Canada Introduces Bill C-41 to Allow Advance Requests for MAID and End Mental Illness Expansion

Canada's government introduced the MAID Safeguards Act, Bill C-41, on October 27, 2026. The bill would allow adults to consent in advance to medical assistance in dying after a diagnosis expected to take away their ability to decide for themselves.

Justice Minister Sean Fraser introduced the bill, joined by Health Minister Marjorie Michel. Fraser said: "Today, we introduced legislation that would allow adults to consent to medical assistance in dying in advance, so their wishes could be respected if they are diagnosed with an incurable illness that could take away the ability to make this decision. It would also end the scheduled expansion of MAID for people on the basis of a mental illness. We will work with provinces and territories on implementation, with rigorous safeguards to protect people and ensure the decision remains voluntary and free from external pressure."

How an advance request would work

An adult diagnosed with an incurable illness expected to remove their decision making ability could set out in advance the circumstances in which they would want MAID later. The government gave Alzheimer's disease as its own example.

An advance request would not make MAID immediate or automatic. The Department of Justice said all eligibility requirements must be met, new safeguards must be followed, and the person must be experiencing intolerable suffering at the time MAID is provided.

Provinces and territories regulate and deliver health care. Under the bill, they would decide whether to make advance requests available in their own jurisdictions.

The mental illness expansion ends

Canada will not move ahead with the scheduled expansion of MAID to people on the basis of a mental illness. A parliamentary committee of senators and MPs from different parties studied MAID for mental illness as the sole condition and recommended that the government not move ahead. Its report was tabled on June 17, 2026, and recommended amending the Criminal Code to indefinitely exclude people whose sole underlying condition is a mental illness.

Health Minister Marjorie Michel said MAID raises deeply personal and complex considerations, and that the approach must respect personal autonomy while maintaining robust safeguards for those who may be vulnerable.

Support, and a warning about a patchwork

Findings from a national conversation on advance requests, published in October 2025, showed 67 percent to 69 percent of Canadians support advance requests for people diagnosed with a serious or incurable condition that will lead to loss of decision making capacity.

Quebec moved earlier. In 2024 it became the first and so far only province to allow residents to authorize an early request for MAID, limited to a person diagnosed with a serious and incurable illness leading to incapacity to give consent to care,.

Dying With Dignity Canada criticised leaving implementation to the provinces and territories. Its chief executive, Helen Long, said: "At best, this legislation will create a patchwork of systems across the country, thus further increasing inequity in MAID access, instead of a federal framework that would ensure that all people across Canada could have access to advance requests for MAID if they are eligible."

A law in place since 2016

MAID has been available since 2016 to adults with an incurable illness who meet strict eligibility requirements, including intolerable suffering and informed consent, with the right to withdraw at any time.

Bill C-41 must pass Parliament before any advance request becomes law.