Canada proposes major changes to medical assistance in dying legislation

Federal government plans to permanently exclude mental illness as a sole qualifying condition while introducing a framework for advance requests.

The federal government has announced plans to introduce significant changes to Canada’s medical assistance in dying (MAID) legislation, addressing two of the most debated aspects of the country’s assisted-dying framework: eligibility for people with mental illness and advance requests for individuals who may lose the capacity to provide consent.

The proposed changes, announced October 7, 2026, would indefinitely maintain the exclusion of people whose sole underlying medical condition is a mental illness. The government also intends to introduce legislation addressing advance requests for MAID.

Mental illness exclusion

Under current federal legislation, individuals whose only underlying medical condition is a mental illness are temporarily excluded from eligibility for MAID until March 17, 2027.

The federal government now proposes making that exclusion indefinite, rather than allowing eligibility to expand when the existing deadline expires.

The issue has generated considerable discussion among healthcare professionals, mental health advocates, policymakers and disability rights organizations.

Supporters of maintaining the exclusion have raised concerns about assessing whether psychiatric conditions are irremediable, protecting vulnerable patients and ensuring adequate access to mental healthcare.

Others argue that excluding mental illness as a sole qualifying condition raises questions about equitable access to MAID for people experiencing severe and persistent psychiatric disorders.

Advance requests for MAID

The government is also proposing a legislative framework that would address advance requests for medical assistance in dying.

Advance requests would allow eligible individuals diagnosed with certain serious, incurable conditions to document their wishes while they retain decision-making capacity, in anticipation of potentially losing that capacity as their illness progresses.

The issue is particularly relevant for people diagnosed with neurodegenerative conditions, including Alzheimer’s disease and other forms of dementia.

Under the proposed approach, provinces and territories would have a role in determining whether advance requests are available within their healthcare systems.

Quebec has already established a framework permitting certain advance requests for MAID.

Implications for Canadian healthcare providers

The proposed changes could have important implications for hospitals, physicians, nurse practitioners and healthcare organizations responsible for assessing and delivering MAID services.

Healthcare providers would need to understand any new eligibility requirements, consent procedures and documentation obligations arising from future legislation.

Advance requests could also introduce additional clinical and ethical considerations involving patient autonomy, capacity assessments and the interpretation of previously expressed wishes.

The federal government is expected to introduce legislation later this fall.

The proposed changes have not yet become law. Existing federal MAID eligibility requirements and safeguards remain in effect.

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