Legislative Background: Medical Assistance in Dying (Bill C-14)
Archived information
Bill C-14, legislation on medical assistance in dying, received royal assent on June 17, 2016. For more information, visit canada.ca/health
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 |
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 |
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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