Bill C-41, titled the Medical Assistance in Dying Safeguards Act, proposes changes to the Criminal Code and related amendments to other Acts. It would create a limited route for medical assistance in dying (MAID) based on an advance request, while keeping the exclusion for MAID based on mental illness. The stated goal is to allow advance requests in certain circumstances, with safeguards.
The supplied text does not establish whether the bill became law. The changes below are proposed, not confirmed to be in force.
A medical practitioner or nurse practitioner could provide MAID to someone who has lost capacity to consent, but only if the person meets detailed eligibility and safeguard rules.
The person must have made the request while capable, after diagnosis with a serious and incurable illness or disease reasonably expected to cause irreversible loss of capacity. Mental illness cannot be the basis for an advance request.
Advance-request MAID could be provided only in a province with legislation setting rules for making, storing, accessing, withdrawing and changing requests, and protecting them from unauthorized changes.
A practitioner must not proceed if the person demonstrates refusal or resistance. If the practitioner doubts whether words, sounds or gestures show refusal or resistance, they must wait at least 30 clear days; a clear demonstration of refusal or resistance ends the request.
The bill would also amend federal reporting rules and related pension, veterans’ benefits and corrections laws to address MAID provided under the proposed advance-request rules.
People making an advance request: The proposed route would be limited to adults who are capable when they sign, are eligible for publicly funded health services, and meet the bill’s other conditions. They would need practitioner assistance and information about their diagnosis, prognosis and available ways to relieve anticipated suffering.
People who later lose capacity: MAID could be provided only if the person meets the criteria at that time, including recurring clinical manifestations described in the request, advanced irreversible decline, and enduring and intolerable suffering that cannot be relieved through reasonable means. The practitioner must base the suffering assessment on the person’s current medical state and available information, not only on those recurring manifestations.
Practitioners and pharmacists: Practitioners would have to meet the proposed safeguards, including getting a second written opinion and checking for conflicts that could affect objectivity. A practitioner obtaining the substance must tell the pharmacist its intended use before it is dispensed. Knowingly failing to meet specified safeguards or provide that notice could lead to an offence punishable by up to five years in prison if prosecuted by indictment, or by summary conviction.
Provinces: A provincial legislative regime and repository would be a condition for providing advance-request MAID in that province. The bill does not itself create provincial repositories or require provinces to pass those laws.
Everyone else: The text does not create a new independent agency, require any practitioner to provide MAID, or establish a new front-line service. It says no individual is compelled to provide or help provide advance-request MAID.
No publicly available information on the bill’s cost is included in the supplied material.
The bill would require provincial legislation to identify a repository and set rules for advance requests, but it gives no cost estimate for those systems.
It does not specify new federal funding, staffing levels, fees or payments for practitioners.
The supplied material does not establish whether the bill passed, when it might take effect, or which provisions—if any—are in force.
The supplied text does not include the parent Acts, so the existing law and the full extent of the proposed changes to it cannot be verified.
It does not set out detailed rules for deciding whether a person’s condition meets terms such as “advanced state of irreversible decline” or “enduring and intolerable” suffering.
It does not explain how provinces would set up or fund repositories, or whether and when provinces would adopt the required legislation.
It does not specify the full process for resolving disagreements about eligibility or how a person could challenge a decision.
The bill appears intended to let people state their wishes while they still have capacity, for a time when a serious illness may have taken that capacity away.
Requiring eligibility checks both when the request is made and when MAID would be provided could help limit the route to the circumstances set out in the request and the bill.
A second practitioner’s written opinion, conflict-of-interest rules and provincial controls on stored requests could add checks against errors or unauthorized changes.
The refusal rule gives priority to a person’s later words, sounds or gestures that clearly show resistance.
Whether the person’s later condition matches the request, or amounts to intolerable suffering, would require clinical judgment. The bill does not fully define these terms.
Access would depend on whether a province has the required legislation and repository. The bill does not ensure that every province will create them.
The person would no longer be able to consent at the time MAID is provided, so applying an earlier request raises difficult questions about how to interpret their later behaviour.
The bill sets federal minimum rules but leaves important details of storage and request management to provincial law. The supplied text does not explain how those rules would be monitored or how errors would be addressed.