Canada to Update MAID Law to Allow Advance Directives
The Canadian federal government is preparing to update its medical assistance in dying (MAID) law to permit advance directives, shielding doctors from criminal charges when acting on prior patient consent. While the move aims to help those facing capacity-losing illnesses, critics warn that leaving implementation to provinces could create unequal access nationwide.
The Canadian federal government is set to update the country's medical assistance in dying (MAID) law to permit advance directives, a change designed to allow individuals diagnosed with progressive illnesses to secure access before losing their mental capacity.
Justice Minister Sean Fraser and Health Minister Marjorie Mitchel are scheduled to reveal further details about the new legislation on Wednesday. According to Fraser, the government intends to grant MAID access to people who provided consent while having decision-making capacity but were subsequently diagnosed with an illness that would take that capacity away.
An "advance request" involves a mentally competent person making a written request for MAID to be honoured if they later lose the ability to decide, such as in cases of Alzheimer's or dementia. The updated law will include changes to the Criminal Code to ensure that doctors providing MAID based on an advance directive will not be treated as criminals.
In 2024, Quebec became the first and only province in Canada to allow residents to authorize an early request for MAID. Quebec's law restricts advance requests to persons diagnosed with a serious and incurable illness leading to incapacity to give consent, requiring them to identify a willing physician or specialized nurse practitioner.
University of Toronto bioethicist Kerry Bowman described the principle of advance directives as "profoundly ethically complex," citing difficulties in predicting disease progression and the potential loss of self-identity.
Dying With Dignity Canada CEO Helen Long criticized the federal approach as "fundamentally flawed" for downloading implementation to provinces and territories. Long argued that without a unified federal framework, the legislation may create a patchwork of systems increasing inequity in MAID access, or leave some Canadians without access entirely.