Euthanasia and assisted suicide in Canada

MAID first became legal for those whose death is reasonably foreseeable, effective in June 2016. In March 2021, the law was further amended by Bill C-7 to include those suffering from a grievous and irremediable condition whose death is not reasonably foreseeable. The possible inclusion of people with mental illnesses is controversial and has been repeatedly delayed. The legality of this postponement to 2027 is being challenged in court.

In 2024, 16,499 MAID provisions were reported, accounting for 5.1% of all deaths in Canada. As of November 2025 there had been about 76,000 MAID deaths reported in Canada since the introduction of legislation in 2016.

Background

Euthanasia was previously prohibited under the Criminal Code as a form of culpable homicide. The prohibition was overturned in a February 2015 decision by the Supreme Court of Canada in Carter v Canada (Attorney General), which ruled that the Criminal Code provisions that make it a crime to help a person end their life violate the Canadian Charter of Rights and Freedoms and that eligible adults with grievous and irremediable medical conditions are entitled to an assisted death. The Court delayed its suspension of invalidity for a period of 12 months, to allow Parliament the opportunity to amend its laws if it so chose.

In January 2016, the Court granted an additional four-month extension to the suspension to allow for further time. As an interim measure, it ruled that provincial courts can now begin approving applications for euthanasia pursuant to the criteria in the Carter decision. On 6 June 2016, the suspension of invalidity expired and the law was struck down. On 17 June 2016, a bill to legalize and regulate euthanasia passed in Canada's Parliament. Canada's current law makes euthanasia available only to residents eligible for Canadian healthcare coverage.

The previous law's requirement that a natural death must be reasonably foreseeable and that the medical condition be grievous and irremediable medical condition had been controversial for how it limited the original Supreme Court of Canada ruling, mandating that euthanasia be made available to all adults with grievous and irremediable medical conditions. The British Columbia Civil Liberties Association (BCCLA) challenged the constitutionality of the previous law because it excluded people with long-term disabilities and those with "curable" medical conditions whose only treatment options people may find unacceptable. The BCCLA argued these medical conditions should qualify under the court's definition of grievous and irremediable. The BC Supreme Court and the Quebec Supreme Court in Truchon ruled in 2019 that the law could not limit euthanasia only to individuals whose death was reasonably foreseeable.

The current law prohibits mental illnesses as being considered as a grievous and irremediable condition. This prohibition was initially set to expire on 17 March 2023. On 2 February 2023, the Canadian government introduced legislation to extend the temporary exclusion of eligibility in circumstances where a person's sole underlying medical condition is a mental illness for a period of one-year, until 17 March 2024. In 2024, this was further delayed until 2027. After this date, persons with a mental illness can be eligible for medical assistance in dying, subject to any further amendments to the law or any new regulations.

Canada's euthanasia law includes some legal safeguards aimed at preventing abuse and ensuring informed consent. Neither the legal witness nor the physicians involved can have any legal or financial interest in the outcomes of the patient. Consent must be repeatedly expressed, not implied, including in the moment right before death. Consent can be revoked at any time, in any manner. There are no consequences for backing out and there are no limits to how often it can be requested. Doctors are permitted to suggest euthanasia to patients, regardless of whether the patient has already said that they do not want it.

To receive euthanasia, patients experiencing disease, disability or terminal illness must sign a written request expressing their wish to end their life in front of one independent witness who can confirm it was done willingly free of coercion. Next, two physicians and/or nurse practitioners must independently confirm their written agreement that the patient has an incurable grievous and irremediable medical condition that is in an advanced state of irreversible decline, and that the patient is capable of receiving and willing to receive euthanasia. If their death is not reasonably foreseeable, a medical expert in the underlying medical condition must sign off on the request, their assessment must take at least 90 days, and they must be informed about and decline all other forms of treatment, including palliative care.

Canada's law is consistent with many other nations that allow euthanasia in requiring at least two physicians to confirm the details of a diagnosis. Canada's law no longer requires the presence of a terminal illness, unlike many other countries where euthanasia is only legal in those circumstances. Canada's law is more restrictive than those of Belgium and the Netherlands in that it does not permit minors access to euthanasia. Canada does not yet allow it on the grounds of mental illness, a practice allowed in the Netherlands, Belgium, and Switzerland, until at least 17 March 2027.

Canada's law is less restrictive in that it does not require a patient to have exhausted all other treatment options, unlike Belgium and the Netherlands. While Belgium allows advanced directives in all circumstances, such advance directives in Canada may only be used if the patient's death is reasonably foreseeable. Canada is the only country that allows nurses to administer the drugs used for euthanasia.

According to The Atlantic, "[t]he law currently states that any sign of [patient] refusal [of MAID under an advance directive] 'must be respected'; at the same time, if the clinician determines that expressions of resistance are 'behavioural symptoms' of a patient's illness, and not necessarily an actual objection to receiving MAID, the euthanasia can continue anyway."

On 18 March 2026, Alberta Minister of Justice Mickey Amery introduced Bill 18, or the Safeguards for Last Resort Termination of Life Act, to the Legislative Assembly of Alberta. The bill would prevent doctors or nurse practitioners from administering MAID to patients whose sole underlying condition is mental illness. The bill, supported by Alberta Premier Danielle Smith, would make Alberta the first Canadian jurisdiction to place these types of limitations on federally permitted assisted deaths.

Carter v Canada (Attorney General) decision

In June 2012, in a case filed by Gloria Taylor, the Supreme Court of British Columbia ruled that provisions in the Criminal Code prohibiting euthanasia were unconstitutional as they apply to severely disabled patients capable of giving consent. The lower court ruled that the Criminal Code provisions "infringe s. 7 [and s. 15] of the Charter, and are of no force and effect to the extent that they prohibit physician-assisted suicide by a medical practitioner in the context of a physician–patient relationship". The court found that the relevant sections were legislatively overbroad, had a disproportionate effect on people with disabilities, and was "grossly disproportionate to the objectives it is meant to accomplish."

