Canadian gov't seeks to halt expansion of euthanasia based on mental illness
Canada is moving to change its law on medical assistance in dying (MAID) to add safeguards, allow advance requests and prohibit euthanasia solely based on mental illness.
Canada’s Department of Justice announced Tuesday that it was introducing the MAID Safeguards Act, also known as Bill C-41, which it says will “establish rigorous safeguards” for euthanasia.
The bill would let adults “consent in advance to receive MAID after being diagnosed with an incurable illness expected to take away their ability to make this decision.”
“For example, an adult who is diagnosed with Alzheimer’s could specify, in advance, the circumstances in which they would want MAID later in their illness,” the government noted.
“Making an advance request would not mean MAID is immediately or automatically provided later. All eligibility requirements would have to be met, and new rigorous safeguards would need to be followed.”
Bill C-41 would also halt a scheduled expansion of MAID to people whose sole underlying condition is a mental illness. The Justice Department cited expert reports for the decision.
“When it comes to MAID, serious concerns remain about whether these cases can be assessed safely and consistently. For that reason, Canada will not move ahead with expanding MAID to people on the basis of a mental illness,” the government said.
“Most recently, a parliamentary committee made up of senators and Members of Parliament from different parties studied the issue, heard from experts and stakeholders, and recommended the Government of Canada not move ahead with the scheduled expansion.”
Alex Schadenberg, executive director of the London, Ontario-based Euthanasia Prevention Coalition, criticized the proposed legislation in a blog post.
“Based on the text of the bill it appears that it prevents euthanasia for mental illness, as a sole criteria but the law lacks any effective oversight,” Schadenberg wrote. “The law only requires that the medical or nurse practitioner be of the opinion that the person meets all of the criteria of the law.”
“Therefore, if a person, who has a mental illness as a sole criteria, is killed by a medical or nurse practitioner, it would be impossible to prosecute the medical or nurse practitioner as they only need to claim that they were of the opinion that the person, who they killed, met the full criteria of the law.”
In 2016, Canada passed a law legalizing physician-assisted suicide. It applied to citizens or permanent residents 18 or older who had “a serious and incurable disease, illness or disability” and were experiencing “enduring and intolerable suffering.”
The law required people seeking MAID to get medical approval and wait 15 days, and it required two witnesses to be present when a patient signed a request for the procedure.
Canada expanded the law in 2021 to allow people with non-life-threatening disabilities to die by assisted suicide. That pathway, for people whose natural death is not reasonably foreseeable, is known as Track 2. The 2021 law temporarily excluded people whose sole underlying condition is a mental illness.
Canada had long considered expanding MAID to people with mental illness, a move that drew criticism from many, including the United Nations.
In a 2025 report, the United Nations Committee on the Rights of Persons with Disabilities said it was “extremely concerned” about the planned expansion.
The U.N. also called on Canada to “repeal the Track 2 medical assistance in dying provision, including the provision to, in 2027, Track 2 for persons whose ‘sole underlying medical condition is a mental illness.’”
Last November, the Canadian government released its “Sixth Annual Report on Medical Assistance in Dying in Canada,” which found that 16,499 people died by MAID in 2024, accounting for 5.1% of all deaths in the country.
The 2024 share was up 0.4 percentage points from 2023, and the total was the highest number of MAID deaths since Canada legalized assisted suicide in 2016.
Earlier this month, Canada’s MAID law drew controversy after an op-ed highlighted the case of a woman in her 70s who, according to the piece, was approved for assisted suicide solely because she had lost the ability to cook for her family.
