8. Technical Briefing Deck

Bill C-39, An Act to amend An Act to amend the Criminal Code (medical assistance in dying)

March 8, 2023

To extend the exclusion of eligibility for receiving medical assistance in dying (MAID) in circumstances where the sole underlying medical condition identified in support of the request for MAID is a mental illness (MI-SUMC).
To ensure the safe provision of MAID in these circumstances by allowing more time for the dissemination and uptake of key resources by the medical and nursing communities to ensure healthcare system preparedness, and by providing the Government with more time to consider the final report of the Special Joint Parliamentary Committee on MAID.

On March 17, 2021, former Bill C-7 expanded eligibility for MAID to persons whose natural death is not reasonably foreseeable.
It also temporarily excluded eligibility to receive MAID in circumstances where the sole underlying medical condition identified in support of the request for MAID is a mental illness.
In the absence of legislative change, this exclusion will be automatically repealed on March 17, 2023, at which point MAID in these circumstances will become lawful, if the existing eligibility criteria and safeguards are met.
Former Bill C-7 also required:
- An independent expert review “respecting recommended protocols, guidance and safeguards” for MAID requests made by persons with mental illness. The Final Report of the Expert Panel on MAID and Mental Illness was tabled on May 13, 2022.
- A comprehensive Parliamentary review of the MAID Criminal Code provisions and their application, and related issues including MAID for mental illness. The Special Joint Committee on MAID tabled its Final Report on February 15, 2023.

The Bill would extend the temporary MAID mental illness exclusion for one year (until March 17, 2024).
It would do this by amending section 6 of former Bill C-7, which currently sets the coming into force date of the repeal of the mental illness exclusion to two years after the former Bill received Royal Assent (i.e., on March 17, 2023). The Bill would change the coming into force date of the repeal to March 17, 2024.

Practice standards for assessing complex MAID requests, including MI-SUMC, are being developed for adaptation or adoption by provincial/territorial clinical regulators and clinicians (anticipated release in March 2023).
An accredited Canadian MAID curriculum is being developed for MAID clinicians (rolling launch will begin in the fall 2023 and aim to be completed by the end of 2023).
The revised Regulations for the Monitoring of Medical Assistance in Dying, which permit significantly enhanced data collection and reporting on MAID activity, came into force on January 1, 2023.