Canada tables Bill C-41 to allow advance MAID requests, ending mental-illness expansion

The Government of Canada introduced the MAID Safeguards Act, Bill C-41, in Ottawa on October 27, 2026, proposing to amend the medical assistance in dying (MAID) law so adults can consent in advance to receive MAID later in their illness. Justice Minister and Attorney General Sean Fraser introduced the bill, joined by Health Minister Marjorie Michel. The bill must still pass through Parliament before it becomes law.

How an advance request would work

Under the proposal, an adult diagnosed with an incurable illness expected to take away their ability to make decisions would give informed consent while they can still decide for themselves, setting out in advance the circumstances in which they would want MAID later. The Department of Justice gives the example of an adult diagnosed with Alzheimer’s disease specifying in advance at what stage of the illness they would want MAID.

An advance request would not mean MAID is provided immediately or automatically later. All eligibility requirements would still have to be met and new rigorous safeguards followed, and the person would have to be experiencing intolerable suffering at the time MAID is provided, even if every condition in the advance request has been met. The decision must remain voluntary and free from external pressure, and the person keeps the right to withdraw the request at any time. Because provinces and territories organize and deliver health care, each would decide whether to make advance requests available in its jurisdiction.

Mental-illness expansion will not proceed

The bill also ends the scheduled expansion of MAID for people on the basis of a mental illness as the sole underlying condition. The government says serious concerns remain about whether such cases can be assessed safely and consistently. On June 17, 2026, the Special Joint Committee on Medical Assistance in Dying, made up of senators and members of Parliament from different parties, tabled a report recommending that the Criminal Code be amended to indefinitely exclude people whose sole underlying condition is a mental illness, and the government has adopted that recommendation.

The government launched a national conversation on advance requests in November 2024, and findings published in October 2025 showed that 67 to 69 percent of Canadians support advance requests for people diagnosed with a serious or incurable condition that will lead to a loss of decision-making capacity. Since 2016, MAID has been available only to adults with an incurable illness who meet strict eligibility requirements, including intolerable suffering and informed consent, under two tracks: one where death is reasonably foreseeable and one where it is not, with the second track carrying extra safeguards including generally at least 90 days from first assessment to MAID.

What happens next

The bill now goes through debate, committee study and votes in the House of Commons and the Senate, and needs the Governor General’s assent before it takes effect. Fraser said the government will work with provinces and territories on implementation, with rigorous safeguards to protect people and keep the decision voluntary. Michel said the approach must respect personal autonomy while maintaining robust safeguards for people who may be vulnerable.

The government also announced an additional one-year commitment of 1.2 billion dollars in 2027-28 to keep supporting access to mental health and substance use services and home and community care while longer-term health funding discussions continue. A technical briefing for media and a ministerial availability were scheduled for October 27, with further details of the bill to emerge as Parliament studies it.