Provinces can allow MAID advance requests

Summary#

This bill changes the Criminal Code to let provinces create their own rules for medical assistance in dying (MAID) based on advance requests by people who are expected to lose the ability to consent to care. It adds criminal-law protection for health workers and others who act under such a provincial framework, and it makes failure to follow those provincial safeguards a crime (amends ss. 227, 241, 241.2, 241.3). Existing federal MAID eligibility and safeguards remain in place.

• Allows MAID to be provided under a provincial framework that permits advance requests for people with an illness that will remove capacity to consent (adds eligibility after s. 241.1).
• Extends criminal exemptions to doctors, nurse practitioners, pharmacists, and helpers when acting under a compliant provincial framework, not only under federal s. 241.2 rules (amends ss. 227(1)-(2); 241(2)-(5); 245(2)).
• States that a person is eligible for MAID if they meet either the existing federal criteria or a qualifying provincial framework’s criteria for advance requests (adds eligibility after s. 241.1; amends s. 241.2(1) opening).
• Makes it an offence to knowingly ignore required safeguards of the applicable provincial framework, similar to current federal safeguards rules (amends s. 241.3).
• Does not set national standards for advance requests; provinces decide the criteria and safeguards (structure of amendments).

What it means for you#

• Households

  • If you have an illness that will remove your ability to consent to care, you could make an advance request for MAID if your province creates a qualifying framework. The request could be acted on later, after loss of capacity, if all provincial criteria are met (adds eligibility after s. 241.1).
  • If your province does not adopt a framework, nothing changes. You would still need to meet the existing federal MAID criteria under s. 241.2 (amends s. 241.2(1) opening).

• Caregivers and families

  • Your role in making, recording, or invoking an advance request would be set by your province’s framework, if one exists. The federal bill does not define these roles (structure of amendments).
  • Dispute processes, notifications, and consent checks would also depend on provincial rules. The federal bill does not specify them (structure of amendments).

• Healthcare workers (physicians and nurse practitioners)

  • You gain federal criminal-law protection when providing MAID under a provincial framework that meets the bill’s conditions, as well as when operating under s. 241.2 (amends ss. 227(1); 241(2)).
  • You must follow all safeguards in the applicable provincial framework. Knowingly failing to do so can be a criminal offence, similar to failing federal safeguards under s. 241.2 (amends s. 241.3).
  • People who aid you in providing MAID under a provincial framework also receive criminal-law protection (amends ss. 227(2); 241(3)).

• Pharmacists and others

  • Pharmacists who dispense substances under a valid MAID prescription within a provincial framework receive criminal-law protection (amends s. 241(4)).
  • People who help a patient self-administer a prescribed MAID substance at the patient’s explicit request are protected when the MAID is under a provincial framework (amends s. 241(5)).

• Provincial governments and health systems

  • You may create and run a MAID framework for advance requests by people expected to lose capacity. The bill does not require you to do so (adds eligibility after s. 241.1).
  • If you do, your safeguards and procedures become legally binding for providers under the Criminal Code (amends s. 241.3).

• Timing

  • The bill does not set a special coming-into-force date. If enacted, changes would take effect on coming into force, and access under advance requests would depend on if and when a province implements a framework (bill text).

Expenses#

Estimated net cost: Data unavailable.

• No federal appropriations, taxes, or fees are created by the bill (bill text).
• The bill changes criminal exemptions and offences but does not fund provincial frameworks or federal implementation (bill text).
• If provinces choose to create frameworks, they may face administrative, training, and oversight costs. Data unavailable.
• Potential federal justice system costs (guidance, prosecutions, data) are not stated. Data unavailable.

Proponents' View#

• Expands choice for people who will lose capacity by allowing advance requests to be honoured under clear, lawful rules set by provinces (adds eligibility after s. 241.1).
• Gives legal certainty to clinicians, pharmacists, and helpers by extending criminal-law protections when they follow a provincial framework, reducing fear of liability (amends ss. 227(1)-(2); 241(2)-(5); 245(2)).
• Respects provincial roles in health service delivery, letting provinces tailor criteria and safeguards to local needs while keeping federal criminal oversight (structure of amendments).
• Preserves current federal MAID pathway and safeguards; the bill adds a second, narrower route only for advance-request cases, rather than changing s. 241.2 for everyone (amends s. 241.2(1) opening; adds eligibility after s. 241.1).
• Maintains accountability by making it a criminal offence to knowingly ignore required safeguards in the applicable provincial framework (amends s. 241.3).

Opponents' View#

• Creates uneven access and protections because each province could set different eligibility rules, documentation standards, and safeguards for advance requests (structure of amendments).
• Sets no federal minimum safeguards for advance requests (for example, witness rules, triggers, or confirmation steps), raising concern about weak or inconsistent protections across provinces (bill text).
• Increases compliance risk for providers, who must interpret and apply provincial safeguards in complex loss-of-capacity cases; errors could carry criminal liability (amends s. 241.3).
• Leaves gaps on monitoring and transparency: the bill does not update federal MAID reporting provisions to reflect provincial-framework cases, so data and oversight pathways are unclear (bill text; no changes to reporting provisions noted).
• May cause cross-border complexity for patients and providers who move or practice across provinces, given differing frameworks and documentation requirements (structure of amendments).