MINISTER OF JUSTICE
90795
SUMMARY
This
enactment amends the Criminal Code to, among other things,
(a) create exemptions from the
offences of culpable homicide, of aiding suicide and of administering a noxious
thing, in order to permit medical practitioners and nurse practitioners to
provide medical assistance in dying and to permit pharmacists and other persons
to assist in the process;
(b) specify the eligibility
criteria and the safeguards that must be respected before medical assistance in
dying may be provided to a person;
(c) require that medical
practitioners and nurse practitioners who receive requests for, and pharmacists
who dispense substances in connection with the provision of, medical assistance
in dying provide information for the purpose of permitting the monitoring of
medical assistance in dying, and authorize the Minister of Health to make regulations
respecting that information; and
(d) create new offences for
failing to comply with the safeguards, for forging or destroying documents
related to medical assistance in dying, for failing to provide the required
information and for contravening the regulations.
This
enactment also makes related amendments to other Acts to ensure that recourse
to medical assistance in dying does not result in the loss of a pension under
the Pension Act or benefits under the Canadian Forces Members and
Veterans Re-establishment and Compensation Act. It amends the Corrections
and Conditional Release Act to ensure that no investigation need be
conducted under section 19 of that Act in the case of an inmate who receives
medical assistance in dying.
Lastly, this
enactment provides for a parliamentary review of its provisions, to commence at
the start of the fifth year following the day on which it receives royal
assent.
Available on the Parliament of Canada Web Site at the following address:
http://www.parl.gc.ca
1st Session, 42nd Parliament,
64-65 Elizabeth II, 2015-2016
HOUSE OF COMMONS OF CANADA
BILL C-14
An Act to
amend the Criminal Code and to make related amendments to other Acts (medical
assistance in dying)
Preamble
Whereas the
Parliament of Canada recognizes the autonomy of persons who have a grievous and
irremediable medical condition that causes them enduring and intolerable
suffering and who wish to seek medical assistance in dying;
Whereas
robust safeguards, reflecting the irrevocable nature of ending a life, are
essential to prevent errors and abuse in the provision of medical assistance in
dying;
Whereas it
is important to affirm the inherent and equal value of every person’s life and
to avoid encouraging negative perceptions of the quality of life of persons who
are elderly, ill or disabled;
Whereas
vulnerable persons must be protected from being induced, in moments of
weakness, to end their lives;
Whereas
suicide is a significant public health issue that can have lasting and harmful
effects on individuals, families and communities;
Whereas, in
light of the above considerations, permitting access to medical assistance in
dying for competent adults whose deaths are reasonably foreseeable strikes the
most appropriate balance between the autonomy of persons who seek medical
assistance in dying, on one hand, and the interests of vulnerable persons in
need of protection and those of society, on the other;
Whereas it
is desirable to have a consistent approach to medical assistance in dying
across Canada, while recognizing the provinces’ jurisdiction over various
matters related to medical assistance in dying, including the delivery of
health care services and the regulation of health care professionals, as well
as insurance contracts and coroners and medical examiners;
Whereas
persons who avail themselves of medical assistance in dying should be able to
do so without adverse legal consequences for their families — including the loss of
eligibility for benefits — that would result from their
death;
Whereas the
Government of Canada has commit-ted to uphold the principles set out in the Canada
Health Act — public administration, comprehensiveness,
universality, portability and accessibility — with respect to medical
assistance in dying;
And whereas
the Government of Canada has committed to develop non-legislative measures that
would support the improvement of a full range of options for end-of-life care,
respect the personal convictions of health care providers and explore other
situations — each having unique implications — in which a person may seek
access to medical assistance in dying, namely situations giving rise to
requests by mature minors, advance requests and requests where mental illness
is the sole underlying medical condition;
Now,
therefore, Her Majesty, by and with the advice and consent of the Senate and
House of Commons of Canada, enacts as follows:
R.S., c. C-46
1 Section 14 of the Criminal Code is replaced by the following:
Consent to death
14 No person is entitled to
consent to have death inflicted on them, and such consent does not
affect the criminal responsibility of any person who inflicts death on
the person who gave consent.
2 The Act is amended by adding the following after section 226:
Exemption for medical
assistance in dying
227 (1) No medical
practitioner or nurse practitioner commits culpable homicide if they provide a
person with medical assistance in dying in accordance with section 241.2.
Exemption for person aiding
practitioner
(2) No person is a party to
culpable homicide if they do anything for the purpose of aiding a medical
practitioner or nurse practitioner to provide a person with medical assistance
in dying in accordance with section 241.2.
Reasonable but mistaken belief
(3) For greater certainty, the
exemption set out in subsection (1) or (2) applies even if the person invoking
it has a reasonable but mistaken belief about any fact that is an element of
the exemption.
