Today, the federal government introduced Bill C-41, making changes to Canada's criminal law around Medical Assistance in Dying (MAID).

Advance requests

Bill C-41, if passed, will legalize advance requests for MAID, meaning persons diagnosed with a serious capacity-limiting illness may outline in writing the circumstances under which a doctor may euthanize them after they lose the mental capacity to consent.

"Bill C-41 will remove the existing requirement for present consent, leaving it to provinces to determine whether to legalize advance euthanasia requests," said Daniel Zekveld, Policy Analyst for ARPA Canada. "Advance consent is not informed consent. It is based only on fear of a future condition that the person has never experienced."

Zekveld noted, "Rather than being a clear choice about when to die, advance requests delegate a future life-and-death decision to third-parties to determine when a person should die by MAID. Instead of offering MAID to those with capacity-limiting illnesses, Canada must provide appropriate care and support so that those facing loss of capacity can live well despite their illness."

Proposed safeguards around advance euthanasia requests in the legislation will be inadequate, as understanding the wishes of a patient who has lost capacity is difficult, if not impossible, to determine. The decision is a subjective determination left to doctors and nurses to conclude that a person who cannot communicate their present wishes is suffering intolerably and wants to die.

"By seeking to permit advance euthanasia requests," said Zekveld, "the federal government is negating its responsibility to protect Canadians through the Criminal Code. ARPA Canada calls on Parliament to move forward with the much-needed repeal of MAID for mental illness, but to reject MAID without present consent."

Mental illness exclusion

Bill C-41 also preserves the rule against permitting MAID for patients whose sole underlying condition is a mental illness. The government recently defeated Bill C-218, which would have accomplished the same objective had it passed.

"We commend the government for maintaining the exclusion on MAID for mental illness," said Zekveld. "Since MAID for mental illness was included in the law in 2021, it has become increasingly clear that such an expansion fails to protect vulnerable Canadians and must not happen. At the same time, combining advance euthanasia requests with the mental illness exclusion in the same legislation will complicate the process and reduce scrutiny and study of advance requests."

Zekveld continued, "In 2025, the United Nations Committee on the Rights of Persons with Disabilities recommended that Canada repeal MAID for mental illness alone. We're thankful the government is finally implementing that recommendation. But the Committee also urged that Canada refuse to expand MAID further to include advance euthanasia requests. Today, the federal government is disregarding that call."