10 May 2001 Internal T.I. 2001-0077537 - CHRISTIAN SCIENCE; MEDICAL PRACTITIONERS

Please note that the following document, although believed to be correct at the time of issue, may not represent the current position of the CRA.
Prenez note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle de l'ARC.

Please note that the following document, although believed to be correct at the time of issue, may not represent the current position of the Department.

Prenez note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle du ministère.

Principal Issues:

Whether Christian Science practitioners qualify as "medical practitioners" under the Act.

Position:

Depends on whether laws of jurisdiction where services were performed authorize the services that they provide

Reasons:

Paragraph 118.4(2)(a) of the Act provides that, for the purposes of section 118.2 of the Act, a reference to a "medical practitioner," etc. means, for a service rendered, a person who is authorized to practice as such according to the laws of the jurisdiction in which the service is rendered. Accordingly, one must look to provincial (or state, etc.) legislation to determine whether payments to a medical practitioner will qualify for the medical expense tax credit.

		May 10, 2001

	Individual Returns & 	HEADQUARTERS
	   Processing Directorate	Denise Dalphy, LL.B.
	Validation Section,
	   Special Processing Division

	Attention: Carol Hussey, A/Manager
		2001-007753

Medical Expenses - Christian Science Practitioners

This is in reply to your memorandum of March 28, 2001 where you enquire whether the position in Interpretation Bulletin IT-519R2, that Christian Science practitioners may, depending on the laws of the applicable jurisdiction, qualify as medical practitioners for the purpose of the medical expense income tax credit, is correct.

Paragraph 118.2(2)(a) of the Income Tax Act (the "Act") provides that payments made "to a medical practitioner, dentist or nurse or a public or licensed private hospital in respect of medical or dental services" may qualify for medical expense tax credits. Paragraph 118.4(2)(a) of the Act states that, for the purposes of certain provisions of the Act, including section 118.2, a reference to a "medical practitioner", "dentist", "pharmacist", "nurse", or "optometrist" means, for a service rendered, a person who is "authorized to practice as such, ..." "pursuant to the laws of the jurisdiction in which the service is rendered." Accordingly, in order to determine whether a Christian Science practitioner is a "medical practitioner", it would be necessary to note the province (or other jurisdiction) where those services were rendered by the Christian Science practitioner and then to ascertain whether there is a specific law in that province (or other jurisdiction) that authorizes Christian Scientists to practice as medical practitioners.

Paragraph 4 of It-519R2 states:

"For purposes of the medical expense and disability tax credits under sections 118.2 and 118.3, subsection 118.4(2) provides that a reference to a medical practitioner, dentist, pharmacist, nurse or optometrist means a person who is authorized to practice as such according to the following laws:

(a) for a service rendered to an individual, the laws of the jurisdiction in which the service is rendered;

(b) for a certificate issued for an individual, the laws of the jurisdiction in which the individual resides or of a province; and

(c) for a prescription issued to an individual, the laws of the jurisdiction in which the individual resides, of a province or of the jurisdiction in which the prescription is filled.

Medical practitioners authorized to practice in accordance with the above laws can include (depending on the applicable province or jurisdiction, as the case may be) the following:

(i) ...

(vii) a Christian Science practitioner;

(viii) ...

Additionally, a "nurse" includes a practical nurse whose full-time occupation is nursing as well as a Christian Science nurse authorized to practice according to the relevant laws referred to in subsection 118.4(2)."

The above position, which can be traced at least as far back as the 1967 version of Revenue Canada's Assessing Guide, is correct. However, it must be noted that the IT bulletin does not state that all Christian Science practitioners automatically qualify; the IT bulletin states that whether a Christian Science practitioner or nurse will qualify as a medical practitioner or nurse will depend upon whether there is legislation in the relevant province or other jurisdiction that authorizes Christian Science practitioners or nurses to practice as "medical practitioners" or "nurses".

You enquired about the significance of references to religious freedoms in legislation concerning the practice of medicine in Nova Scotia and Manitoba. The Nova Scotia Medical Act provides: "Nothing in this Act applies to or prevents ... (d) the practice of the religious tenets or general beliefs of any religious organization" and the Manitoba Medical Act] states: "Nothing in this Act applies to, or affects, those who practise the religious tenets of their church without professing a knowledge of medicine or surgery."

Black's Law Dictionary, 6th edition, defines the term "authorize" as follows:

"To empower; to give right or authority to act. To endow with authority or effective legal power, warrant or right...

"Authorized" is sometimes construed as equivalent to "permitted"; or "directed", or to similar mandatory language..."

The fact that a particular enactment that authorizes certain persons to practice medicine provides that the enactment does not to take away from a person's religious freedom does not mean that the jurisdiction has authorized religious groups to perform medical services. The above legislative provisions do not, in and of themselves, authorize Christian Science practitioners or nurses to practice medicine. A person is "authorized" by a province or other jurisdiction to act as a medical practitioner or nurse if there is specific legislation that enables, allows, permits, or empowers a person "to practice as such", that is, to practice as a medical practitioner or nurse. Although the legislation need not use the words "medical practitioner", it would have to specifically allow a person to perform medical services.

If you have a question as to whether a particular province or other jurisdiction authorizes a person or class of persons to act as medical practitioners or nurses, you should contact the relevant province or jurisdiction, perhaps through the Intergovernmental and International Affairs Directorate of the Policy and Legislation Branch. Alternatively, with respect to the provinces of Canada, it is our understanding that most, if not all, provinces maintain registries of persons who they have authorized to act as "medical practitioners" or nurses. The latter may be a way to receive a speedy response should you have a specific question that relates to services rendered in Canada.

We hope this opinion will be of assistance.

For your information a copy of this memorandum will be severed using the Access to Information Act criteria and placed in the Legislation Access Database (LAD) on the Canada Customs and Revenue Agency's mainframe computer. A severed copy will also be distributed to the commercial tax publishers for inclusion in their databases. The severing process will remove all material that is not subject to disclosure, including information that could disclose the identity of the taxpayer. Should your client request a copy of this memorandum, they can be provided with the LAD version, or they may request a copy severed using the Privacy Act criteria, which does not remove client identity. Requests for this latter version should be made by you to Mrs. Jackie Page at (819) 994-2898. A copy will be sent to you for delivery to the client.

Steve Tevlin
for Director
Business and Partnerships Division
Income Tax Rulings Directorate

- 3 -