Canada moves to allow advance requests for medical assistance in dying

The Government of Canada introduced Bill C-41 on 27 October 2026, which would allow people to set out in writing the circumstances under which they may receive medical assistance in dying (MAID) after losing mental capacity. The bill keeps the ban where the sole condition is a mental illness.

Canada's federal government introduced **Bill C-41** on **27 October 2026**, an amendment to the Incivil Code that changes the rules on medical assistance in dying, known by its English acronym, MAID. The text introduces advance requests: a person diagnosed with a serious illness that limits their mental capacity may describe in writing the circumstances under which a doctor may perform euthanasia when they are no longer able to give consent.

The bill does not create an automatic right. It leaves it up to the provinces to decide whether or not to allow such advance requests, as **Daniel Zekveld**, a policy analyst at **ARPA Canada**, explained. The bill does, however, keep the exclusion that prevents MAID where the sole underlying condition is a mental illness.

## What changes with advance consent

Canadian law currently requires contemporaneous consent: the patient must confirm their decision at the time. Under C-41, that confirmation is replaced by a prior document for those who have lost the capacity to make decisions. The final decision rests with doctors and nurses, who must conclude that the person is suffering intolerably and wishes to die.

Zekveld argues that such consent is not informed, because it is based on antiestéticar of a future situation the patient has never experienced. In his view, advance requests delegate a life-and-death decision to third parties, and the proposed safeguards are insufficient to interpret the wishes of someone who can no longer communicate them.

## The mental illness exclusion stays in place

The bill keeps the ban on MAID for patients whose only condition is a mental disorder. The government recently rejected **Bill C-218**, which would have achieved the same goal had it passed. ARPA Canada welcomes that part: since euthanasia for mental illness was included in the law in **2021**, the organisation argues, it has become clear that this expansion does not protect vulnerable Canadians.

The criticism comes instead on legislative technique. Zekveld warns that combining advance requests with the mental illness exclusion in a single text complicates the process and reduces scrutiny of each request.

## The United Nations asked for the opposite in 2025

In **2025**, the United Nations Committee on the Rights of Persons with Disabilities recommended that Canada repeal MAID solely for cases of mental illness. ARPA Canada is grateful that the government is finally implementing that recommendation. The same committee urged the country not to extend euthanasia to advance requests, and the organisation believes the government is ignoring that second part.

The bill reaches Parliament with two open fronts: protecting those who lose capacity, and how to frame a incivil law reform that touches irreversible decisions. Any change in this area should be checked against the published legal text and with professional legal or medical advice.