A/HRC/43/41/Add.2 they are being offered the “choice” between a nursing home and medical assistance in dying. I. Health 70. The health-care system of Canada is largely organized through the Constitution, which sets out which roles and responsibilities are divided among the federal, provincial and territorial governments and which are shared.22 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 financial support necessary for the delivery of health-care services. The federal Government is also responsible for the health-care services for First Nations and Inuit peoples, as well as serving military and veterans, refugees and inmates in the federal corrections system. 71. Provincial and territorial governments are responsible for funding the provision of health-care services in their own jurisdictions. Each province or territory has health insurance plans which cover hospital and physician services, and provides additional coverage to persons eligible for health-care services not covered under the universal publicly funded health-care system, including prescription drugs outside hospitals, dental care, eye care, medical equipment and appliances such as prostheses, and wheelchairs, and the services of other health professionals. Because of that, the level of coverage and the availability of services vary across the country. 72. While acknowledging the universal publicly funded health-care system of Canada, the Special Rapporteur remains concerned about the disparities in the levels of coverage and the availability of health services across the country, particularly between urban and rural areas and between on-reserve and off-reserve populations. She has also learned that community-based mental health-care support services, as well as palliative care services, were significantly underfunded. 73. Assistive devices and technologies are generally covered through separate provincial and territorial programmes. In some cases, the province or territory pays a fixed amount for a device or provides grants directly to a person with disabilities for supplies. Usually, these payments do not cover the full cost of assistive devices, batteries or repairs, and persons with disabilities must contribute with a co-payment. J. Legal capacity 74. Canada is recognized at the international level as one of the first countries that developed the notion of supported decision-making, which was later embedded in the Convention on the Rights of Persons with Disabilities. Some provinces and territories have introduced legislative measures for supported decision-making that aim at enabling persons with disabilities to exercise choice and control over their own lives, instead of having others make decisions on their behalf. However, there are disability-related restrictions in much of the legislation, guardianship is still provided for and there is little investment to ensure that people can create and sustain the decision-making supports they may require. While supported decision-making has existed in practice for many years, its impact and the possibility of scaling it up have been limited due to the lack of an enabling legal framework that ensures universal legal capacity through the provision of support. 75. Accordingly, many persons with intellectual and psychosocial disabilities continue to be denied the exercise of their legal capacity through substitute decision-making systems such as guardianship and curatorship. For example, in Ontario and Quebec alone, there are approximately 54,800 adults under different forms of guardianship or curatorship. Although this is reportedly done for their own protection, in reality persons with disabilities placed under these measures are far from protected: they are deprived of equal recognition before 22 14 See www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-caresystem/canada.html#a4.