This enactment amends the Criminal Code to

(a) permit an individual whose death is not reasonably foreseeable to enter into a written arrangement to receive medical assistance in dying on a specified day if they lose the capacity to consent to receiving medical assistance in dying prior to that day; and

(b) permit an individual who has been diagnosed with a serious and incurable illness, disease or disability to make a written declaration to waive the requirement for final consent when receiving medical assistance in dying if they lose the capacity to consent to receive medical assistance in dying, are suffering from symptoms outlined in the written declaration and have met all other relevant safeguards outlined in the Criminal Code.

Her Majesty, by and with the advice and consent of the Senate and House of Commons of Canada, enacts as follows:

Safeguards — natural death not foreseeable

(3.‍1)  Insertion start Subject to subsection (3.‍2), Insertion end before a medical practitioner or nurse practitioner provides medical assistance in dying to a person whose natural death is not reasonably foreseeable, taking into account all of their medical circumstances, the medical practitioner or nurse practitioner must

Final consent — waiver

(3.‍2)  Insertion start A Insertion end medical practitioner or nurse practitioner may Insertion start , despite Insertion end paragraph (3)‍(h) Insertion start or (3.‍1)‍(k), Insertion end administer a substance to a person to cause their death if

• (a) before the person loses the capacity to consent to receiving medical assistance in dying, they met all of the criteria set out in subsection (1), all other safeguards in either subsection (3) Insertion start or (3.‍1) Insertion end were met Insertion start , and the person Insertion end

  • (i)  Insertion start entered into an arrangement under paragraph (3.‍21), or Insertion end

  • (ii)  Insertion start made a declaration under paragraph (3.‍22); Insertion end

• (b) the person has lost the capacity to consent to receiving medical assistance in dying;

• (c) the person does not demonstrate, by words, sounds or gestures, refusal to have the substance administered or resistance to its administration; and

• (d) the substance is administered to the person in accordance with the terms of the arrangement Insertion start or declaration Insertion end .

Waiver — specified day

(3.‍21) For the purposes of subparagraph (3.‍2)‍(a)‍(i), a person may waive the need for final consent if

• (a) they entered into an arrangement in writing with the medical practitioner or nurse practitioner who will be administering a substance to cause that person’s death that the medical practitioner or nurse practitioner would administer a substance to cause their death on a specified day;

• (b) they were informed by the medical practitioner or nurse practitioner of the risk of losing the capacity to consent to receiving medical assistance in dying prior to the day specified in the arrangement; and

• (c) in the written arrangement, they consented to the administration by the medical practitioner or nurse practitioner of a substance to cause their death on or before the day specified in the arrangement if they lost their capacity to consent to receiving medical assistance in dying prior to that day.

  End of inserted block

Waiver — specified conditions

(3.‍22) For the purposes of subparagraph (3.‍2)‍(a)‍(ii), a person may waive the need for final consent if

• (a) they made a declaration in writing that a medical practitioner or nurse practitioner may administer a substance to cause that person’s death should the person lose the capacity to consent to receiving medical assistance in dying and be suffering conditions related to their serious and incurable illness, disease or disability that are identified clearly in the declaration and can be observed by the medical practitioner or nurse practitioner;

• (b) the declaration was made after a diagnosis of a serious and incurable illness, disease or disability by a medical practitioner, but no more than five years have elapsed since the declaration was made;

• (c) in the declaration, the person consented to the administration by a medical practitioner or nurse practitioner of a substance to cause their death if they are suffering from the conditions listed in the declaration and have lost their capacity to consent to receiving medical assistance in dying prior to that point;

• (d) the declaration was witnessed by two independent witnesses to confirm that it was made voluntarily and not as a result of external pressure and each witness signed and dated it; and

• (e) a medical practitioner has certified that

  • (i) the conditions specified in the declaration are clearly identified,

  • (ii) the conditions specified can be observed by a medical practitioner or nurse practitioner should the person be experiencing them, and

  • (iii) each witness is an independent witness as described in subsection (5).

    End of inserted block

Advance consent invalidated

(3.‍4) Once a person demonstrates, by words, sounds or gestures, in accordance with subsection (3.‍2), refusal to have the substance administered or resistance to its administration, medical assistance in dying can no longer be provided to them on the basis of Insertion start subsections (3.‍21) or (3.‍22) Insertion end .