Non-application of section 14
(4) Section 14 does not apply with
respect to a person who consents to have death inflicted on them by means of
medical assistance in dying provided in accordance with section 241.2.
Definitions
(5) In this section, medical
assistance in dying, medical practitioner and nurse
practitioner have the same meanings as in section 241.1.
R.S., c. 27 (1st Supp.), s. 7(3)
3 Section 241 of the Act is replaced by the following:
Counselling or aiding suicide
241 (1) Everyone is guilty of an indictable offence and liable to imprisonment
for a term of not more than14 years who, whether suicide ensues
or not,
(a) counsels a person to die by
suicide or abets a person in dying by suicide; or
(b) aids a person to die by
suicide.
Exemption for medical
assistance in dying
(2) No medical practitioner or
nurse practitioner commits an offence under paragraph (1)(b) if they provide a person with medical
assistance in dying in accordance with section 241.2.
Exemption for person aiding
practitioner
(3) No person is a party to an
offence under paragraph (1)(b) if they do anything for the purpose of
aiding a medical practitioner or nurse practitioner to provide a person with
medical assistance in dying in accordance with section 241.2.
Exemption for pharmacist
(4) No pharmacist who dispenses a
substance to a person other than a medical practitioner or nurse practitioner
commits an offence under paragraph (1)(b) if the pharmacist dispenses the substance
further to a prescription that is written by such a practitioner in providing
medical assistance in dying in accordance with section 241.2.
Exemption for person aiding
patient
(5) No person commits an offence
under paragraph (1)(b) if they do anything, at another person’s explicit request, for the
purpose of aiding that other person to self-administer a substance that has
been prescribed for that other person as part of the provision of medical
assistance in dying in accordance with section 241.2.
Reasonable but mistaken belief
(6) For greater certainty, the
exemption set out in any of subsections (2) to (5) applies even if the person
invoking the exemption has a reasonable but mistaken belief about any fact that
is an element of the exemption.
Definitions
(7) In this section, medical
assistance in dying, medical practitioner, nurse
practitioner and pharmacist have the same meanings as in
section 241.1.
Medical Assistance in Dying
Definitions
241.1 The following definitions
apply in this section and in sections 241.2 to 241.4.
medical assistance in dying means
(a) the administering by a medical
practitioner or nurse practitioner of a substance to a person, at their
request, that causes their death; or
(b) the prescribing or providing
by a medical practitioner or nurse practitioner of a substance to a person, at
their request, so that they may self-administer the substance and in doing so
cause their own death. (aide médicale à mourir)
medical practitioner means a person who is entitled to practise medicine under the laws of a
province. (médecin)
nurse practitioner means a registered nurse who, under the laws of a province, is entitled
to practise as a nurse practitioner – or under an equivalent designation – and
to autonomously make diagnoses, order and interpret diagnostic tests, prescribe
substances and treat patients. (infirmier praticien)
pharmacist means a person who is entitled to practise pharmacy under the laws of a
province. (pharmacien)
Eligibility for medical
assistance in dying
241.2 (1) A person may receive medical
assistance in dying only if they meet all of the following criteria:
(a) they are eligible — or, but for any applicable
minimum period of residence or waiting period, would be eligible — for health services funded by
a government in Canada;
(b) they are at least 18 years of
age and capable of making decisions with respect to their health;
(c) they have a grievous and
irremediable medical condition;
(d) they have made a voluntary
request for medical assistance in dying that, in particular, was not made as a
result of external pressure; and
(e) they give informed consent to
receive medical assistance in dying.
Grievous and irremediable
medical condition
(2) A person has a grievous and
irremediable medical condition if
(a) they have a serious and
incurable illness, disease or disability;
(b) they are in an advanced state
of irreversible decline in capability;
(c) that illness, disease or
disability or that state of decline causes them enduring physical or
psychological suffering that is intolerable to them and that cannot be relieved
under conditions that they consider acceptable; and
(d) their natural death has become
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.
Safeguards
(3) Before a medical practitioner
or nurse practitioner provides a person with medical assistance in dying, 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’s natural death has become reasonably foreseeable, taking into account
all of their medical circumstances;
(c) be satisfied that the request
was signed and dated by the person — or by another person under
subsection (4) — before two independent witnesses who then also
signed and dated the request;
(d) ensure that the person has
been informed that they 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);
(f) be satisfied that they and the
other medical practitioner or nurse practitioner referred to in paragraph (e)
are independent;
(g) ensure that there are at least
15 clear days between the day on which the request was signed by the person and
the day on which the medical assistance in dying is provided or — if they and the other medical
practitioner or nurse practitioner referred to in paragraph (e) are both of the
opinion that the person’s death, or the loss of their capacity to provide
informed consent, is imminent — any shorter period that the
first medical practitioner or nurse practitioner considers appropriate in the
circumstances; and
(h) 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.
