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Regulations for the Monitoring of Medical Assistance in Dying (SOR/2018-166)

Regulations are current to 2022-09-22 and last amended on 2019-11-01. Previous Versions

Regulations for the Monitoring of Medical Assistance in Dying

SOR/2018-166

CRIMINAL CODE

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.

Ottawa, July 25, 2018

La ministre de la Santé
blank line
Ginette Petitpas Taylor
Minister of Health

Interpretation

Marginal note:Definitions

 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 means a person who has made a written request for medical assistance in dying. (patient)

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)

refer

refer does not include referring a patient to a practitioner in order to obtain that practitioner’s written opinion, for the purposes of paragraph 241.2(3)(e) of the Code, regarding whether the patient meets all of the eligibility criteria. (aiguiller)

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

  •  (1) The Minister of Health is designated as the recipient of information for the purposes of subsections 241.31(1) and (2) of the Code.

  • Marginal note:Designation — other recipients

    (2) Despite subsection (1), the following persons are designated as the recipients of information for the purposes of subsections 241.31(1) and (2) of the Code in respect of the following information:

    • (a) in respect of the information to be provided under paragraph 7(2)(b) or subsection 8(2), the Chief Coroner for Ontario;

    • (a.1) in respect of the information to be provided by a practitioner who receives a written request for medical assistance in dying in Quebec or by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying, the Deputy Minister of Health and Social Services of Quebec;

    • (b) in respect of the information to be provided by a practitioner who receives a written request for medical assistance in dying in British Columbia or by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying, the Deputy Minister of Health of British Columbia;

    • (c) in respect of the information to be provided by a practitioner who receives a written request for medical assistance in dying in Saskatchewan or by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying, the Chief Executive Officer of the Saskatchewan Health Authority;

    • (d) in respect of the information to be provided by a practitioner who receives a written request for medical assistance in dying in Alberta or by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying, the Minister of Health of Alberta;

    • (e) in respect of the information to be provided by a practitioner who receives a written request for medical assistance in dying in the Northwest Territories or by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying, the Deputy Minister of Health and Social Services of the Northwest Territories; and

    • (f) in respect of the information to be provided by a practitioner who receives a written request for medical assistance in dying in Nunavut or by a pharmacist who dispenses a substance there in connection with the provision of medical assistance in dying, the Minister of Health of Nunavut.

Practitioners

Marginal note:Exception — no information required

 A practitioner who has received a patient’s written request for medical assistance in dying from the patient directly or from another practitioner, a care coordination service or another person on the patient’s behalf in order to obtain the practitioner’s written opinion, for the purposes of paragraph 241.2(3)(e) of the Code, regarding whether the patient meets all of the eligibility criteria, is not required, in respect of the request, to provide information under subsection 5(1) or 6(1) or section 9.

Marginal note:Referral or transfer of care of patient

  •  (1) A practitioner who has received a patient’s written request for medical assistance in dying and refers the patient, in respect of the request, to another practitioner or to a care coordination service, or, as a result of the request, transfers the care of the patient to another practitioner, must provide the applicable recipient designated under section 2 with the information referred to in Schedules 1 and 2 within 30 days after the day on which they refer, or transfer the care of, the patient.

  • 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:Withdrawal of request

  •  (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 patient’s written 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 patient met all of the eligibility criteria, the information referred to in Schedule 3;

    • (c) the patient’s reasons for withdrawing the request, if known; and

    • (d) in the case where the patient withdrew their request after having been given an opportunity to do so under paragraph 241.2(3)(h) 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

  •  (1) A practitioner who has received a patient’s written request for medical assistance in dying and determines that the patient does not meet one or more of the eligibility criteria must provide the applicable recipient designated under section 2 with the information referred to in Schedules 1 and 3 within 30 days after the day on which the practitioner makes that determination.

  • Marginal note:Clarification

    (2) For greater certainty, subsection (1) applies if the practitioner determined that the patient met all of the eligibility criteria but subsequently determines that the patient 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 section 9.

Marginal note:Prescribing or providing a substance — general

  •  (1) A practitioner who has received a patient’s written request for medical assistance in dying and provides medical assistance in dying by prescribing or providing a substance to the patient for self-administration must provide the applicable recipient designated under section 2 with the information referred to in Schedules 1 and 3 to 5 no earlier than 90 days after the day on which the practitioner prescribes or provides the substance and no later than 120 days after that day.

  • Marginal note:Prescribing or providing a substance — Ontario

    (2) Despite subsection (1), a practitioner who has received a patient’s written request for medical assistance in dying and provides medical assistance in dying in Ontario by prescribing or providing a substance to the patient for self-administration must provide the information referred to in Schedules 1 and 3 to 5, no earlier than 90 days after the day on which the practitioner prescribes or provides the substance and no later than 120 days 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 patient has died following self-administration of the substance.

  • Marginal note:Exception — time to report

    (3) The practitioner may provide the information earlier than 90 days after the day on which the practitioner prescribes or provides the substance to the patient if the practitioner knows that the patient 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

  •  (1) A practitioner who has received a patient’s written request for medical assistance in dying and provides medical assistance in dying by administering a substance to the patient must provide the applicable recipient designated under section 2 with the information referred to in Schedules 1, 3, 4 and 6 within 30 days after the day on which the patient dies.

  • Marginal note:Administering a substance — Ontario

    (2) Despite subsection (1), a practitioner who has received a patient’s written request for medical assistance in dying and provides medical assistance in dying in Ontario by administering a substance to the patient must provide the recipient designated under paragraph 2(2)(a) with the information referred to in Schedules 1, 3, 4 and 6 within 30 days after the day on which the patient dies.

Marginal note:Death — other cause

 A practitioner who has received a patient’s written request for medical assistance in dying must, within 30 days after the day on which the practitioner becomes aware that the patient 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 patient met all of the eligibility criteria, the information referred to in Schedule 3; and

  • (c) the date of the patient’s death, if known, and, if the patient’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

 A practitioner who has received a patient’s written 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, after the 90th day after the day on which the practitioner received the request.

Pharmacists

Marginal note:Dispensing of substance

 A pharmacist who dispenses a substance in connection with the provision of 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:Information from provinces and territories

  •  (1) The Minister of Health may, for the purposes of monitoring medical assistance in dying, collect personal information relating to written 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:Coroners and medical examiners

    (2) Without restricting the generality of subsection (1), the Minister of Health may, for the purposes of monitoring medical assistance in dying, request that the Chief Coroner or Chief Medical Examiner of a province or territory provide the Minister, on a voluntary basis, with the following information:

    • (a) the number of patients 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 patients 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 patients; and

      • (ii) the findings of any investigations undertaken by the Chief Coroner or Chief Medical Examiner in respect of the deaths of those patients.

Publication of Information

Marginal note:Report

  •  (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 written requests for medical assistance in dying received by 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 patients;

    • (c) the nature of the intolerable physical or psychological suffering of patients who received medical assistance in dying;

    • (d) the reasons for which patients did not receive medical assistance in dying, including which of the eligibility criteria were not met by patients;

    • (e) the places in which medical assistance in dying was provided;

    • (f) time periods relating to the handling of requests for, and the provision of, medical assistance in dying;

    • (g) information as to whether practitioners consulted with other health care professionals or social workers regarding requests;

    • (h) 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

    • (i) information as to whether patients 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 written 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

 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.

 
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