What to know
- The federal government introduced Bill C-41, the proposed MAID Safeguards Act, which would allow eligible adults diagnosed with an incurable illness to make advance requests for medical assistance in dying (MAID) while they still have decision-making capacity.
- Provinces and territories would decide whether to offer advance requests through their health-care systems, potentially creating unequal access across Canada. Quebec authorized advance requests in 2024, while Dying With Dignity Canada has criticized the proposed province-by-province approach.
- The legislation would indefinitely exclude people whose sole underlying medical condition is a mental illness from MAID eligibility, preventing a currently scheduled expansion set for March 17, 2027.
- Bill C-41 must pass through Parliament to become law. Justice Minister Sean Fraser hopes it will pass the House of Commons before the parliamentary winter sitting ends in December 2026.
Eligible Canadian adults diagnosed with an incurable illness may soon be able to request medical assistance in dying (MAID) in advance after the federal government introduced new legislation that would allow them to do so.
The proposed MAID Safeguards Act, Bill C-41, was introduced on Tuesday by Justice Minister Sean Fraser. The legislation would adjust Canada’s Criminal Code to allow people the ability to provide consent for MAID while they still have decision-making capabilities.
The bill was created so these patients’ wishes could be considered later in their illness, when they’re unable to decide in the moment, such as with conditions such as Alzheimer’s disease.
If approved, an advance request would allow an individual to go into specific circumstances in which they would want MAID to be administrated, after losing the ability to make that decision in the moment.
It’s important to note that making an advance request would not mean a person would automatically receive the assistance in dying in the future.
Instead, they would still need to meet the applicable eligibility requirements, as well as experience intolerable conditions prior to MAID being provided.
The federal government added in a release that additional safeguards would be required to make sure these requests are truly voluntary.
“We will work with provinces and territories on implementation, with rigorous safeguards to protect people and ensure the decision remains voluntary and free from external pressure,” Fraser stated.
Provinces would determine access
If approved, provinces and territories would be able to decide if they agree with making advance requests available through their health-care systems, meaning access could vary across Canada.
Quebec was the first province to authorize advance requests for MAID in 2024.
Alternatively, Alberta has passed legislation to restrict the use of MAID and ignore legislation passed by the federal government.
Dying With Dignity Canada, an organization that advocates for a patient’s choice on end-of-life administration, has criticized the individual province and territory approach, adding that leaving the bill’s implementation to each provincial jurisdiction could create unequal access.
In a statement released on Tuesday, the organization said the bill would require these jurisdictions to establish systems for storing advance requests before they could be used.
Dying with Dignity also called on the federal government to change the legislation in order to ensure eligible people could access advance requests regardless of where they live.
Proposed bill would also rule out MAID solely for mental illness circumstances
The proposed legislation would also prevent the currently scheduled expansion of MAID eligibility to people whose only underlying medical condition is a mental illness.
Under current federal law, eligibility for those circumstances is only excluded until Mar. 17, 2027. The new bill would make the exclusion indefinite.
The federal government has noted concerns on if requests that are involving mental illness by itself can be assessed safely and consistently.
The government added that access to meaningful treatment, compassionate care and support remains a priority for people living with physical or mental illness.
Health Minister Marjorie Michel said the approach must be balanced.
“Our approach must respect personal autonomy and individual choice while maintaining robust safeguards for those who may be vulnerable,” Michel said.
What happens next?
Bill C-41 would need to pass through Parliament before becoming law. Fraser said he wants the bill to pass through the House of Commons before the parliamentary winter sitting ends in December 2026.
Canada legalized MAID in 2016. The legislation has since gone through multiple changes for eligibility requirements and safeguards.
According to the federal government, a national discussion in 2024 found that between 67 and 69 per cent of Canadians supported advance requests for people diagnosed with a significant or incurable condition that was expected to affect decision-making ability over time.
