Bill S-231, An Act to amend the Criminal Code (medical assistance in dying), would amend the Criminal Code; it does not create a separate law or program. It would expand when a medical practitioner or nurse practitioner may provide medical assistance in dying (MAID) without final consent after a person loses capacity. The stated goal is to allow advance arrangements for people who may lose capacity before receiving MAID.
The bill would allow a person to make a written arrangement for MAID on a specified day if they lose capacity before that day.
It would also allow a person diagnosed with a serious and incurable illness, disease or disability to make a written declaration for MAID if they later lose capacity and experience conditions clearly identified in the declaration.
Before losing capacity, the person must have met the eligibility criteria and all other safeguards in the relevant Criminal Code pathway.
For the conditions-based declaration, two independent witnesses must confirm it was made voluntarily, and a medical practitioner must certify that the conditions are clearly identified and observable, and that the witnesses are independent.
MAID could not be provided under either route if the person shows, by words, sounds or gestures, that they refuse or resist it. The substance must also be given according to the arrangement or declaration.
The supplied text shows that current law already allows a specified-day arrangement in one Criminal Code pathway. The bill would extend that waiver to another pathway and add the conditions-based declaration. The current consolidated Criminal Code was not supplied, so this comparison could not be verified against current law.
People considering MAID: If enacted, you could make one of these written arrangements before losing capacity. The bill does not require anyone to make one.
Medical practitioners and nurse practitioners: They may provide MAID under these arrangements if the bill’s conditions are met. It does not require them to do so.
People who later show refusal or resistance: MAID could no longer be provided under either advance-consent route.
The public: The bill would change MAID consent rules. It does not change taxes, create a benefit, or set up a new MAID office or service.
A possible argument for the bill is that people could record their wishes while they have capacity, in case they lose capacity before a planned MAID date or while experiencing specified conditions.
The bill sets limits: eligibility criteria and other safeguards must already have been met, and the person’s later refusal or resistance prevents MAID.
Requiring witnesses and a medical practitioner’s certification could help ensure the declaration is voluntary and its conditions can be observed.
One concern is that MAID could be provided after a person loses the capacity to give final consent. The bill relies on an earlier written consent and the absence of later refusal or resistance.
The bill does not explain how practitioners should decide whether a person’s observed condition matches the declaration. That may leave important judgments to the people applying it.
The five-year limit may mean a declaration is no longer usable if more than five years have passed, but the bill does not explain how a person can keep it current.
The bill does not specify how the new options would interact in practice with existing safeguards or how their use would be monitored.