Canada introduced Bill C-41 on October 27 to permit advance requests for medical assistance in dying and prevent a planned eligibility expansion for mental illness alone. Justice Minister Sean Fraser presented the proposal in Ottawa, according to the government and Canadian Press. It is not yet law.
The government says adults diagnosed with an incurable illness expected to remove their decision-making capacity could consent beforehand. It cites Alzheimer's disease as an example. An advance request would not automatically trigger an assisted death: eligibility and safeguards would still apply when the procedure is considered.
The bill requires enduring, intolerable suffering that cannot be relieved by reasonable means and agreement from two independent medical or nurse practitioners. A request must be voluntary. Under the proposed text, clear refusal or resistance through words, sounds or gestures would prevent the procedure and invalidate use of that request.
The legislation would also stop the expansion scheduled for March 17, 2027, for people whose sole underlying condition is mental illness. The government cites unresolved concerns about safe, consistent assessments. A joint parliamentary committee recommended maintaining that exclusion indefinitely in June, according to Justice Canada.
The proposal has drawn concerns over consent. Reuters reported that Inclusion Canada chief executive Krista Carr regards a person's consent to their death as a fundamental protection and opposes removing it. Fraser says the framework aims to respect earlier wishes while ensuring decisions remain voluntary and free of outside pressure.
Parliament must approve the changes before they can become law. Provinces and territories would then decide whether to offer advance requests through their health systems, the government says. The bill requires a local legislative framework and a repository for requests, making implementation dependent on more than federal approval.
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