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.
Principal Issues: Whether Christian Science Practitioners qualify as "medical practitioners" under the Act.
Position: Depends on whether laws of jurisdiction where services are performed authorize the services that they provide. To our knowledge no province or territory currently authorizes Christian Science practitioners as medial practitioners.
Reasons: Legislation. One must look to provincial (or territorial, state, etc...) legislation to determine whether payments to a medical practitioner will qualify for the medical expense tax credit.
XXXXXXXXXX 2005-012693
Shaun Harkin, CMA
June 21, 2005
Dear XXXXXXXXXX:
Re: Permissible Medical Expense Deductions
This is in reply to your letter of April 11, 2005 wherein you concluded that Christian Science practitioners and nurses providing services in Ontario are "medical practitioners" or "nurses" within the meaning of subsection 118.4(2) of the Income Tax Act (the "Act"). In particular, you have referred to comments on this subject in Interpretation Bulletin IT-519R2 (Consolidated) (the "IT") and various provincial acts.
Paragraph 118.2(2)(a) of 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 the Christian Science practitioner rendered those services 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 3 of the IT 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 has been a long-standing one. However, it must be noted that the IT does not state that all Christian Science practitioners and nurses automatically qualify. 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".
In your view Christian Science practitioners are authorized to practice as "medical practitioners" or "nurses" under the following provincial acts:
? Alberta Medical Profession Act, RSA 1980, c. M-12, s.94;
? British Columbia Medical Practitioners Act, RSBC 1996, c.285, s.84;
? Manitoba Medical Act, Chapter M90, Part 1, s.4 and
? Ontario Regulated Health Professions Act, SO 1991, c.18, s.29(1)(c) & (30).
For example 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 it does not take away from a person's religious freedom does not, in our view, mean that the jurisdiction has authorized religious groups to perform medical services. Further we feel that 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. We are not aware of any province in Canada that specifically authorizes Christian Science practitioners or nurses to act as medical practitioners.
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 responsible for such matters.
We are currently in the process of amending the IT. These amendments will include a change to clarify our position concerning Christian Science practitioners.
The foregoing comments represent our general views with respect to the subject matter. As indicated in paragraph 22 of Information Circular 70-6R5, the above comments do not constitute an income tax ruling and accordingly are not binding on the Canada Revenue Agency. Our practice is to make this disclaimer in all instances in which we provide an opinion.
We trust the above comments are of assistance.
Yours truly,
John Oulton, CA
for Director
Business and Partnerships Division
Income Tax Rulings Directorate
Policy and Planning Branch
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