S-231 (45-1) - An Act to amend the Criminal Code (medical assistance in dying)
Chamber
senate
Stage
2nd Reading
Introduced
Jun 12, 2025
Progress
This bill lets Canadians make advance written requests for MAID if they later lose the mental capacity to consent.
Key Changes
- Allows a person to enter a written arrangement with a practitioner to receive MAID on a specified future date if they lose capacity before that date
- Allows a person diagnosed with a serious and incurable illness to make a written declaration waiving final consent, tied to clearly identified observable conditions
- Extends the existing final-consent waiver (previously only for Track 1 — reasonably foreseeable death) to also apply to Track 2 (death not reasonably foreseeable)
- Requires advance declarations to be witnessed by two independent witnesses and certified by a medical practitioner
- Sets a five-year expiry on advance declarations made under the new conditions-based waiver
- Preserves the rule that MAID cannot proceed if the person shows any refusal or resistance by words, sounds, or gestures
Gotchas
- Quebec already has a similar advance request system under provincial law; this bill would create a federal equivalent, potentially harmonizing rules across Canada
- The conditions-based declaration expires after five years, meaning a person would need to renew it to keep it valid
- A person can invalidate their advance consent at any time by showing refusal or resistance through words, sounds, or gestures — but this relies on observable behaviour, which may be difficult to interpret in some conditions like advanced dementia
- The bill requires a medical practitioner to certify that the conditions listed in a declaration are clearly identifiable and observable, adding a professional gatekeeping step
- The bill does not specify what happens if a practitioner has a conscientious objection to administering MAID under an advance declaration
Who's Affected
- Canadians with serious and incurable illnesses who may lose mental capacity in the future (e.g., dementia, neurological conditions)
- Medical practitioners and nurse practitioners who administer MAID
- Patients whose death is not reasonably foreseeable but who wish to plan ahead for MAID
- Families and caregivers of individuals who have made advance MAID requests
- Provinces and territories that administer health care and end-of-life services
Vibes
0 responses
Gotchas
- Quebec already has a similar advance request system under provincial law; this bill would create a federal equivalent, potentially harmonizing rules across Canada
- The conditions-based declaration expires after five years, meaning a person would need to renew it to keep it valid
- A person can invalidate their advance consent at any time by showing refusal or resistance through words, sounds, or gestures — but this relies on observable behaviour, which may be difficult to interpret in some conditions like advanced dementia
- The bill requires a medical practitioner to certify that the conditions listed in a declaration are clearly identifiable and observable, adding a professional gatekeeping step
- The bill does not specify what happens if a practitioner has a conscientious objection to administering MAID under an advance declaration
Summary
Bill S-231 changes the Criminal Code to expand how people can access medical assistance in dying (MAID) when they may lose the ability to consent in the future. Currently, a person must be able to give final consent right before MAID is administered. This bill creates two new ways to waive that final consent requirement in advance. The first option allows a person whose death is not reasonably foreseeable to make a written arrangement with their doctor or nurse practitioner to receive MAID on a specific date, even if they lose capacity before that date arrives. The second option allows someone diagnosed with a serious and incurable illness to write a declaration stating the conditions under which they would want MAID administered if they later lose capacity — essentially an advance request tied to observable symptoms. This bill was introduced in the Senate by Senator Wallin and is partly inspired by Quebec's 2023 law (Bill 11), which already allows advance requests for MAID at the provincial level. The federal Criminal Code currently does not have an equivalent provision, creating a gap between Quebec's rules and the rest of Canada.
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Vibes
0 responses