Unable to sign
(4) If the person requesting
medical assistance in dying is unable to sign and date the request, another
person — who is at least 18 years of age and who
understands the nature of the request for medical assistance in dying — may do so in the person’s presence on their behalf.
Independent witness
(5) Any person who is at least 18 years
of age and who understands the nature of the request for medical assistance in
dying may act as an independent witness, except if they
(a) know or believe that they are
a beneficiary under the will of the person making the request, or a recipient,
in any other way, of a financial or other material benefit resulting from that
person’s death;
(b) are an owner or operator of
any health care facility at which the person making the request is being
treated or any facility in which that person resides;
(c) are directly involved in
providing health care services to the person making the request; or
(d) directly provide personal care
to the person making the request.
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) are independent if they
(a) are not in a business
relationship with the other practitioner, a mentor to them or responsible for
supervising their work;
(b) do not know or believe that
they are a beneficiary under the will of the person making the request, or a
recipient, in any other way, of a financial or other material benefit resulting
from that person’s death, other than standard compensation for their services
relating to the request; or
(c) do not know or believe that
they are connected to the other practitioner or to the person making the
request in any other way that would affect their objectivity.
Reasonable knowledge, care and
skill
(7) Medical assistance in dying
must be provided with reasonable knowledge, care and skill and in accordance
with any applicable provincial laws, rules or standards.
Informing pharmacist
(8) The medical practitioner or
nurse practitioner who, in providing medical assistance in dying, prescribes or
obtains a substance for that purpose must, before any pharmacist dispenses the
substance, inform the pharmacist that the substance is intended for that
purpose.
Failure to comply with
safeguards
241.3 A medical practitioner or
nurse practitioner who, in providing medical assistance in dying, knowingly
fails to comply with all of the requirements set out in paragraphs 241.2(3)(b) to (h) and subsection 241.2(8) is guilty of an offence and is liable
(a) on conviction on indictment,
to a term of imprisonment of not more than five years; or
(b) on summary conviction, to a
term of imprisonment of not more than 18 months.
Forgery
241.4 (1) Everyone commits an offence
who commits forgery in relation to a request for medical assistance in dying.
Destruction of documents
(2) Everyone commits an offence
who destroys a document that relates to a request for medical assistance in
dying with intent to interfere with
(a) another person’s access to
medical assistance in dying;
(b) the lawful assessment of a
request for medical assistance in dying; or
(c) another person invoking an
exemption under any of subsections 227(1) or (2), 241(2) to (5) or 245(2).
Punishment
(3) Everyone who commits an
offence under subsection (1) or (2) is liable
(a) on conviction on indictment,
to a term of imprisonment of not more than five years; or
(b) on summary conviction, to a
term of imprisonment of not more than 18 months.
Definition of document
(4) In subsection (2), document
has the same meaning as in section 321.
4 The Act is amended by adding the following after section 241.3:
Filing information — medical practitioner or nurse
practitioner
241.31 (1) Unless they
are exempted under regulations made under subsection (3), a medical
practitioner or nurse practitioner who receives a written request for medical
assistance in dying must, in accordance with those regulations, provide the
information required by those regulations to the recipient designated in those
regulations or, if no recipient has been designated, to the Minister of Health.
Filing information — pharmacist
(2) Unless they are exempted under
regulations made under subsection (3), a pharmacist who dispenses a substance
in connection with the provision of medical assistance in dying must, in
accordance with those regulations, provide the information required by those
regulations to the recipient designated in those regulations or, if no
recipient has been designated, to the Minister of Health.
Regulations
(3) The Minister of Health may
make regulations
(a) respecting the provision and
collection, for the purpose of monitoring medical assistance in dying, of
information relating to requests for, and the provision of, medical assistance
in dying, including
(i) the information to be
provided, at various stages, by medical practitioners or nurse practitioners
and by pharmacists, or by a class of any of them,
(ii) the form, manner and time in
which the information must be provided, and
(iii) the designation of a person as
the recipient of the information;
(b) respecting the use of that
information, including its analysis and interpretation, its protection and its
publication and other disclosure;
(c) respecting the disposal of
that information; and
(d) exempting, on any terms that
may be specified, a class of persons from the requirement set out in subsection
(1) or (2).
Offence and punishment
(4) A medical practitioner or
nurse practitioner who knowingly fails to comply with subsection (1), or a
pharmacist who knowingly fails to comply with subsection (2),
(a) is guilty of an indictable
offence and liable to a term of imprisonment of not more than two years; or
(b) is guilty of an offence
punishable on summary conviction.
Offence and punishment
(5) Everyone who knowingly
contravenes the regulations made under subsection (3)
(a) is guilty of an indictable
offence and liable to a term of imprisonment of not more than two years; or
(b) is guilty of an offence
punishable on summary conviction.
