Expanded MAID monitoring and reporting rules

Summary#

These final regulations — Regulations Amending the Regulations for the Monitoring of Medical Assistance in Dying (SOR/2022-222) — change what information is collected about requests for, and the provision of, medical assistance in dying (MAID) in Canada.
They add new reporters, expand the kinds of data collected (including demographic details with consent), change reporting deadlines, and mostly come into force on January 1, 2023 (with one provision coming into force on January 1, 2024).

What it does#

• Designates the Minister of Health as the main federal recipient of MAID monitoring information, while naming certain provincial/territorial officials to receive some types of reports in their regions.
• Requires reporting from more people involved in the process:
  • medical practitioners and nurse practitioners,
  • preliminary assessors (people who do initial assessments but are not practitioners),
  • pharmacists and pharmacy technicians.
• Expands what is reported:
  • demographic information where the person consents (including race, Indigenous identity, disability, sex at birth and gender identity),
  • data on all assessments after a request (verbal or written), including preliminary assessments,
  • information about the new procedural safeguards for people whose natural death is not reasonably foreseeable (for example, the minimum 90‑day assessment and requirement for expert input or consultations),
  • details about waiver or advance‑consent arrangements and what happened if safeguards were later judged unmet.
• Changes timing rules:
  • Many reports must be submitted within 30 days of a reportable outcome (for example, an eligibility decision or a death).
  • When a practitioner prescribes or provides a substance for self‑administration, the report must be given no earlier than the 90th day and no later than one year after the prescription/provision (unless the person dies sooner).
  • Reporting obligations stop after 90 days if the person’s natural death is reasonably foreseeable and no reportable outcome occurs, and after two years if the person’s natural death is not reasonably foreseeable — except that actual MAID provision must still be reported.
• Removes or simplifies some older reporting items (for example, certain referral/transfer details and report fields tied to rules that were changed).
• Updates language and structure in the monitoring rules (for example, replacing the word “patient” with “person,” and adding separate reporting schedules for the two MAID tracks).

Who's affected#

• People who request MAID. They may be asked for optional demographic information. That information is collected only if the person consents.
• Health professionals involved in MAID:
  • medical practitioners and nurse practitioners (new and adjusted reporting duties),
  • preliminary assessors (now required to report findings of ineligibility),
  • pharmacists and pharmacy technicians (new reporting role for some pharmacy technicians).
• Provincial and territorial governments and selected officials who will receive some reports in their jurisdictions.
• Health Canada and Statistics Canada, which will operate the federal reporting platform and analyze the data.
• Researchers, advocacy groups and the public, who will see more detailed annual summaries about MAID trends and characteristics.
• Small practices and clinicians will face extra administrative work. Health Canada estimated affected numbers and costs:
  • about 1,900 practitioners and 200 preliminary assessors involved in the first year,
  • about 2,437 small businesses would be affected,
  • estimated administrative familiarization costs of $223,000 in year one,
  • estimated ongoing administrative costs of $314,000 per year,
  • estimated one‑time costs to governments of about $210,000 and ongoing costs of about $139,000 per year (including a federal one‑time system update of $75,000 and ongoing $35,000).

Why it matters#

• The changes aim to give a fuller, more consistent picture of who requests MAID and how it is carried out across Canada. That improves public reporting and helps spot patterns or inequalities (for example, by race, Indigenous identity, disability or gender identity), subject to the person’s consent.
• The regulations reflect major legal changes that expanded MAID eligibility and added different safeguards depending on whether a person’s natural death is reasonably foreseeable. The new monitoring rules are meant to track how those legal changes work in practice.
• In real life this means clinicians will spend more time on mandatory reporting. That could raise costs or administrative strain for small practices. Health Canada says it will provide guidance and adjust reporting tools to reduce burden.
• The first full year of data under these amended rules will be collected in 2023, and Health Canada plans to present findings in its annual report on MAID for 2023 in summer of 2024.