Oct 28, 2026
Government Bill Would Allow Euthanasia Without Consent
On October 27, the federal government tabled Bill C-41, the “MAID Safeguards Act.” The bill would halt the upcoming expansion of euthanasia eligibility to persons with mental illness.
But the bulk is about legalizing “advance requests” for euthanasia.
Euthanasia and Mental Illness
In June 2026, a Parliamentary committee urged the government to cancel the upcoming (in March 2027) legalization of euthanasia for mental illness.
Canadians have been engaged on this issue for years, contacting Members of Parliament, delivering Care Not Kill flyers in their neighbourhoods, and calling for suicide prevention rather than suicide assistance for people with mental illness.
The government recently defeated Bill C-218, which would have canceled the pending legalization of euthanasia for mental illness. But the government’s Bill C-41, if passed, will cancel that expansion. Regrettably, it pairs this cancellation with yet another euthanasia expansion.
Euthanasia and Advance Requests
Bill C-41 would permit advance euthanasia requests in any province or territory that creates a framework for handling such requests.
Quebec has permitted advance euthanasia requests since late 2024, in violation of the Criminal Code. By contrast, earlier this year Alberta explicitly prohibited advance euthanasia requests.
With Bill C-41, the federal government is avoiding responsibility for deciding a life-and-death matter (the circumstances in which homicide is permitted), shifting it to the provinces. .
What are Advance Requests?
Advance euthanasia requests are for people diagnosed with dementia, Alzheimer’s, or another illness that will cause them to lose decision-making capacity. In an advance request, a person outlines the conditions they think would make them want to die in the future when they can no longer consent to being killed. For example, someone may think he will want to die when he can no longer feed himself or when he can no longer recognize loved ones.
Euthanasia Without Consent
Allowing advance euthanasia requests permits euthanasia without consent.
Proponents of advance requests will argue that there is consent because the patient consents in advance and writes down his or her wishes. Additionally, Bill C-41 includes supposed safeguards clarifying that a doctor cannot euthanize a patient if they demonstrate refusal or resistance.
But in an advance request, a person “consents” in advance to being killed under circumstances he has never experienced. Then, when he is unable to effectively communicate his wishes, his doctor must determine when the conditions outlined are present and then decide when the patient is “suffering intolerably.”
Note that this “intolerable suffering” is based on the patient’s preconceived opinion and the doctor’s subjective perspective. A doctor who believes patients who have lost mental capacity have lost their dignity is far more likely to think a patient is suffering intolerably than a doctor who believes in the dignity of every human life.
Next, the doctor will need to determine whether the patient is demonstrating refusal or resistance. But a person who has lost mental ability may not even know what is happening when the doctor begins the euthanasia process. And the legislation includes no requirement for the doctor to try to make the patient aware that they are about to be killed. Additionally, people with advanced dementia tend to resist other procedures as well.
Bill C-41 states that “involuntary words, sounds or gestures … do not constitute a demonstration of refusal or resistance.” Only voluntary refusal or resistance counts. So the doctor needs to determine whether resistance is voluntary or involuntary. So it remains up to the doctor whether to end the patient’s life. The bill also clarifies that if the doctor is in doubt about whether the patient is refusing, he or she should wait 30 days before trying again. But that highlights the fact that once a person who has signed an advance request has lost capacity, there is no withdrawing such a request.
No Comparison to Advance Care Directives
Proponents of advance requests will point out that Canadian healthcare already includes advance care directives by which a person can outline their wishes for their future healthcare. For example, a Do Not Resuscitate order indicates that a person does not want to receive CPR if their heart stops. But advance euthanasia requests go well beyond ordinary advance care planning about medical treatment and comfort care.
Medical advance directives allow a person to clarify whether they might accept or refuse potentially life-saving interventions in situations where a decision must be made quickly. Such directives do not demand any intervention, and at most, indicate a wish to be left alone in serious medical circumstances. Advance euthanasia requests are radically different, asking a doctor
to deliberately end a person’s life without current consent.
Euthanasia and Dementia
Canadians with dementia are already eligible for euthanasia if they consent immediately before being euthanized. Pro-euthanasia advocates argue that advance requests will allow people to live longer because they can be euthanized after losing mental capacity rather than before. But this presents a false dichotomy, suggesting that the two options are euthanasia now or euthanasia later.
The option they don’t mention is adequate care and supports so people can live well with dementia. Canadians with dementia who have died by euthanasia have higher rates of feeling like a burden on loved ones and being isolated and lonely. Canada ought to be a country that cares for people with mental disabilities rather than offering them death, either now or later.
Some Canadians want advance requests because of a fear of what their illness could hold in the future. But allowing advance requests builds on the false notion that the lives of people with dementia and similar illnesses are not worth living. Canada must support care for those with capacity-limiting illnesses rather than devalue their lives.
Next Steps
The government is committed to stopping euthanasia for mental illness because it cannot be done “safely.” But despite serious ethical and practical problems with implementing advance requests, there is no discussion of “safety” for patients who will be killed without their consent.
But we can take action. Bill C-41 has yet to be debated or passed in the House or Senate. Members of Parliament of all political stripes need to hear from their constituents about the problems with allowing advance euthanasia requests.
Send an email to your Member of Parliament today and ask them to oppose the expansion of euthanasia. Consider meeting with your MP to discuss the topic further. Reach out to [email protected] if you would like assistance with a meeting.
