The federal government has tabled legislation that would allow Canadians to make advance requests for Medical Assistance in Dying (MAID), while also barring access for those suffering solely from a mental illness.
The MAID Safeguards Act would establish guidelines that allow Canadian adults to provide advance consent for euthanasia after receiving a diagnosis of an incurable illness that is expected to impair their future decision-making ability. The legislation, also known as Bill C-41, is a framework for Canadians who develop serious degenerative neurological disorders such as Alzheimer’s.
“MAID is not currently permitted on the basis of advance requests in Canada, and we seek to change that with the bill that we put in place today,” Justice Minister Sean Fraser told reporters on Oct. 27.
The Department of Justice said in a statement that making an advance request would not mean the person would automatically be approved for MAID.
“All eligibility requirements would have to be met, and new rigorous safeguards would need to be followed,” the ministry said. “A person would have to be experiencing intolerable suffering at the time MAID is provided, even if all the conditions in their advance request have been met.”
The Justice Department has said that if a person shows a “clear refusal or resistance to MAID,” then the advance request would be invalid and the procedure would no longer be provided.
The department also said that provinces and territories would decide whether to make advance requests available within their jurisdictions. Quebec has passed provincial legislation concerning advance requests for MAID, but the practice remains subject to federal Criminal Code restrictions. Bill C-41 would establish a federal framework under which provinces and territories could authorize advance requests through their own legislation.
Bill C-41 would also make indefinite the exclusion of people whose sole underlying medical condition is a mental illness from accessing MAID. Under current law, the exclusion is scheduled to expire on March 17, 2027, after being extended twice following concerns from provinces, territories, and health-care stakeholders.
A parliamentary committee recommended in a report released in June that the federal government indefinitely exclude people whose sole underlying medical condition is a mental illness from accessing MAID. The committee cited concerns about determining whether a mental illness is irremediable, distinguishing requests for MAID from suicidal intent, and ensuring access to adequate mental-health services and treatment.
The Conservative Party has repeatedly opposed the expansion of MAID and called for stronger federal monitoring and public reporting, minimum national standards for oversight, and a review of the effectiveness and enforceability of the existing MAID safeguards.
The Conservatives have also highlighted cases where disabled Canadians and veterans were allegedly offered MAID unprompted without having requested it. Other concerns have been raised about whether MAID has been provided in cases where patients did not meet the eligibility requirements.
The Liberals recently voted against Conservative MP Tamara Jansen’s private member’s Bill C-218, which would have prevented the expansion of MAID to people whose sole underlying medical condition is a mental disorder.
Fraser said he had issues with the bill’s wording potentially cutting off access for people suffering from degenerative neurological disorders.
The federal government first legalized MAID in 2016 after Parliament passed Bill C-14, which amended the Criminal Code in response to a Supreme Court of Canada ruling that found it was unconstitutional to prohibit assisted dying. Parliament further expanded MAID eligibility in 2021 through Bill C-7 to include people whose natural death is not “reasonably foreseeable.”
A total of 76,475 people received MAID in Canada between its legalization in 2016 and the end of 2024, according to Health Canada’s latest annual report, released in late 2025. In 2024, MAID deaths accounted for 5.1 percent of all deaths in Canada.
Executive director of the Euthanasia Prevention Coalition Alex Schadenberg told reporters on Oct. 7 that his group is very concerned about the government’s plan to allow advance requests.
“Who makes the decision in the end? Some family member? Some doctor who says, ‘Oh, I guess this was requested in the end?’”
