of the withdrawal of a person’s request for medical assistance in dying that they received:
(a) the information referred to in Schedule 1;
(b) in the case where the practitioner has determined that the person met all of the eligibility criteria, the applicable information referred to in Schedule 3;
(c) if known, the person’s reasons for withdrawing the request and the means that were chosen by the person to relieve their suffering, if applicable; and
(d) in the case where the person withdrew their request after having been given an opportunity to do so under paragraph 241.2(3)(h) or (3.1)(k) of the Code, an indication to that effect.
Marginal note:Exception — no other information required
(2) A practitioner who provides information in accordance with subsection (1) is not required to provide information under subsection 6(1) or section 9.
Marginal note:Ineligibility
6 (1) If a preliminary assessor, a practitioner who carries out an assessment of whether a person who has made a request for medical assistance in dying meets the eligibility criteria or a practitioner who has received a person’s written request for medical assistance in dying determines that the person does not meet one or more of the eligibility criteria, they must provide the applicable recipient designated under section 2 with the applicable information referred to in Schedules 1 and 3 within 30 days after the day on which they make that determination.
Marginal note:Clarification
(2) For greater certainty, subsection (1) applies if the preliminary assessor or the practitioner determined that the person met the eligibility criteria but subsequently determines that the person does not meet one or more of those criteria.
Marginal note:Exception — no other information required
(3) A practitioner who provides information in accordance with subsection (1) is not required to provide information under subsection 5(1) or 6.1(1) or section 9.
Marginal note:Safeguard not met
6.1 (1) A practitioner who has received a person’s request for medical assistance in dying and determined that the person met all of the eligibility criteria, but does not provide medical assistance in dying because they subsequently determine that a safeguard set out in subsection 241.2(3) or (3.1) of the Code, as the case may be, has not been met, must provide the applicable recipient designated under section 2 with the applicable information referred to in Schedules 1 and 3 within 30 days after the day on which they make the subsequent determination.
Marginal note:Exception — no other information required
(2) A practitioner who provides information in accordance with subsection (1) is not required to provide information under subsection 5(1) or 6(1) or section 9.
Marginal note:Prescribing or providing a substance — general
7 (1) A practitioner who has received a person’s written request for medical assistance in dying and provides medical assistance in dying by prescribing or providing a substance to the person for self-administration must provide the applicable recipient designated under section 2 with the applicable information referred to in Schedules 1 and 3 and the information referred to in Schedule 4 or 4.1, as the case may be, and Schedule 5 no earlier than the 90th day after the day on which the practitioner prescribes or provides the substance and no later than one year after that day.
Marginal note:Prescribing or providing a substance — Ontario
(2) However, a practitioner who has received a person’s written request for medical assistance in dying and provides medical assistance in dying in Ontario by prescribing or providing a substance to the person for self-administration must provide the applicable information referred to in Schedules 1 and 3 and the information referred to in Schedule 4 or 4.1, as the case may be, and Schedule 5 no earlier than the 90th day after the day on which the practitioner prescribes or provides the substance and no later than one year after that day,
(a) to the recipient designated under subsection 2(1), except in the case referred to in paragraph (b); or
(b) to the recipient designated under paragraph 2(2)(a), in the case where, when the practitioner provides the information, the practitioner knows that the person has died following self-administration of the substance.
Marginal note:Exception — time to report
(3) The practitioner may provide the information earlier than the 90th day after the day on which the practitioner prescribes or provides the substance to the person who has made a request for medical assistance in dying if the practitioner knows that the person has died.
Marginal note:Exception — no other information required
(4) A practitioner who provides information in accordance with subsection (1) or (2) is not required to provide information under section 9.
Marginal note:Administering a substance — general
8 (1) A practitioner who has received a person’s written request for medical assistance in dying and provides medical assistance in dying by administering a substance to the person must provide the applicable recipient designated under section 2 with the applicable information referred to in Schedules 1, 3 and 6 and the information referred to in Schedule 4 or 4.1, as the case may be, within 30 days after the day on which the person dies.
Marginal note:Administering a substance — Ontario
(2) However, a practitioner who has received a person’s written request for medical assistance in dying and provides medical assistance in dying in Ontario by administering a substance to the person must provide the recipient designated under paragraph 2(2)(a) with the applicable information referred to in Schedules 1, 3 and 6 and the information referred to in Schedule 4 or 4.1, as the case may be, within 30 days after the day on which the person dies.
