Legislative Background: Bill C-7: Government of Canada’s Legislative Response to the Superior Court of Québec Truchon Decision

Annex A – International MAID Regimes

In addition to Canada, there are 16 jurisdictions with precise legal rules for the provision of MAID: 9 US states (California, Colorado, District of Columbia, Hawaii, Maine, New Jersey, Oregon, Vermont, Washington), the states of Victoria and Western Victoria (adopted on December 10, 2019, not yet in force) in Australia, New Zealand (would come into force after a referendum in 2020), Colombia and the “Benelux” countries (Belgium, the Netherlands and Luxembourg). As outlined in the chart below, foreign laws take differing approaches with respect to eligibility for MAID. Thirteen of them are considered “end of life” regimes, which means that they limit eligibility to circumstances were a person is at the end of life, while three jurisdictions (the “Benelux” countries) have enacted broader MAID regimes, where persons who are not nearing the end of life, including those with a physical disability or mental illness, can be found eligible for MAID if their suffering is unbearable and cannot be relieved.

Belgium, though not an “end of life” regime, does require different safeguards to be applied to persons who are not expected to die in the short term (“à brève échéance”), and so does treat patients dying in the short term differently from all other patients requesting MAID, insofar as the mandatory safeguards are concerned (specifically, Belgium requires a mandatory reflection period of 1 month and a mandatory third opinion from a psychiatrist or a specialist in the person’s medical condition only in the case of persons not dying in the near future).

Foreign laws also take different approaches with respect to advance requests for MAID (whether a person can receive MAID after they have lost the ability to consent to die, based on a request made while they were competent). Only four jurisdictions allow some kind of advance request. Belgium and Luxembourg limit such requests to circumstances where a person is irreversibly unconscious, Colombia limits them to circumstances where death is imminent (for both conscious and unconscious persons), while the Netherlands allow them for persons over 16 years of age who are still conscious, but have lost decision making capacity.

Key Features of Foreign MAID Regimes
Eligibility for persons not nearing end of life
(includes physical disability and mental illnesses)		 Advance Requests
Person has lost capacity but is conscious Person is irreversibly unconscious
Canada No No No
United States
(California, Colorado, District of Columbia, Hawaii, Maine, New Jersey, Oregon, Vermont, Washington)		 No No No
Australia
(Victoria, Western Australia)		 No No No
New Zealand
(would come into effect after referendum)		 No No No
Colombia No Yes
(death must be imminent)		 Yes
(death must be imminent)
Belgium Yes No Yes
Netherlands Yes Yes No
Luxembourg Yes No Yes