5 Subsection 241.4(2) of the Act is amended by striking out “or” at the end of paragraph (b),
by adding “or” at the end of paragraph (c) and by adding the
following after that paragraph:
(d) the provision by a person of
information under section 241.31.
6 Section 245 of the Act is renumbered as subsection 245(1) and is
amended by adding the following after that subsection:
Exemption
(2) Subsection (1) does not apply
to
(a) a medical practitioner or
nurse practitioner who provides medical assistance in dying in accordance with
section 241.2; and
(b) a person who does anything for
the purpose of aiding a medical practitioner or nurse practitioner to provide
medical assistance in dying in accordance with section 241.2.
Definitions
(3) In subsection (2), medical
assistance in dying, medical practitioner and nurse
practitioner have the same meanings as in section 241.1.
R.S., c. P-6
7 (1) The definition improper conduct in subsection 3(1) of the Pension
Act is replaced by the following:
improper conduct includes wilful disobedience of orders, vicious or criminal conduct and
wilful self-inflicted wounding — except if the wound results from the receipt of
medical assistance in dying and the requirement set out in paragraph 241.2(3)(a) of the Criminal Code has been met; (mauvaise conduite)
(2) Subsection 3(1) of the Act is amended by adding the following in
alphabetical order:
medical assistance in dying has the same meaning as in section 241.1 of the Criminal Code; (aide médicale
à mourir)
(3) Section 3 of the Act is amended by adding the following after
subsection (3):
Deeming — medical assistance in dying
(4) For the purposes of this Act,
if a member of the forces receives medical assistance in dying, that member is
deemed to have died as a result of the illness, disease or disability for which
they were determined to be entitled to receive that assistance, in accordance
with paragraph 241.2(3)(a) of the Criminal Code.
1992, c. 20
Corrections and Conditional
Release Act
8 Section 19 of the Corrections and Conditional Release Act is
amended by adding the following after subsection (1):
Medical assistance in dying
(1.1) Subsection (1) does not apply to a death that
results from an inmate receiving medical assistance in dying, as
defined in section 241.1 of the Criminal Code, in accordance with section 241.2 of that Act.
2005, c. 21
Canadian Forces Members and
Veterans Re-establishment and Compensation Act
9 (1) Subsection 2(1) of the Canadian Forces Members and Veterans
Re-establishment and Compensation Act is amended by adding the following in
alphabetical order:
medical assistance in dying has the same meaning as in section 241.1 of the Criminal Code. (aide médicale
à mourir)
(2) Section 2 of the Act is amended by adding the following after
subsection (5):
Interpretation — medical assistance in dying
(6) For the purposes of this Act,
a member or veteran has neither inflicted wilful self-injury nor engaged in
improper conduct by reason only that they receive medical assistance in dying,
if the requirement set out in paragraph 241.2(3)(a) of the Criminal Code has been met.
Deeming — medical assistance in dying
(7) For the purposes of this Act,
if a member or a veteran receives medical assistance in dying, that member or
veteran is deemed to have died as a result of the illness, disease or
disability for which they were determined to be entitled to receive that assistance,
in accordance with paragraph 241.2(3)(a) of the Criminal Code.
Review by committee
10 (1) At the start of the fifth year after the day on which this Act
receives royal assent, the provisions enacted by this Act are to be referred to
the committee of the Senate, of the House of Commons or of both Houses of
Parliament that may be designated or established for the purpose of reviewing
the provisions.
Report
(2) The committee to which the provisions are referred is to review them
and submit a report to the House or Houses of Parliament of which it is a
committee, including a statement setting out any changes to the provisions that
the committee recommends.
Order in council
11 Sections 4 and 5 come into force on a day to be fixed by order of the
Governor in Council.
Published under authority of the Speaker of the
House of Commons
Criminal Code
Clause 1: Existing
text of section 14:
14 No person is entitled to
consent to have death inflicted on him, and such consent does not affect the
criminal responsibility of any person by whom death may be inflicted on the
person by whom consent is given.
Clause 2: New.
Clause 3: Existing
text of section 241:
241 Every one who
(a) counsels a person to commit
suicide, or
(b) aids or abets a person to
commit suicide,
whether
suicide ensues or not, is guilty of an indictable offence and liable to
imprisonment for a term not exceeding fourteen years.
Clause 4: New.
Clause 5: New.
Clause 6: New.
Pension Act
Clause 7: (1) Existing
text of the definition:
improper conduct includes wilful disobedience of orders, wilful self-inflicted wounding
and vicious or criminal conduct; (mauvaise conduite)
(2) and (3) New.
Corrections and Conditional
Release Act
Clause 8: New.
Canadian Forces Members and
Veterans Re-establishment and Compensation Act
Clause 9: New.
