Canada introduces bill on advance requests for euthanasia after loss of decision-making capacity

Right · 1The Canadian government said it would introduce a bill on Tuesday 27 October allowing people to request euthanasia in advance, to be carried out at a later date when they have lost the mental capacity to make that decision. 1 Right · 1Reuters described this as a potential further expansion of one of the world's most liberal assisted dying programs. 1 Right · 1Justice Minister Sean Fraser said the legislation would let adults consent in advance so their wishes could be respected if they are diagnosed with an incurable illness that could take away the ability to decide. 1

Right · 1Fraser said the government would work with provinces and territories on implementation, with "rigorous safeguards to protect people and ensure the decision remains voluntary and free from external pressure." 1 Right · 1The government said an advance request would not mean euthanasia is automatically provided later, and that people would have to be experiencing "intolerable suffering" at the time. 1 Right · 1Reason's commentary says the Justice Department announced the planned rules on 23 October, that ministers would discuss them on 27 October, and that the proposal must pass both houses of Parliament and receive approval from the governor general. It adds that committees can hear testimony and consider amendments, and that the announcement promises safeguards but gives few details. 2

Right · 1Canada legalized euthanasia in 2016 for terminally ill people and in 2021 broadened the law to cover people with incurable but not terminal conditions. 1 Right · 1If the bill passes, provinces and territories would still decide whether to offer advance requests; Quebec already allows them. Reuters says they are also legal in the Netherlands, Belgium and Spain. 1 Right · 1Reason's author notes that the rules differ among those countries: in the Netherlands a written advance request can replace an oral one, including in advanced dementia, while Belgium permits advance requests only when a patient becomes irreversibly unconscious. 2

Right · 1Krista Carr, CEO of the disability rights charity Inclusion Canada, has raised concerns, saying that a person consenting to their death "is the most basic protection a person has" and that "Parliament should not take it away." 1 Right · 1Reason's Jeffrey A. Singer argues that loss of capacity should not let the government override instructions given while competent. He raises open questions: how clearly patients must describe their circumstances, who decides they have arrived, and what happens if a patient who no longer understands the directive resists or seems content. He also says clinicians and private institutions should be free to decline to take part. 2