Marginal note:Death — other cause
9 A practitioner who has received a person’s request for medical assistance in dying must, within 30 days after the day on which the practitioner becomes aware that the person died from a cause other than medical assistance in dying, provide the applicable recipient designated under section 2 with the following information:
(a) the information referred to in Schedule 1;
(b) in the case where the practitioner has determined that the person met all of the eligibility criteria, the applicable information referred to in Schedule 3;
(c) if known, the reasons for which the person did not receive medical assistance in dying; and
(d) the date of the person’s death, if known, and, if the person’s medical certificate of death was completed by the practitioner, the immediate and underlying causes of death as indicated on the certificate.
Marginal note:Cessation of certain requirements
10 A practitioner who has received a person’s request for medical assistance in dying is not required to provide information under a provision of these Regulations — other than subsection 7(1) or (2) or 8(1) or (2), as the case may be — with regard to any circumstances relating to the request that the practitioner becomes aware of, or any actions that the practitioner takes in respect of the request,
(a) in the case of a person whose natural death is reasonably foreseeable, taking into account all of their medical circumstances, after the 90th day after the day on which the practitioner received the request; and
(b) in the case of a person whose natural death is not reasonably foreseeable, taking into account all of their medical circumstances, two years after the day on which the practitioner received the request.
Pharmacists and Pharmacy Technicians
Marginal note:Dispensing of substance
11 A pharmacist who dispenses a substance in connection with the provision of medical assistance in dying or a pharmacy technician who dispenses a substance to aid a practitioner in providing medical assistance in dying must provide the applicable recipient designated under section 2 with the information referred to in Schedule 7 within 30 days after the day on which they dispense the substance.
Collection of Information
Marginal note:Personal information collected from provinces and territories
12 (1) The Minister of Health may, for the purposes of monitoring medical assistance in dying, collect personal information relating to requests for, and the provision of, medical assistance in dying from a provincial or territorial government, or any of its institutions, or from a public body established under an Act of the legislature of a province or territory.
Marginal note:Other information
(2) Without restricting the generality of subsection (1), the Minister of Health may, for the same purposes, request that they provide the Minister, on a voluntary basis, with the following information:
(a) the number of persons who died as a result of having received medical assistance in dying in the province or territory; and
(b) personal information relating to the death of persons who died as a result of having received medical assistance in dying in the province or territory, including
(i) copies of medical certificates of death of those persons, and
(ii) the findings of any investigations undertaken by the Chief Coroner or Chief Medical Examiner in respect of the deaths of those persons.
Publication of Information
Marginal note:Report
13 (1) The Minister of Health must cause to be published, at least once a year, on the website of the Government of Canada a report that is based on information that the Minister obtained under these Regulations.
Marginal note:Content — period covered by report
(2) The report must contain information relating to requests for medical assistance in dying received by preliminary assessors or practitioners, and the provision of medical assistance in dying during the period covered by the report, including
(a) the number of requests that were made and the results of those requests;
(b) the characteristics, including medical characteristics, of persons who have made a request;
(c) information respecting the race or Indigenous identity of persons who have made a request, and any disability of those persons, if they consented to providing that information;
(d) the nature of the intolerable physical or psychological suffering of persons who received medical assistance in dying;
(e) the reasons for which persons who have made a request did not receive medical assistance in dying, including which of the eligibility criteria they did not meet;
(f) the places in which medical assistance in dying was provided;
(g) time periods relating to the handling of requests for, and the provision of, medical assistance in dying;
(h) information as to whether practitioners consulted with other health care professionals or social workers regarding requests;
(i) the nature of involvement of practitioners in requests and the provision of medical assistance in dying, including the respective involvement of medical practitioners and nurse practitioners; and
(j) information as to whether persons who have made a request consulted with practitioners concerning their health, for a reason other than seeking medical assistance in dying, before practitioners received their requests for medical assistance in dying.
Marginal note:Other content
(3) The report must also contain
(a) the methodology employed to arrive at any findings set out in the report;
(b) information on trends in relation to requests for, and the provision of, medical assistance in dying; and
(c) the period covered by the report.
