Bill C-41 would amend the Criminal Code to exclude people whose sole condition is a mental illness, while letting provinces build regimes for advance requests made before a person loses capacity.
The Canadian
Newsroom
October 28, 2026
3 min read
The federal government tabled legislation on October 27 that would indefinitely exclude people suffering solely from mental illness from medical assistance in dying, while opening a path for Canadians to request MAID in advance of losing the capacity to consent. Justice Minister Sean Fraser introduced the measure as Bill C-41, which would amend the Criminal Code to clarify that a person cannot receive MAID on the basis of a mental illness alone.
Fraser said the exclusion followed a long period of study, including work by a special joint parliamentary committee and a review inside his own department. The expansion of eligibility to mental-illness-only cases had been delayed repeatedly since 2021, and the new bill would end the cycle of temporary postponements by removing that category from the law altogether, rather than pushing its start date further into the future.
The bill’s second major change concerns advance requests. A person could set out their wishes while still capable, but MAID could only be provided later if they were in an advanced state of irreversible decline in capability and experiencing enduring and intolerable suffering that cannot be relieved through reasonable means. Crucially, advance requests could only be honoured in provinces that have passed their own legislated regime setting out rules and safeguards.
That design hands much of the decision to the provinces. Fraser described it as the start of a national conversation that will largely play out provincially. Alberta said it would carefully review the changes and consider further consultation, while Saskatchewan and Newfoundland and Labrador said they were reviewing Ottawa’s position. Quebec already permits advance requests under its own law, which means access could look very different from one province to the next.
Reaction split along familiar lines. Dying with Dignity Canada had already called the mental-illness exclusion stigmatizing and argued it violates the Charter, warning that provincial choice on advance requests risks a patchwork of access. Inclusion Canada, which supports people with intellectual disabilities, welcomed the exclusion but opposed advance requests, arguing they leave consequential judgments about suffering to others. The bill now faces debate and committee study, where both sides are expected to press their case and where a court challenge is likely to be foreshadowed.
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