The case reached the Supreme Court of Canada in Carter v Canada (Attorney General). The court ruled that the law banning euthanasia of terminally ill patients (based on the Rodriguez v British Columbia (Attorney General) decision) was unconstitutional, and violated Section 7 of the Canadian Charter of Rights and Freedoms. The Supreme Court issued a 12-month suspended declaration of invalidity.

As a result of the decision, euthanasia was expected to be made legal for "a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition". The court decision includes a requirement that there must be stringent limits that are "scrupulously monitored". This will require the death certificate to be completed by an independent medical examiner, not the treating physician, to ensure the accuracy of reporting the cause of death.

Bill C-14

As required by the 2015 Supreme Court decision, Justice Minister Jody Wilson-Raybould tabled a bill in parliament in April 2016 to amend the Criminal Code to allow euthanasia. Bill C-14 "create[s] exemptions from the offences of culpable homicide, of aiding suicide and of administering a noxious thing, in order to permit medical practitioners and nurse practitioners to provide medical assistance in dying and to permit pharmacists and other persons to assist in the process". The bill restricted euthanasia only to mentally competent adults with "enduring and intolerable suffering" and in cases where death is reasonably foreseeable. It also mandated a 10-day reflection period.

After the House of Commons passed Bill C-14 that would allow for euthanasia, it was debated in the Senate in mid-June 2016. Initially, that chamber amended the bill, expanding eligibility for euthanasia. When it became apparent that the elected House of Commons would not accept the amendment, a final vote was held on 18 June. At that time, a majority agreed with the restrictive wording provided by the House of Commons indicating that "only patients suffering from an incurable illness whose natural death is 'reasonably foreseeable' are eligible for a medically assisted death", as summarized by the Toronto Star.

Some opponents to the law indicate that the Carter v Canada (AG) decision was broader, including desperately ill individuals and not only those who are terminally ill or near death. The House of Commons did accept a few Senate amendments, such as requiring that patients be counseled about alternatives including palliative care and barring beneficiaries from acting in the euthanasia. Senators such as Serge Joyal who disagree with the restrictive wording believe that the provinces should refer the issue to the Supreme Court of Canada for an opinion in order to preclude the need for individuals to proceed with such an Appeal and incur the significant expense of doing so.

There was also a debate on the issue of suicide in Indigenous communities with MP Robert-Falcon Ouellette (Liberal) voting against the government on C-14. Ouellette believes that large-scale changes to social norms like euthanasia should move very slowly because the impacts will be felt differently across Canada and societies.

Truchon v Attorney General of Canada

On 11 September 2019, the Superior Court of Quebec declared that restricting euthanasia to those whose death is reasonably foreseeable violated the Charter's guarantee to "life, liberty, and security of the person" as well as the Charter's guarantee of "equal protection" under the law. The ruling declared the reasonably foreseeable clause in the federal euthanasia legislation to be unconstitutional. Neither the Attorney General of Canada or the Attorney General of Quebec appealed the decision.

Bill C-7

The federal government passed Bill C-7 on 17 March 2021. The new legislation distinguished two "tracks" for assisted death. Under Track 1, the legislation relaxed or eliminated some of the safeguards for patients whose deaths were reasonably foreseeable, notably removing the 10-day waiting period, requiring only a single independent witness, and removing the requirement to offer palliative care. The legislation also introduced a new avenue, Track 2, for those whose death was not reasonably foreseeable to access euthanasia—conditional on the approval of medical practitioner who specialized in the underlying condition; a 90-day assessment period; and ensuring "serious consideration" by applicants of "reasonable and available means" of treatment.

The legislation included a sunset clause that would allow people with mental illnesses to be eligible for euthanasia two years after the legislation passed. This clause has been particularly controversial due to the perceived difficulty of receiving informed consent from individuals suffering from a mental illness, particularly when the mental illness is already associated with suicide ideation. However, multiple studies show that the majority of people with mental illnesses do not lack the mental competence or the capacity to make treatment-related decisions. This expansion in access to medical assistance in dying was originally planned for March 2023 before being postponed by one year, to 17 March 2024. It was further postponed to 2027.

A panel was established by the government to study potential issues and safeguards with implementing medical assistance in dying for people whose sole medical condition was a mental illness. A report of this process was given to parliament on 6 May 2022. The panel had nineteen recommendations that could be implemented without amending the Criminal Code. Some arguments addressed to the panel suggested that there was no evidence that safeguards and protocols could be adequate and thus the panel's mandate could not be fulfilled. The panel concluded that despite these uncertainties, people could still voluntarily wish to request medical assistance in dying and thus its mandate could be fulfilled.

One member of the panel, Ellen Cohen, resigned for ethical reasons. Cohen believes that the issues faced by those in poverty or seeking housing was not adequately considered by the rest of the panel. A person can simultaneously seek medical assistance in dying while waiting for other treatments. Proponents of including mentally ill patients regard the delays as discriminatory. Opponents are sceptical that mental illness is irremediable or concerned about endangering vulnerable individuals.

In 2024, a lawsuit about the legality of delaying expansion of euthanasia to those with a mental disorder was filed due to the belief that denying it on these grounds is discriminatory and violates the Charter of Rights and Freedoms. A separate charter challenge was also filed in 2024, on the grounds that the Track 2 criteria cause premature deaths of disabled people and euthanasia should be limited to those with reasonably foreseeable deaths.