Marginal note:Restriction
(4) The report must not include any personal information of an individual
(a) who provided information under these Regulations; or
(b) in respect of whom information was obtained by the Minister of Health under these Regulations.
Other Disclosure
Marginal note:Disclosure to provinces and territories
14 The Minister of Health may disclose to a provincial or territorial government, or any of its institutions, or to a public body established under an Act of the legislature of a province or territory personal information that the Minister obtained under these Regulations if the purpose of the disclosure is to support the monitoring of medical assistance in dying in the province or territory.
Marginal note:Research
15 The Minister of Health may disclose, for the purposes of enabling research or statistical analysis with respect to medical assistance in dying, personal information that the Minister obtained under these Regulations — other than an individual’s name — to any individual or organization if the Minister
(a) determines that the disclosure is necessary to achieve the objectives of the research or statistical analysis; and
(b) receives a written undertaking by the individual or organization
(i) to use the information only for the purpose for which it was disclosed, and
(ii) not to disclose the information in any form that could reasonably be expected to identify the individual to whom it relates.
Marginal note:Disclosure to Minister of Health
16 (1) A recipient designated under subsection 2(2) must disclose to the Minister of Health, within 30 days after the day on which a quarter begins, the information — other than the information referred to in paragraphs 2(a) and (g) and 2.1(a) and (d) of Schedule 1 and paragraphs 2(a) and (d) of Schedule 7 — that the recipient obtained under these Regulations in the preceding quarter.
Marginal note:Definition
(2) For the purposes of subsection (1), quarter means any period of three consecutive months beginning on January 1, April 1, July 1 or October 1.
Coming into Force
Marginal note:Fourth month after registration
Footnote *17 (1) These Regulations, except section 13, come into force on the first day of the fourth month following the month in which they are registered.
Marginal note:Section 13
(2) Section 13 comes into force on the first anniversary of the day on which section 2 of these Regulations comes into force.
Return to footnote *[Note: Regulations, except section 13, in force November 1, 2018; section 13 in force November 1, 2019.]
SCHEDULE 1(Paragraph 5(1)(a), subsections 6(1), 6.1(1) and 7(1) and (2), section 8, paragraph 9(a) and subsection 16(1))Basic Information — Request for Medical Assistance in Dying
1 The following information in respect of the person who made the request for medical assistance in dying:
(a) date of birth;
(b) sex at birth and gender identity;
(c) race or Indigenous identity, and any disability of the person, if they consented to providing that information;
(d) usual place of residence and living arrangement on the day on which the preliminary assessor or the practitioner received the request;
(e) health insurance number and the province or territory that issued it or, in the case where they do not have a health insurance number, the province or territory of their usual place of residence on the day on which the preliminary assessor or the practitioner received the request; and
(f) the postal code associated with the person’s health insurance number or, in the case where they do not have a health insurance number, the postal code of their usual place of residence on the day on which the preliminary assessor or the practitioner received the request.
2 The following information in respect of the practitioner:
(a) name;
(b) an indication of whether they are a medical practitioner or nurse practitioner;
(c) if they are a family physician, an indication to that effect;
(d) if they are a medical practitioner other than a family physician, their area of specialty;
(e) the province or territory in which they practise and, if they practise in more than one province or territory, the province or territory in which they received the request;
(f) the licence or registration number assigned to them in the province or territory in which they received the request;
(g) the telephone number, mailing address and email address that they use for work; and
(h) to the best of their knowledge or belief, an indication of whether, before they received the request, the person who made the request consulted them concerning the person’s health for a reason unrelated to seeking medical assistance in dying.
2.1 The following information in respect of the preliminary assessor:
(a) name;
(b) profession or occupation;
(c) the province or territory in which they work; and
(d) the telephone number, mailing address and email address that they use for work.
3 The following information in respect of the request:
(a) the date on which the person made the request; and
(b) an indication of whether the preliminary assessor or the practitioner received the request from the person who made it directly or from a preliminary assessor, a practitioner, a care coordination service or another third party.
4 If known, an indication by the preliminary assessor or practitioner of whether the person had previously made a request for medical assistance in dying, and if so, the outcome of that request.
