Canada is preparing to let some adults with incurable illnesses authorize medical assistance in dying (MAID) before losing decision-making capacity, making earlier consent central to a proposed change in federal law.
Justice Canada says the planned change would apply after a person is diagnosed with an incurable illness expected to remove their ability to decide about MAID. The advisory promises safeguards but does not set out detailed eligibility rules or explain how a request could be withdrawn.
Under current federal rules, a person generally must be capable of consenting immediately before MAID is provided. A limited exception applies to someone already assessed as eligible, close to death and scheduled to receive it. Health Canada says an advance request cannot currently serve as the basis for providing MAID.
Quebec has allowed advance requests since Oct. 30, 2024. A person must have a serious, incurable illness expected to cause incapacity and make the request while still capable. The written request identifies illness-related signs that must recur later. Clinicians must also establish that other legal conditions are met, and a second physician or specialized nurse practitioner must confirm their findings. Quebec treats this process separately from advance medical directives, which set out treatment preferences for a time when someone cannot consent.
The change raises questions about how clinicians should apply an earlier decision when a patient can no longer confirm it. University of Toronto bioethicist Kerry Bowman told Global News, “You’ve almost got a stranger making a decision for a stranger.”
Dying With Dignity Canada says Ottawa’s approach would leave provinces and territories to decide whether to permit advance requests. The advocacy group argues that access could vary by location, leaving some people to seek MAID before losing capacity or lose the option. CEO Helen Long has called for a national framework to create consistent rules.
In February 2023, the Special Joint Committee on MAID urged Parliament to amend the Criminal Code to permit advance requests in some circumstances. The federal government later consulted the public on the issue from late 2024 through February 2025. EconoTimes previously covered the ministers’ planned discussion of the proposed MAID change.
Justice Canada’s advisory lists Minister of Justice and Attorney General Sean Fraser and Minister of Health Marjorie Michel for a media availability Tuesday, Oct. 27, from 1 p.m. to 1:30 p.m. ET. It also lists an on-background media technical briefing by government officials from 11:45 a.m. to 12:45 p.m. ET.
