Legislative Background: Medical Assistance in Dying (Bill C-14, as Assented to on June 17, 2016)

Annex C: Overview of Existing Medical Assistance in Dying Regimes

State or Country Type of Medical Assistance in Dying Eligibility Criteria Safeguards
Oregon (1997), Vermont (2013), Washington (2008), California (2015) Physician-assisted suicide only

Patient must be terminally ill with less than 6 months to live

Terminal disease: incurable / irreversible disease that will, within reasonable medical judgment, produce death within six months

(Mental disorders alone: not eligible)

Adults only

No advance directives

Approval of request: Attending physician + 1 consulting physician + mental health specialist if needed

Oral + written requests

Written request in prescribed form signed before 2 independent witnesses

Time delays between oral requests, between written request and prescription

Patient may rescind request at any time

The Netherlands (2002) Physician-assisted suicide and voluntary euthanasia

Patient must be suffering intolerably, either physically or mentally, with no prospect of improvement

Minors 12 years and older

Advance directives

Attending physician + 1 consulting independent physician

Patient may revoke request at any time

Belgium (2002) Voluntary euthanasia

Patient has a medically futile condition and is experiencing constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident

Adults and emancipated minors

Minors younger than emancipated minors (of any age) but only where dying in the short term and experiencing unbearable physical (not mental) suffering

Advance directives only where patient irreversibly unconscious

Attending physician + 1 consulting independent physician

Physician talks to patient at reasonable intervals to verify persistence of request; written request signed

Consult with nursing team or relatives if patient desires; if not terminal, must consult with psychiatrist or expert and 1 month delay after request; if child must consult with child psychiatrist or psychologist

Patient may revoke request at any time

Luxembourg (2009) Physician-assisted suicide and voluntary euthanasia

Patient has a medically futile condition, caused by illness or accident, and is experiencing constant and unbearable physical or mental suffering that cannot be alleviated

Adults only

Advance directives only where patient irreversibly unconscious

Attending physician + 1 consulting independent physician

Physician talks to patient at reasonable intervals to verify persistence of request; written request signed

Consult with medical team, other physicians treating patient or designated substitute decision-maker unless patient objects

Patient may revoke request at any time

Québec (2014) Voluntary euthanasia

Patient must be at the “end-of-life” + suffering from an incurable serious illness + in an advanced state of irreversible decline in capability + experiencing constant and unbearable physical or psychological pain which cannot be relieved in a manner the person deems tolerable

(Mental disorders alone: not eligible)

Adults only

No advance directives

Physician + 1 consulting physician

Consult with members of care team and/or family (if patient wishes)

Written request in prescribed form; signed before 1 witness

Physician talks to patient at reasonable intervals to verify persistence of request

Patient may revoke request at any time

Colombia (2015) Voluntary euthanasia

Terminal patient: serious condition or pathology that is progressive and irreversible with a prognosis of approaching death or death within a relatively short timeframe, and that is not susceptible to a proven effective healing treatment that would change the prognosis (Mental disorders alone: not eligible)

Adults only

Advance directives if patients become no longer capable of expressing their wishes in the future

Attending physician + medical expert(s) if uncertain diagnosis

Interdisciplinary committee composed of medical specialist, lawyer and mental health expert must review request and confirm wish to die within 10 days of receiving request; must ensure request is carried out within 15 days of patient re-iteration of request; can suspend request if irregularities

Patient may revoke request at any time

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