Legislative Background: Medical Assistance in Dying (Bill C-14, as Assented to on June 17, 2016)

Annex A: Clause by Clause Guide to Bill C-14

An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)

Preamble – describes legislative objectives of the Bill

Clause 1 of the Bill

Section 14 of the Criminal Code is re-enacted

Section 14 was found unconstitutional by the Supreme Court in Carter

Section 14 specifies that no person may consent to death and any person who inflicts death on another is criminally responsible regardless of whether they consented to die

In new subsection 227(4) of the Criminal Code (clause 2 of the Bill), it is made clear that the rule in section 14 does not apply where medical assistance in dying is provided in accordance with the criminal law regime

Clause 2 of the Bill

New section 227 of the Criminal Code is enacted

Exemptions for medical practitioners and nurse practitioners and others who assist them, from culpable homicide, where they provide or assist in the provision of medical assistance in dying in the form of administration of medication to a person, at their request, that causes their death

Includes a cross-reference to definitions found in new section 241.1 (clause 3)

Clause 3 of the Bill

Paragraph 241(1)(b) of the Criminal Code is re-enacted

Paragraph 241(b) was found unconstitutional by the Supreme Court in Carter

Paragraph 241(1)(b) makes it an offence for any person to “aid a person” to die by suicide
New subsections 241(2) – (7) are enacted

Exemptions for medical practitioners and nurse practitioners and others who assist, from aiding a person to die by suicide, where such assistance is in the form of providing or prescribing medication to a person, at their request, that the person could self-administer to cause their own death

Includes exemptions for pharmacists who fill prescriptions in relation to medical assistance in dying, and for any person who aids the person to self-administer the medication, and clarifies that no social worker, psychologist, psychiatrist, therapist, medical practitioner, nurse practitioner or other health care professional commits an offence if they provide information to a person on the lawful provision of medical assistance in dying

Cross-reference to definitions found in new section 241.1 (clause 3)

New section 241.1 is enacted
Provides definitions for the terms used in the lawful medical assistance in dying regime (medical assistance in dying; medical practitioner; nurse practitioner; pharmacist)
New section 241.2 is enacted

Requirements for lawful provision of medical assistance in dying:

  • eligibility criteria including definition of “grievous and irremediable medical condition”
  • mandatory procedural safeguards
  • meaning of “independence” in relation to witnesses and physicians and nurse practitioners
  • requirement for reasonable care and skill, compliance with applicable PT rules and duty to inform pharmacist that medication is prescribed or obtained for medical assistance in dying
  • clarification that nothing in this section compels an individual to provide or assist in providing medical assistance in dying
New section 241.3 is enacted
New hybrid offence for failing to comply with safeguards in providing medical assistance in dying
New section 241.4 is enacted

New hybrid offences for forging medical assistance in dying documents or destroying such documents with criminal intent

Definition of “document”

Clause 4 of the Bill

New section 241.31 is enacted

Will be brought into force at a later date when regulations are ready

Creates an obligation on the Minister of Health to make regulations that she considers necessary to create a monitoring regime, and to create guidelines, in cooperation with PTs, regarding information to be included on death certificates

Creates legal obligations on medical practitioners, nurse practitioners and pharmacists to provide information on medical assistance in dying requests, in accordance with the regulations

Creates offences for failing to provide reports or for knowingly breaching regulations

Clause 5 of the Bill

New offence (241.4(2)) of destroying documents is amended

Will be brought into force at a later date when regulations are ready

Adds an additional criminal intent (“to interfere with the provision of information” under the monitoring regime) to the offence of destroying documents, to address conduct that could arise after the regulatory requirement to provide information (monitoring) is in place

Clause 6 of the Bill

Section 245 of the Criminal Code is amended
Exemptions are added to the current offence of administering a noxious substance for lawful medical assistance in dying

Clause 7 of the Bill

Section 3 of the Pension Act is amended
Provides that where a person dies by medical assistance in dying, this is not considered improper conduct that would disqualify family members of Canadian Forces members and veterans from receiving pension benefits

Clause 8 of the Bill

Section 19 of the Corrections and Conditional Release Act is amended
Provides that where an inmate dies by medical assistance in dying, this does not trigger an investigation into their death

Clause 9 of the Bill

Section 2 of the Canadian Forces Members and Veterans Re-establishment and Compensation Act is amended
Provides that where a person dies by medical assistance in dying, this is not considered improper conduct that would disqualify family members of Canadian Forces members and veterans from receiving pension benefits

Clause 9.1 of the Bill

Statutory duty to undertake 3 studies

Creates a statutory obligation on the Ministers of Justice and Health to undertake 3 studies on mature minors, advance requests and requests where mental illness is the sole underlying medical condition:

  • no later than 6 months after the Act receives royal assent
  • must report back to Parliament no later than 2 years after the reviews are initiated

Clause 10 of the Bill

Parliamentary review
A Parliamentary review of the provisions of the Act and the state of palliative care in Canada will be launched 5 years after its coming into force

Clause 11 of the Bill

Coming into force of Clauses 4 and 5 by Order in Council
The monitoring regime and related provisions will come into force no later than 12 months after royal assent (other clauses come into force on royal assent)