Canada’s MAID rules are changing: What the new federal plan means
Canada is set to change its medical assistance in dying (MAID) framework in two significant ways: the federal government plans to keep MAID unavailable indefinitely when mental illness is the sole underlying medical condition, while also proposing to allow advance requests for some people who know they will later lose the capacity to consent. The changes are not yet law. The government says it will introduce legislation this fall.
The announcement follows a parliamentary review that recommended against expanding MAID eligibility to people whose only underlying condition is a mental illness. It also opens a new debate over advance requests, an issue that has already created differences between federal law and Quebec’s approach.
What is changing in Canada’s MAID rules?
The federal government announced the new direction on October 7.
Justice Minister Sean Fraser said the government will introduce legislation that would:
- indefinitely exclude people whose sole underlying medical condition is a mental illness from MAID eligibility;
- allow advance requests for MAID in specified circumstances involving people who retain decision-making capacity but have been diagnosed with an illness expected to remove that capacity later; and
- amend the Criminal Code so that health-care professionals providing MAID under the new advance-request framework would not face criminal liability.
The details will depend on the bill that Parliament ultimately considers. Until legislation is introduced, debated and receives Royal Assent, these proposals do not change the Criminal Code.
MAID for mental illness: the planned expansion is being stopped
The most significant change concerns people whose sole underlying medical condition is a mental illness.
Under the current law, this group is temporarily excluded from MAID. Parliament extended that exclusion until March 17, 2027 through Bill C-62, which received Royal Assent on February 29, 2024.
That legislation was designed as a temporary measure. Unless Parliament changes the law again, the exclusion would otherwise expire and eligibility could extend to people whose sole underlying condition is mental illness, provided they met all other legal requirements and safeguards.
The federal government’s new position changes that trajectory.
Parliament recommended an indefinite exclusion
A Special Joint Committee of the House of Commons and Senate examined the issue in 2026. Its report, tabled on June 17, recommended that Parliament amend the Criminal Code to indefinitely exclude people whose sole underlying medical condition is a mental illness from MAID.
The committee concluded that the evidentiary and systemic conditions needed for safe and equitable implementation were not currently in place.
The report was a recommendation, not legislation. The government was free to accept, reject or modify it.
The government has now said it intends to follow that recommendation.
Why did the government change course?
Fraser pointed to two major concerns: continuing disagreement within the medical community over when certain mental illnesses can be considered incurable or irremediable, and unequal access to mental-health services and supports.
Those concerns matter because MAID law requires a person to have a grievous and irremediable medical condition. Under the existing framework, eligibility also depends on informed consent, voluntariness and other safeguards.
The government therefore argues that permanently excluding mental illness as the sole underlying condition is the more appropriate approach at this stage.
The decision remains controversial. Supporters of access argue that people with severe mental disorders should not be excluded from an individualized MAID assessment solely because their condition is psychiatric. Opponents and some disability and mental-health organizations have argued that expanding MAID in this area could place vulnerable people at risk, particularly where adequate treatment, housing or other supports are unavailable.
Those competing positions are likely to remain central when the legislation reaches Parliament.
Advance requests could become legal
The second major proposed change goes in the opposite direction: expanding access in a different area.
An advance request is made by a person while they still have the capacity to make health-care decisions. The person specifies circumstances in which they would want MAID in the future, after an illness has caused them to lose the ability to provide consent.
Under Canada’s current federal law, MAID cannot be provided on the basis of an advance request.
The government now intends to change that.
Fraser said the proposed legislation would allow people with an illness expected to take away their capacity to provide consent to make arrangements in advance. The proposal is particularly relevant to progressive conditions in which a person may fear losing the ability to make decisions later.
The government’s approach would not automatically require every province or territory to provide advance-request MAID. Health care is largely administered provincially and territorially, while the federal government controls the relevant criminal-law framework.
That means the practical availability of advance requests could still vary across Canada.
Quebec is already taking a different approach
The issue is especially complicated because Quebec has already created a provincial framework for advance requests.
Quebec’s rules came into force in 2024 and permit advance requests for MAID in certain circumstances. Federal criminal law, however, has continued to prohibit providing MAID on the basis of an advance request.
The federal government launched a national conversation on the issue between late 2024 and early 2025. More than 47,000 people participated through questionnaires, roundtables and other consultation activities.
Health Canada’s resulting report found broad support for the concept of advance requests among participants, while also identifying concerns about safeguards, implementation and health-system capacity.
The proposed federal legislation would therefore address an existing legal tension rather than introduce the subject from scratch.
What the rules currently say
For now, the existing MAID framework remains in place.
A person seeking MAID generally must:
- be eligible for publicly funded health services in Canada;
- be at least 18 years old and capable of making health-care decisions;
- have a grievous and irremediable medical condition;
- make a voluntary request that is not the result of outside pressure or influence; and
- give informed consent.
A person does not have to be terminally ill to qualify.
The law also distinguishes between two broad categories of MAID requests.
Track 1 applies where a person’s natural death is reasonably foreseeable.
Track 2 applies where natural death is not reasonably foreseeable. These cases are subject to additional safeguards, including a longer assessment period in most circumstances and discussion of reasonable and available means of relieving suffering.
Mental illness as the sole underlying medical condition remains excluded under the current law.
