A/HRC/43/41/Add.5 Comment/Rationale 48. As per the Home and Community Care Policy Manual, Chapter 4, health authorities (HA) are responsible for determining eligibility for CSIL and the appropriate funding to meet the client’s needs. Once deemed eligible, CSIL clients sign a contract with the HA, and assume full responsibility for training, hiring and scheduling care providers. Clients who cannot direct their own care or who cannot always direct their own care may still be able to participate in CSIL through a client support group, a legal representative, or a committee of estate. 49. As with all HCC services, there is an expectation that HAs provide CSIL clients with services to supplement, rather than replace, the efforts of individuals and their caregivers to meet their health needs and make decisions about lifestyle and care. Home support services are direct care services provided by unregulated care providers to clients who require personal assistance with activities of daily living, such as mobilization, nutrition, lifts and transfers, bathing, cueing, grooming and toileting, and may include safety maintenance activities as a supplement to personal assistance when appropriate, as well as specific nursing and rehabilitation tasks delegated under Policy 1.C, Delegation of Tasks. A client who requires support with instrumental activities of daily living, such as transportation, housekeeping or shopping will be directed to appropriate community resources. Page 14, Paragraph 68 Recommended language 50. In June 2016, the Parliament of Canada passed federal legislation allowing adults to request medical assistance in dying. The Criminal Code was amended to allow physicians and nurse practitioners, to provide medical assistance in dying, and pharmacists, family members or other people to assist in the process without being charged under criminal law. As a general rule, the Criminal Code provides that persons who have a grievous and irremediable medical condition that causes them enduring and intolerable suffering are allowed to seek medical assistance in dying. The definition of a grievous and irremediable medical condition includes disability. Recently, the Quebec Superior Court has invalidated sections of both the federal and Quebec laws on medically assisted dying, ruling invalid the Criminal Code requirement that a natural death be "reasonably foreseeable" before someone can be eligible for assisted death. Comment/Rationale 51. The original text risks being misunderstood as stating that all the listed individuals can provide medical assistance in dying; the Criminal Code only permits medical practitioners and nurse practitioners to provide medical assistance in dying, and others benefit from an exemption if they aid medical and nurse practitioners in providing that assistance. Page 14, Paragraph 70 Recommended language 52. The organization of Canada's health care system is largely determined by the Canadian Constitution, in which roles and responsibilities are divided between the federal, and provincial and territorial governments, while some areas are shared10. The federal government sets out the legislative framework for universal, publicly funded hospital and physician services through the Canada Health Act, and provides provinces and territories with the necessary funding for the delivery of health-care services. The federal government is also responsible for some health care services for First Nations and Inuit peoples, as well as serving military and veterans, refugees, and inmates in the federal corrections system. 10 Source : https://www.canada.ca/en/health-canada/services/health-care-system/reportspublications/health-care-system/canada.html#a4. 11