Scope changes in effect July 1, 2025

Starting July 1, 2025, under the Vital Statistics Act, 1990, Registered Nurses (RNs) and Nurse Practitioners (NPs) can certify death in the following situations.

Registered Nurses (RNs)

RNs in the General Class* can complete and sign a Medical Certificate of Death (MCOD) in specified circumstances when death was expected as outlined below:

  1. the nurse had an established nurse-patient relationship with the deceased during the last illness of the deceased
  2. the death was expected during the last illness of the deceased
  3. there was a documented medical diagnosis of a terminal disease for the deceased made by a legally qualified medical practitioner or an NP during the last illness of the deceased
  4. there was a predictable pattern of decline for the deceased during the last illness of the deceased 
  5. there were no unexpected events or unexpected complications during the last illness of the deceased
  6. the death did not result from medical assistance in dying within the meaning of section 241.1 of the Criminal Code 

*The term ‘Registered Nurse’ or ‘RN’ refers only to those in the General Class. Nurses in the Temporary, Special Assignment, Emergency or Non-Practising Class are not authorized to certify death in any circumstance. 

Nurse Practitioners (NPs)

  • As of July 1, 2025, NPs can complete and sign a Medical Certificate of Death in any circumstance. 
  • However, NPs are not permitted to complete a Medical Certificate of Still-Birth. NPs should refer to physicians and/or coroners in this circumstance.

All nurses are accountable for following any applicable laws and employer policies, while ensuring they have the knowledge, skill and judgment to certify death.