VP-NET Vulnerable Persons and End of Life New Emerging Team
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Legislation Relevant to End of Life Decision Making

The Canada Health Act is Canada’s federal legislation for publicly funded health care insurance. It is general in nature and palliative care and end of life care services are not specifically funded or protected under the Act but there are strategies and guidelines laid out around end of life care.

There is no federal legislation to support the use of advance directives in Canada. However, two attempts have been made to enact federal legislation on advance directives or legalize Euthanasia in Canada through the Criminal code to allow patients to refuse medical treatment and protect physicians who carried out their wishes. The first attempt was in 1992,59 the second was in June 2005. These were both unsuccessful.60

All Canadian provinces and territories have legislation dealing with advance health care directives except Nunavut, which provides for powers of attorney for property and financial matters only. Most advance directives cover health and personal care, such as hygiene, nutrition and where the person will live or receive treatment. In some jurisdictions, (e.g. Ontario under a Power of Attorney for Personal Care) the maker of an advance directive can restrict the areas in which a proxy can make decisions.61 There are a number of legislative differences between provinces and between countries which have the potential to impact the effectiveness of advance care directives.

Because of this variety, a directive could be valid in one jurisdiction and not in another. Confusion could be avoided if federal legislation provided guidelines to ensure provinces adopt uniform basic requirements for advance directives. 62 However there is a danger that national guidelines could harmonize provincial legislation to the lowest standard of rights for the dying and result in people losing rights that they currently have in provinces with more developed legislation.

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