Current rules versus the government’s proposal
| Issue | Current federal position | Government’s proposed direction |
|---|---|---|
| Mental illness as the sole underlying condition | Excluded until March 17, 2027 | Exclusion would continue indefinitely |
| Advance requests | Not permitted under the Criminal Code | Would be permitted in defined circumstances |
| Consent at the time of MAID | Generally required, subject to existing limited exceptions | Certain advance-consent arrangements would be recognized |
| Provincial delivery | Provinces and territories administer health services | Would remain an important part of implementation |
| Legal status of the announced changes | Not yet in force | Legislation still needs to be introduced and passed |
The numbers show why the debate matters
MAID is no longer a marginal part of Canada’s health-care system.
Health Canada’s latest annual report, covering 2024, recorded 16,499 people who received MAID from 22,535 reported requests. Of those requests, 1,327 people were assessed as ineligible and 692 withdrew their requests, while 4,017 died from another cause.
Track 2 cases, involving people whose natural death was not reasonably foreseeable, represented 4.4% of MAID provisions in 2024.
The figures underline why changes to eligibility rules have consequences well beyond a narrow legal debate. The federal government, provinces, territories and health professionals are dealing with a system that now accounts for thousands of deaths each year.
Health Canada also cautions that changes to reporting requirements make some comparisons with earlier years difficult and that certain demographic data remain subject to important limitations.
The 2026 parliamentary review exposed a deep divide
The committee’s work did not produce a consensus.
Its majority recommended an indefinite exclusion for mental illness as the sole underlying condition. Some senators issued dissenting views and criticized the committee’s process and conclusions, arguing that the evidence did not justify permanently excluding people with mental disorders.
That disagreement matters because the government has chosen to act on the majority recommendation rather than allow the existing March 2027 expiry to take effect.
The government is therefore moving from a temporary legal pause to a proposed indefinite exclusion.
That is a significant policy shift.
What has happened — and what has not
The distinction between announcement and law is particularly important in this case.
Confirmed: The federal government has announced that it will introduce legislation to keep mental illness as a sole underlying condition outside MAID eligibility and to create a framework for advance requests.
Confirmed: A parliamentary committee recommended indefinitely excluding people whose sole underlying condition is mental illness.
Already law: Mental illness as the sole underlying condition remains excluded until March 17, 2027 under the current Criminal Code framework.
Not yet law: The proposed indefinite exclusion.
Not yet law: The proposed federal framework for advance requests.
The government has said legislation will be introduced this fall. Until Parliament passes that legislation and it receives Royal Assent, the existing Criminal Code rules continue to apply.
What happens next?
The next major step is the government’s bill.
Parliament will have to determine the precise wording of the proposed changes, including the eligibility criteria and safeguards for advance requests. The bill could also face amendments during parliamentary debate.
The advance-request proposal may be particularly contentious because it changes the relationship between MAID and consent. Under the current system, informed consent immediately before provision is generally a central safeguard. An advance request is designed for a situation in which the person may no longer have the capacity to give that final consent.
Provincial and territorial governments will also have an important role in deciding how any new federal framework is implemented through their health systems.
For Canadians, the practical question is therefore not simply whether the Criminal Code changes. It is also how provinces and territories respond if Parliament authorizes advance requests.
Our analysis
From this outlet’s perspective, the government’s decision represents a major reset of Canada’s MAID debate rather than a simple technical amendment.
The mental-illness decision closes off an expansion that had been scheduled after several previous delays. The advance-request proposal, meanwhile, would broaden the circumstances in which MAID could ultimately be provided.
Putting both issues into the same legislative package could make the parliamentary debate unusually complex. They involve different questions: one concerns whether a category of medical conditions should remain excluded, while the other concerns how consent should operate when a person anticipates losing capacity.
The most important issue now is the legislation itself. The government’s announcement establishes its policy direction, but the safeguards, definitions and conditions written into the bill will determine what the new MAID framework actually looks like.
Until then, Canadians should distinguish carefully between the current law and the changes Ottawa has announced.
Frequently asked questions
Is MAID for mental illness legal in Canada now?
No. A person whose sole underlying medical condition is a mental illness is currently excluded from MAID eligibility. Under the existing law, that exclusion is scheduled to end on March 17, 2027 unless Parliament changes the legislation.
Will MAID for mental illness become legal in 2027?
The government has announced that it does not intend to allow that expansion and plans to introduce legislation maintaining the exclusion indefinitely. However, the proposed change is not yet in force.
Are advance requests for MAID legal across Canada?
No. The federal Criminal Code currently does not permit MAID based on an advance request. Quebec has adopted its own provincial framework allowing advance requests in certain circumstances, creating a distinct legal situation in that province.
What is an advance request?
It is a request made while a person still has decision-making capacity, setting out circumstances in which they would want MAID in the future after losing that capacity because of illness.
How many people received MAID in Canada?
Health Canada’s latest annual report recorded 16,499 MAID provisions in 2024, based on reports received from across Canada.
Official Sources
- Government of Canada, Health Canada — Medical assistance in dying: Overview — https://www.canada.ca/en/health-canada/services/health-services-benefits/medical-assistance-dying.html
- Government of Canada, Health Canada — Medical assistance in dying: Legislation in Canada — https://www.canada.ca/en/health-canada/services/health-services-benefits/medical-assistance-dying/legislation-canada.html
- Parliament of Canada — Bill C-62: An Act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2 — Royal Assent — https://www.parl.ca/documentviewer/en/44-1/bill/C-62/royal-assent
- Parliament of Canada — Special Joint Committee on Medical Assistance in Dying: About — https://www.parl.ca/Committees/en/AMAD/About
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