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 D: Overview of Recent Foreign Medical Assistance in Dying Bills

State or Country Type of Medical Assistance in Dying Eligibility Criteria Safeguards
US States (Arizona, Colorado, Hawaii, Iowa, Maryland, Missouri, Nebraska, New Hampshire (study), New Jersey, New York, Rhode Island, Utah)
(before State legislatures)

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 (except Hawaii: at least fifty years of age)

No advance directives

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

Oral + written requests; Iowa: for patients incapable of making oral request, a written submission to the attending physician will be required

Written request in prescribed form signed before 2 independent witnesses; Hawaii: if patient is in health care facility, 3rd witness designated by facility

Time delays between oral requests, between written request and prescription

Patient may rescind request at any time

South Australia (Second Reading debates in March 2016)

Voluntary euthanasia

Patients must be suffering from medical condition (whether terminal or not) that is unbearable to the person (determined subjectively) and hopeless (determined by reasonable availability of medical treatment to reduce/relieve suffering)

Adult only

No advance requests

Approval of request: Attending physician + 1 consulting physician + psychiatrist if deemed necessary by attending physician

Written request in prescribed form; signed in presence of independent witness and attending physician

Time delay between request and administration of medication

Patient may revoke request at any time

New Zealand (Private Member’s Bill in Parliament)

Physician-assisted suicide only

Competent adults who suffer from a terminal illness likely to die within 6 months or have a grievous and irremediable medical condition; advanced state of irreversible decline in capability; and unbearable suffering that cannot be relieved in a manner they consider tolerable

No advance requests

Approval of request: attending physician + 1 consulting physician + 1 mental health specialist if necessary

Oral and written requests; written request in prescribed form signed before 1 independent witness and in the presence of the attending physician

(adopted January 27, 2016)

Does not permit medical assistance in dying
Permits terminal palliative sedation

Conscious patients with serious and incurable disease, and who decide to stop taking medication or whose treatment no longer successful

Patients have the right to refuse artificial life-support treatments

Advance directives: adults can express their preference not to be kept alive by medical interventions, should they become too ill to make that decision

Patients can designate a person (e.g., relative or attending physician) who could be consulted in cases where patients are not able to express their wishes with regards to their advance directives

Advance directives can be modified or cancelled at any moment

Creation of a national registry of advance directives

(November 6, 2015)

Prohibits the commercialization of assisted suicide

This legislation criminalizes organizations that assist patients in terminating their own lives for profit, and includes penalties of up to three years of imprisonment; prevents the commercialization of the procedure as a “suicide business”

United Kingdom
(defeated September 2015)

Physician-assisted suicide only

Patients must be competent adults diagnosed by a registered medical practitioner as having a terminal illness and reasonably expected to die within six months

Terminal illness is defined as “an inevitably progressive condition which cannot be reversed by treatment”

No advance directive

Approval of request: Attending physician + 1 consulting physician; approval by Family Court

Written request in prescribed form; signed in presence of one independent witness and countersigned by attending physician

Time delays between written request and delivery of medication

(defeated on May 27, 2015)

Physician-assisted suicide only

Competent individual (at least 16 years old) suffering from an illness that is terminal or life-shortening or a condition that is, for them, progressive and either terminal or life-shortening

No advance directive

Approval of request: 2 registered medical practitioners

Three written requests in prescribed forms; signed in presence of qualified witness and confirmed by medical practitioner

Time delay between requests

Tasmania (defeated on October 17, 2013)

Physician-assisted suicide and voluntary euthanasia

Patients must have incurable and irreversible medical condition caused by an illness, disease or injury, causing persistent and intolerable suffering, and that is in advanced stages with no reasonable prospect of improvement

No advance requests

Approval of request: Attending physician + 1 consulting physician

Two oral and one written requests; written request signed before 2 independent witnesses

Time delays between requests

Patient may rescind request at any time