An Act to amend the Criminal Code (medical assistance in dying)

This bill, introduced in the Senate, would expand who can arrange in advance to receive medical assistance in dying (MAID) even after they lose the ability to give final consent at the time it is provided. Currently, only people whose natural death is reasonably foreseeable can waive final consent, and only by arranging with their doctor or nurse practitioner for MAID on a specific future date. This bill keeps that option but also extends a similar "waiver of final consent" possibility to people whose death is not reasonably foreseeable.

Specifically, the bill creates two pathways. First, a person can enter a written arrangement with their medical practitioner or nurse practitioner to receive MAID on a specific future date, even if they lose capacity to consent before that date, as long as they met all other MAID eligibility rules and safeguards beforehand and were warned about the risk of losing capacity. Second, a person diagnosed with a serious and incurable illness, disease, or disability can make a written advance declaration, witnessed by two independent people and certified by a doctor, listing specific symptoms or conditions. If the person later loses capacity to consent and develops the symptoms described in that declaration, a practitioner may provide MAID based on that declaration, without needing new consent at the time — as long as the declaration was made within the past five years and all other legal safeguards were followed.

In both cases, if the person shows any signs of refusal or resistance through words, sounds, or gestures when the procedure is about to happen, MAID cannot proceed, even if they previously consented in writing. The bill's preamble notes that Quebec has already allowed similar advance requests for MAID under provincial law, and this bill aims to create an equivalent option under the federal Criminal Code, which governs MAID eligibility nationally.

This bill amends the Criminal Code to let a person arrange in advance to receive medical assistance in dying (MAID) after losing the capacity to give final consent, through either a dated arrangement or a written waiver declaration tied to specified symptoms.

• Specified-day arrangements — a person not reasonably expected to die soon can sign a written arrangement with a medical or nurse practitioner fixing a date for MAID, valid even if they lose capacity to consent before that date, provided they were told of that risk beforehand.
• Advance waiver declarations — a person diagnosed with a serious and incurable illness, disease or disability can make a written declaration listing specific symptoms; if those symptoms occur and the person has since lost capacity to consent, MAID can proceed without final consent at the time.
• Declaration validity period — a waiver declaration made under this section expires if more than five years have elapsed since the diagnosis on which it was based.
• Witnessing and certification requirements — declarations require two independent witnesses confirming voluntariness, and a medical practitioner must certify that the listed symptoms are clearly defined, observable, and that witnesses meet the independence requirement.
• Practitioner's discretion at time of administration — the practitioner administering the substance must judge, at the time, whether the person is showing refusal or resistance "by words, sounds or gestures"; if so, MAID can no longer proceed under the advance arrangement or declaration, but the bill does not further define how such resistance is to be assessed.
• No new oversight body created — the bill does not establish any new review mechanism, reporting requirement, or sunset clause specific to these advance arrangements or waivers beyond the existing Criminal Code MAID safeguards it amends.