Canadian Justice Minister Sean Fraser has introduced Bill C-41, the Medical Assistance in Dying Safeguards Act, after the government said it would not proceed with a planned expansion of medical assistance in dying, or MAiD, for mental illness as the sole diagnosis.
The bill says mental illness alone cannot be used as the basis for MAiD. It also would allow advance requests, including for people diagnosed with conditions such as dementia. That means a person could seek approval before losing decision-making capacity, and later be euthanized under the criminal code exemption from homicide.
Canada legalized MAiD in 2016. The program has since grown quickly, and the country is on track to reach 100,000 MAiD deaths after 10 years. The government had planned to expand eligibility in 2027 to allow mental illness as the only diagnosis, but Fraser said in October that Canada had decided “not to move forward” with that change.
Bill C-41 leaves major decisions in the hands of the physician or nurse practitioner who provides MAiD. The measure also recognizes that health care authority varies by province. Even if Parliament passes the bill, a province could tell the federal government it will not allow advance requests for euthanasia.
The sanctity of life is tested most clearly when people are weak, sick, disabled, or afraid. A law that permits advance requests for euthanasia creates grave danger for people with dementia and other vulnerable patients. Canada’s next step will show whether lawmakers will protect those neighbors or make it easier to end their lives.