SCHEDULE 2
SCHEDULE 3(Paragraph 5(1)(b), subsections 6(1), 6.1(1) and 7(1) and (2), section 8 and paragraph 9(b))Eligibility Criteria and Related Information
1 An indication of whether the preliminary assessor or the practitioner consulted with other health care professionals — other than the practitioners described in section 3 of these Regulations — or social workers in order to determine whether the person who made the request for medical assistance in dying met the eligibility criteria and, if so, the professions of those persons.
2 An indication of which of the following eligibility criteria were assessed by the preliminary assessor or the practitioner and whether they were of the opinion that the person who made the request for medical assistance in dying met or did not meet each of those criteria:
(a) the person was eligible — or, but for any applicable minimum period of residence or waiting period, would have been eligible — for health services funded by a government in Canada;
(b) the person was at least 18 years of age;
(c) the person was capable of making decisions with respect to their health;
(d) the person made a voluntary request for medical assistance in dying that, in particular, was not made as a result of external pressure;
(e) the person gave informed consent to receive medical assistance in dying after having been informed of the means that are available to relieve their suffering, including palliative care;
(f) the person had a serious and incurable illness, disease or disability;
(g) the person was in an advanced state of irreversible decline in capability; and
(h) the illness, disease, disability or state of decline caused the person enduring physical or psychological suffering that was intolerable to the person and that could not be relieved under conditions that the person considered acceptable.
3 An indication by the preliminary assessor or the practitioner of the following:
(a) in the case where they assessed whether the person made a voluntary request for medical assistance in dying that, in particular, was not made as a result of external pressure, the reasons why they were of the opinion that the person met or did not meet this eligibility criteria;
(b) in the case where they assessed whether the person had a serious and incurable illness, disease or disability and were of the opinion that the person met this eligibility criteria, the type of illness, disease or disability and the length of time that the person had it;
(c) in the case where they assessed whether the person was in an advanced state of irreversible decline in capability and were of the opinion that the person met this eligibility criteria, the reasons for that opinion; and
(d) in the case where they assessed whether the illness, disease, disability or state of decline caused the person enduring physical or psychological suffering that was intolerable to the person and that could not be relieved under conditions that the person considered acceptable and were of the opinion that the person met this eligibility criteria, the nature of the suffering as described by the person.
4 In the case where medical assistance in dying was provided to a person whose natural death was not reasonably foreseeable, an indication by the practitioner of the following:
(a) the date on which they began their assessment of whether the person who made the request for medical assistance in dying met the eligibility criteria or the date on which the other practitioner referred to in paragraph 241.2(3.1)(e) of the Code began that assessment, whichever is earlier; and
(b) the number of days during the period beginning on the date provided under paragraph (a) and ending on the latest of the following dates:
(i) the date on which the practitioner completed their assessment,
(ii) the date on which the other practitioner referred to in paragraph 241.2(3.1)(e) of the Code completed their assessment,
(iii) the date on which the safeguard set out in paragraph 241.2(3.1)(g) of the Code was met, and
(iv) the date on which the safeguard set out in paragraph 241.2(3.1)(h) of the Code was met.
5 An indication by the preliminary assessor or the practitioner of whether the person who made the request for medical assistance in dying required palliative care, if known, and if so,
(a) if the person received palliative care, the type of palliative care they received, how long they received it and the place where it was received, if known; or
(b) if the person did not receive palliative care, an indication of whether, to the best of the knowledge or belief of the preliminary assessor or the practitioner, palliative care was accessible to the person.
6 An indication by the preliminary assessor or the practitioner of whether the person who made the request for medical assistance in dying required disability support services, if known, and if so,
(a) if the person received disability support services, the type of disability support services they received and how long they received them, if known; or
(b) if the person did not receive disability support services, an indication of whether, to the best of the knowledge or belief of the preliminary assessor or the practitioner, disability support services were accessible to the person.
7 An indication by the preliminary assessor or the practitioner of whether or not, taking into account all of the medical circumstances of the person who made the request for medical assistance in dying, their natural death was reasonably foreseeable, if known.
8 In the case where after having determined that the person who made the request for medical assistance in dying met all of the eligibility criteria, the practitioner subsequently determined that a safeguard set out in subsection 241.2(3) or (3.1) of the Code, as the case may be, had not been met, an indication of which safeguard had not been met and the reason they made that determination.
