Medical Assistance in Dying Safeguards Act

This bill, called the Medical Assistance in Dying Safeguards Act, makes two main changes to the rules around medical assistance in dying (MAID) in Canada's Criminal Code.

First, it permanently confirms that a person cannot qualify for MAID solely on the basis of a mental illness. This locks in place a restriction that had previously been set to expire or change, removing uncertainty about whether that exclusion would remain law.

Second, and more significantly, it creates a new legal pathway allowing people to receive MAID through an "advance request" after they have lost the mental capacity to consent at the time the procedure is actually performed. To use this option, a person must have been diagnosed with a serious, incurable illness expected to cause loss of decision-making capacity, and while still capable, must have formally prepared a detailed written request describing the specific symptoms or signs that would indicate they want MAID administered. That request has to be made with a doctor's or nurse practitioner's help, follow strict signing and witnessing rules, and be stored in an official registry. Later, when the person has lost capacity, two practitioners must independently confirm the person is eligible, the described symptoms are present, and the person isn't showing signs of refusal or resistance (if they do resist, MAID cannot proceed on that request). Doctors who ignore these specific safeguards can face criminal charges. Importantly, this advance-request option only becomes available in a province if that province passes its own legislation setting up a registry and detailed rules for managing these requests — so it won't take effect nationwide automatically, only where provinces opt in with appropriate laws.

The bill also updates related laws — the Pension Act, the Corrections and Conditional Release Act, and the Veterans Well-being Act — so that references to MAID eligibility rules match these Criminal Code changes, mainly affecting how deaths by MAID are treated for pension, parole, and veterans' benefits purposes.

This bill amends the Criminal Code to permit medical practitioners and nurse practitioners to provide medical assistance in dying to a person who has lost capacity to consent, based on an advance request made while they had capacity, and to create a new offence for practitioners who knowingly fail to follow specified safeguards.

• Who can act — medical practitioners and nurse practitioners are exempted from culpable homicide and the offence of administering a noxious thing when providing medical assistance in dying (MAID) under an advance request, provided they meet the Criminal Code's criteria; anyone assisting them is also exempted.
• Conditions created — MAID on the basis of an advance request becomes permitted only where the person was diagnosed with a serious, incurable illness before signing the request, meets listed eligibility criteria, and the province has in force a provincial legislative regime governing a repository for storing, withdrawing, and amending such requests; mental illness is explicitly excluded as a basis for either standard or advance-request MAID.
• Obligations on practitioners — before acting, a second practitioner must give a written opinion confirming eligibility, and both must be satisfied they are not in conflicting relationships (mentorship, financial benefit, personal connection) with each other or the patient; a pharmacist must be informed when a substance is intended for this purpose.
• Penalties — a practitioner who knowingly fails to comply with specified safeguards (paragraphs 241.21(3)(b) to (e) and subsection 241.21(12)) commits an offence punishable by up to five years' imprisonment on indictment, or by summary conviction.
• What is left to the provinces — the bill does not create the repository or its rules itself; it makes federal permission to provide advance-request MAID conditional on each province enacting and maintaining its own legislative regime covering creation, storage, withdrawal, amendment, and protection of advance requests from falsification or unauthorized change.
• Delayed and coordinated provisions — some reporting-related amendments (subsections 7(2), (3), (5), (7)) only take effect on a day fixed by order of the Governor in Council (Cabinet) rather than immediately, and the bill contains coordinating provisions that repeal or alter sections depending on the timing of a related 2021 Act's provisions coming into force.