Ottawa Moves to Keep Mental Illness Alone Outside Canada's Assisted Dying Law

The federal government will not allow people whose only medical condition is a mental illness to receive medical assistance in dying (MAID), Justice Minister Sean Fraser announced on Wednesday, reversing an expansion that was scheduled to take effect in March 2027.

Speaking to reporters in the foyer of the House of Commons alongside Health Minister Marjorie Michel, Fraser said the government will table legislation this fall to keep the exclusion in place indefinitely. "Canada has made a decision not to move forward with the expansion," he said, adding that "while there is not a perfect consensus on this issue, we believe this is the correct approach at this particular time."

A deadline written into the Criminal Code

The announcement comes with a firm clock. Under current law, people whose sole underlying condition is a mental illness become eligible for MAID on March 17, 2027. To prevent that, the government's bill must pass both the House of Commons and the Senate before that date. Fraser has not said when the bill will be tabled, and about seven sitting weeks remain before the winter break, CTV News reported.

The bill will also do something Ottawa has so far resisted: allow advance requests. People diagnosed with a condition that will eventually take away their capacity to consent, such as dementia or ALS, could ask for MAID while they are still able to make that decision. The change would apply only to the Criminal Code, leaving each province to decide whether its health system offers advance requests, The Canadian Press reported.

Why the government changed course

Fraser said the decision follows the work of the Special Joint Committee on Medical Assistance in Dying, a committee of MPs and senators that heard from more than three dozen witnesses and tabled its report in June. Its single recommendation was that Parliament "should indefinitely exclude persons whose sole underlying medical condition is a mental illness." According to the Toronto Sun, Fraser said: "This decision reflects the conclusion and recommendations of the recent special committee."

The minister also pointed to concerns about Canadians who live in communities where mental health services are hard to reach, and said serious questions remain "about whether MAID requests can be assessed safely and consistently." He rejected suggestions that politics drove the timing, saying the decision was "based on what we sincerely believe is right."

Conservative bill defeated the same day

Fraser said he chose to make the announcement on Wednesday because MPs were scheduled to vote that afternoon on Bill C-218, a private member's bill from Conservative MP Tamara Jansen of British Columbia. The bill would have amended the Criminal Code so that a mental disorder could not be the sole basis for MAID. It was defeated at second reading by 187 votes to 141, according to The Catholic Register. The Canadian Press reported that the Bloc Québécois and most Liberals voted against it, while NDP MPs and two Liberals, Marilyn Gladu and Kent MacDonald, voted with the Conservatives.

Fraser said the government objected to the bill's wording, which refers to "mental disorders" rather than "mental illness." He said that language "could be interpreted in a way that would close off access" for people with serious degenerative neurological conditions. Jansen said her party was "willing to work on wording" and called the government's plan a "phantom bill." "We have no idea what his bill is going to say," she said. Conservative MP Michael Cooper accused Fraser of "playing politics with life and death."

Reaction from advocates

Groups on both sides of the debate responded quickly. Dying With Dignity Canada, which is leading a court challenge arguing that the mental illness exclusion violates the Charter, called it a "profoundly disappointing day." Its chief executive, Helen Long, pointed to differences between provinces on advance requests: "At best, this will create a patchwork."

Cardus, a Christian think tank, and Inclusion Canada, a disability rights organization, welcomed the exclusion but raised concerns about advance requests and urged Parliament to split the bill so that part could be studied further. Fraser has said he will not divide it. Cardus said it is "unclear if this change will be limited to neurological conditions such as Alzheimer's or dementia."

How Canada got here

MAID became legal in Canada in 2016, following the Supreme Court's 2015 ruling in Carter v. Canada. In 2021, Parliament passed Bill C-7, which removed the requirement that a person's natural death be reasonably foreseeable and set a two year delay before mental illness alone could qualify. That expansion has since been postponed twice: first to March 2024, and then, through legislation passed in February 2024 under former prime minister Justin Trudeau, to March 2027.

The number of Canadians receiving MAID has grown steadily. According to Health Canada's sixth annual report, 16,499 people received MAID in 2024, or 5.1 percent of all deaths in the country. Of those, 732 people, or 4.4 percent, were in the group whose natural death was not reasonably foreseeable, the category at the centre of the debate over mental illness.

What comes next

The provinces will play a central role in how the changes work in practice. Quebec already allows advance requests and has directed prosecutors not to pursue health care workers in those cases. Alberta passed legislation in March barring advance consent and said on Wednesday it would not revisit that decision.

For now, the main question is timing. Until the bill is tabled, MPs and senators cannot examine its details, and Parliament has a little over five months, including the winter break, to pass it before March 17. If it does not become law by then, the expansion takes effect automatically under the current Criminal Code.