SCHEDULE 4(Subsections 7(1) and (2) and section 8)Procedural Requirements for Providing Medical Assistance in Dying — Natural Death 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 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;
(h) 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, except in the case where the practitioner provided medical assistance in dying to the person in accordance with subsection 241.2(3.2) of the Code;
(i) in the case where the practitioner provided medical assistance in dying to the person in accordance with subsection 241.2(3.2) of the Code,
(i) whether, before the person lost the capacity to consent to receiving medical assistance in dying,
(A) the person met all of the eligibility criteria and the requirements set out in subsection 241.2(3) of the Code were met,
(B) the person entered into an arrangement in writing with the practitioner that the practitioner would administer a substance to cause their death on a specified day,
(C) the person was informed by the 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
(D) in the written arrangement, the person consented to the administration by the 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,
(ii) whether the person lost the capacity to consent to receiving medical assistance in dying,
(iii) whether the person did not demonstrate, by words, sounds or gestures, refusal to have the substance administered or resistance to its administration, and
(iv) whether the substance was administered to the person in accordance with the terms of the arrangement;
(j) 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
(k) 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.
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.
SCHEDULE 5(Subsections 7(1) and (2))Prescribing or Providing a Substance
1 The date on which the practitioner prescribed or provided the substance to the person who made the request for medical assistance in dying.
2 The place where the person who made the request for medical assistance in dying was staying when the practitioner prescribed or provided the substance to them.
3 The following information:
(a) an indication of whether the person who made the request for medical assistance in dying self-administered the substance, if known;
(b) in the case where the practitioner knows that the person who made the request self-administered the substance,
(i) an indication of whether the practitioner was present when the person self-administered the substance,
(ii) the date on which the person self-administered the substance, if known,
(iii) the place where the person self-administered the substance, if known, and
(iv) an indication of whether the person’s self-administration of the substance caused their death, if known; and
(c) in the case where, to the best of the practitioner’s knowledge or belief, the person who made the request did not self-administer the substance,
(i) an indication of whether the person has died, if known, and
(ii) in the case where the person has died, the date of death, if known.
SCHEDULE 6(Section 8)Administering a Substance
1 The date on which the practitioner administered the substance to the person who made the request for medical assistance in dying.
2 The place where the practitioner administered the substance to the person who made the request for medical assistance in dying.
3 An indication of whether the person who made the request for medical assistance in dying was transferred from one place to another for the purposes of administering the substance to them and, if so, the reasons for the transfer, if known.
4 In the case where the practitioner administered a second substance to the person who made the request for medical assistance in dying in accordance with subsection 241.2(3.5) of the Code, an indication of whether
(a) before the person lost the capacity to consent to receiving medical assistance in dying, the practitioner entered into an arrangement in writing with the person providing that they would be present at the time the person self-administered the first substance and that they would 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-administered the first substance, did not die within the period specified in the arrangement and lost the capacity to consent to receiving medical assistance in dying; and
(c) the second substance was administered to the person in accordance with the terms of the arrangement.
SCHEDULE 7(Section 11 and subsection 16(1))Dispensing a Substance
1 The following information in respect of the person who made the request for medical assistance in dying and for whom the substance was dispensed:
(a) date of birth; and
(b) health insurance number and the province or territory that issued it or, in the case where they do not have a health insurance number or the pharmacist or pharmacy technician does not know the person’s health insurance number, the province or territory of their usual place of residence on the day on which the pharmacist or pharmacy technician dispensed the substance.
2 The following information in respect of the pharmacist or pharmacy technician:
(a) name and an indication of whether they are a pharmacist or pharmacy technician;
(b) the province or territory in which they practise and, if they practise in more than one province or territory, the province or territory in which they dispensed the substance;
(c) the licence or registration number assigned to them in the province or territory in which they dispensed the substance; and
(d) the mailing address and email address that they use for work.
3 The following information in respect of the practitioner who prescribed the substance or obtained the substance from the pharmacist or pharmacy technician:
(a) name; and
(b) the licence or registration number assigned to the practitioner in the province or territory in which they received the request.
4 The following information in respect of the dispensing of the substance:
(a) the date on which the substance was dispensed; and
(b) an indication of whether the pharmacist or pharmacy technician dispensed the substance in a hospital pharmacy or community pharmacy or, if they dispensed the substance elsewhere, a description of that place.
- Date modified: